September 15, 2010, Guwahati, Assam
The government has taken steps to strengthen both the infrastructure and service delivery components in the public healthcare facilities under the National Rural Health Mission (NRHM). This has had a fairly perceptible impact on healthcare delivery in the state of Assam. However the private sector, which still dominates healthcare provision across the state (as in case of the country), still remains totally unregulated.
In order to stimulate a holistic improvement in terms of quality of and access to healthcare facilities in the state, there is a need to introduce proper regulatory supervision of the private sector as well. Healthcare delivery in India is dominated by the presence of a large, unregulated private sector, which is a cause of grave concern.
These issues were highlighted in a meeting organised jointly by CUTS and The ANT to mark the launch of a project titled, “Collusive Behaviour in Healthcare Delivery”, here in Guwahati. The project supported by Oxfam India, is aimed to document the nature and types of collusive behaviour in healthcare delivery in the states of Assam and facilitate a discourse among key stakeholders on the possible ways of addressing them.
Sunil Kaul of The ANT indicated that the study is timely, as there is a need to assess the extent to which progressive legislations like the Right to Health Act 2010 introduced recently in Assam have had on the private healthcare providers. He asserted that in addition to the various legislative and administrative steps being introduced by the government, players in the healthcare delivery market also need to exercise a certain degree of self regulation. He felt this is where the role of the civil society becomes extremely important.
Dr. John Ekka, Mission Director of NRHM in Assam indicated that the programme has made a substantial contribution in addressing constraints in public health facilities across the state. User/consumers can now get the same quality of healthcare in public hospitals as they expect from a private health facility. He added that while undertaking investigations of collusive behaviour in the healthcare delivery sector, it is critical to assess the real motive behind such behaviour of doctors and other players.
Information asymmetry between the consumers/users and the providers in the healthcare sector is one of the prime reasons behind the existence of collusive behaviour in healthcare delivery, felt S Srinivasan of LOCOST. He highlighted that there is no regulation of drug prices in the country, and warned that further increase in drug prices was imminent, especially as a result of the recent spree of acquisition of Indian drug manufacturers by western drug MNCs.
Rijit Sengupta, representing CUTS shared that one of the main objectives of the study (being undertaken in Assam and Chhattisgarh) is to explore if there is a linkage between the high cost of healthcare delivery in the country and the proliferation of collusive practices across various segments of the healthcare sector. He added that it would be necessary to identify a core group of stakeholders in Assam (and in Chhattisgarh), who would act as the ambassador of this project and help link the research findings to policy and practical actions. Deepak Xavier from Oxfam India expressed that improvements in healthcare delivery in the country in terms of quality and access would lead to considerable impact on the lives and livelihoods of poor consumers, and stressed on the need for urgently introducing proper regulatory oversight in the sector.