Meaningful partnership between public and private institutions needs to be built up as it will ultimately determine success of healthcare schemes like Ayushman Bharat, according to J V N Subramanyam, Mission Director, Department of Health & Family Welfare, Government of Assam.
Participating in 2nd Healthcare Innovation Summit, Hyderabad, recently Subramanyam underlined the significance of Public Private Partnership (PPP) as he shared Assam has been in news for a number of effective and much-needed initiatives undertaken by the Government to make healthcare delivery accessible and affordable. He said, “Unless private sector understands public health problems, a meaningful partnership would not emerge.”
“Assam is the biggest State, having almost 70 percent landmass of North-East. We share national and international borders. The State has 3.2 crore population, almost same as of Telangana State. We have 40 percent urban population and 12 percent tribal with lots of ethnic and demographic challenges. Almost 20 percent of our landmass is covered by tea garden,” he said while delivering a speech at the summit held in February.
He said there is a huge scope of private partnership in terms of tele-consultation and other modes to improve healthcare accessibility in the State.
Shedding light on healthcare challenges and how the State Government has taken things head- on to improve the situation, he said: “Assam has highest maternal mortality rate amongst States. We have one in every three children stunted.”
“But I am happy so much work has been done in last 10 years, which leads to a substantial improvement on Maternal Mortality Rare (MMR). It has reduced to 237 from 480 per lakh live births. Things are improving, but still a lot needs to be done. Partnership could help on these fronts.”
Recounting the healthcare initiatives by private players, Subramanyam said, “North-East is a cancer hub. (I’m) happy to share that Ratan Tata came down to Assam and started a programme on Assam Cancer Care Foundation with almost Rs 2,000 crore investment. Entire North-East is going to be developed with L1, L2 and L3 grid facilities on cancer care. It will provide screening, prevention and treatment in cancer care.”
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“We have home delivery pockets and tea garden areas. People living in team garden are those whose ancestors had migrated from Chota Nagpur plateau in 18th century during British rule. They have been cut-off from various healthcare and education needs over a period of time. Now the Government is reaching out to them, so that overall health indices improve. Highest mortality is in tea garden areas,” he said.
Between 2005-2017-18, Assam witnessed 10 times growth in terms of various deliverables of healthcare, he said. “We have 3.3 crore OPDs, almost 13 lakh IPDs, and six lakh institutional deliveries with almost 14 percent cesareans happening across the State,” Subramanyam said.
Highlighting the role of technologies, innovations, and PPP model, he said: “the State Government is developing new partnership on PPP mode and leveraging technologies to boost healthcare delivery across the State. We are using private healthcare expertise to solve public healthcare issues.”
Health budget of Assam is around Rs 7,000 crore and it is growing at the rate of 16-17 percent annually, he said.
Providing details about private partnership, he said: “We have partnership with private players on drugs and dialysis (Pradhan Mantri dialysis with Apollo). We have 130 odd WHO GMP certified manufacturers dealing with the State Government directly with NHM. Referral transport is done through GVK. TVS works with us on bio-medical equipment front.”
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Almost 5,600 centres need to be operationalised as Health and Wellness Centres, which require technology, manpower and capacity building.
“120 private sector hospitals have been empanelled to provide 1,300 plus procedures under Ayushman Bharat Yojna. Under Atal Amrit Abhiyan, we have hospitals like Apollo, Fortis which have been empanelled to provide tertiary care package. Under Atal Amrit Abhiyan, there is unit cost of Rs 2 lakh per beneficiary. In a family of five, Rs 10 lakh cover for critical care such as cancer and nephrology, and neo-natal diseases. Six critical care diseases have been covered,” Subramanyam said.
Human resource plays an important role in healthcare and we are working on the same with private partnership. We are facilitating best possible diagnostics to poor.
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“Spandan diagnostics is providing CT scan services at 25 health facilities. We have teleradiology and real time dash board based X-Ray services, catering 30,000 patients every month. It is being made available at 130 health facilities and has benefitted five lakh patients till now. Krshnaa Diagnostics is working on this front under PPP mode.”
In addition, we have laboratory services, catering one lakh patients every month. Hill Lifecare Ltd. is providing the service under PPP mode. 65.5 lakh tests have been done benefitting 13 lakh patients till date.
“The State Government is facilitating free drug and diagnostics which constitute almost 70 percent out-of-pocket medical expenditure for patients. The Government has contract with 131 manufacturers/ MNCs to provide free drug service. We have robust inventory management system,” he said.
Talking about innovative initiatives including Mobile medical units and Boat Clinics, he said, “People living in tea garden areas don’t have any access to any kind of healthcare services in last 50 to 60 years. Mobile medical units have been started in these areas which have treated almost 20 lakhs patients. These are doctor-led laboratories being stationed in tea garden areas to provide patient care.”
In addition, we have ‘Boat Clinics-Floating Hospitals’ in 13 districts. It provides Comprehensive Primary healthcare services in riverine area. Centre for North East Studies and Policy Research (CNES) is working under PPP mode on this initiative, he said.
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