ACTIVITIES OUTLINE

A research to identify problems plaguing the Indian healthcare delivery system, which adversely affect consumers, would be undertaken. Support for undertaking this research would be sought from the Ministry of Health and Family Welfare, Medical Council of India and other relevant authorities.
An inception meeting would be held in the first month of the project, where representatives from these various relevant institutions would be present along with those from CUTS, Oxfam India and other citizen groups. During this inception meeting, a briefing paper will be presented/disseminated highlighting the need for research on identification of medical malpractices, resulting benefits on the ground such as greater affordability and enhanced quality of healthcare, and the efforts made by other countries in this regard.
To leverage support for the study and associated advocacy, the paper would sketch out a proposed methodology and invite feedback from the stakeholders present. This would not only help to hone the methodology but stimulate support by generating involvement in the research agenda.

In the period following the inception meeting, CUTS would hold one-on-one meetings with important officials and stakeholder representatives and keep them informed of the progress being made in the project.
Apart from analyzing information collected through secondary sources, primary information will also be collected through field surveys in two states of the country from: patients, doctors, hospitals, pharmacists, pharmaceutical companies etc. The fieldwork would also try to identify drawbacks in the healthcare system (such as high prices, poor availability of healthcare facilities etc.) and their possible sources.
The survey would be carried out in two stages. In the first stage, quantitative inferences about price and quality would be used to identify states/regions with likely incidence of anti-competitive action or other market malpractices. A second round of survey would be undertaken in regions with relatively high price and poor quality of healthcare.
The second round of surveys would be carried out only in these ‘suspect regions’ to determine whether vertical agreements exist between doctors on the one hand and pharmaceutical companies/pathologists on the other. Similar exercise would be done to determine existence of cartelisation among physicians to fix prices.

After a robust identification of anti-competitive practices and other market malpractices, recommendations would be made in regard to the enforcement of competition and functioning of the regulatory system. The objective of the study, procedures used for data collection and analysis, and results and recommendations will be captured in a Draft Final Report, which will be presented at a National Seminar of concerned stakeholders both on the demand and supply side, and also sent to two external reviewers for their comments.
Upon the receipt of comments, the draft report would be finalized. The final report would be released in a workshop for print media, radio and television in which the essence of the findings of the study would be highlighted so that these can be given wider publicity through articles in the press and appropriately designed radio and television campaigns.
Workshops would also be held to share the findings of the report with state chapters of the Indian Medical Association (IMA) as well as officials of the relevant ministry and initiate a liaising arrangement through which constant pressure can be maintained on IMA to discipline physicians indulging in such market malpractices.