Proliferation of Private Sector in Service Delivery: An Experience from India

Public-private partnerships in the domain of public service delivery have become hallmark ever since India opened its economy to the global market. This has been the case particularly with health services, both in urban and rural areas. This study is about how the private sector role is expanding in service delivery. The private sector like corporate houses, nongovernmental organizations, and community based organizations are participating in delivery of infrastructure with collaborating with the governments at all levels. Not only collaborations the private sector is solely participating in service delivery in forms of Corporate Social Responsibility. Developing countries governments are unable to deliver proper services for huge masses due to lack of resources, technical knowledge and unfair practices. To overcome all these constraints globalization provided Public Private Partnerships (PPP) as an alternative approach to the governments for service delivery. In countries like India health service delivery is a major challenge at all levels of governments, to overcome this problem one of India's western province Gujarat came up with a innovative programme called "Mukyamanthri Amrutham" (literally it means Chief Minister's Nectar) in this mode of health services delivery, corporate hospitals handle the biggest share of the cases. Unfortunately, there is no provision for day to day services (out patient) which in fact could have made this programme all encompassing. The focus on tertiary healthcare to the exclusion of all other forms of medical assistance leads to an inefficient medical care model with lesser impact on meeting the needs of majority of the people. The scheme aims to provide medical care for BPL families up to a value of 0.2 million (Indian National Rupees) per annum for tertiary surgical and medical treatment of serious ailments, which, in turn, will help them from excessive private borrowing. The scheme is run by a public-private partnership called the state nodal cell of MA. Medical and health services in the private sector are unregulated and where obstetrics is the single largest specialization. The present study is of exploratory in nature and will try to assess the dimensions of PPPs in the health sector where public funding is mostly poor. It will also explain the impact of collaborations on the general reach of health services in the state of Gujarat where the government's role has virtually become defunct.