Public Private Partnership - a key to efficient healthcare services
Author : BioSpectrum- Asia Edition
South east Asian countries are striving to elevate the standard of public healthcare system and what they may need now is a stronger and effective public private partnership (PPP) in order to share the resource constraints including financial, nodded the ministries from Malaysia, Philippines and Indonesia, during Economist Healthcare forum held in Singapore on March 28th and 29th.
In the time to come, the emerging countries of Asia like Philippines, Vietnam, Malaysia and Indonesia will increasingly rely on private sources of financing to deliver the required health services in their country.
“Malaysia is on a journey of transformation for providing healthcare services. The country is adopting some innovative methods to speed up the healthcare delivery. In order to provide affordable and efficient services, the country is experimenting with the same methods as adopted by successful countries such as Singapore,” said Mr Ling Tiang Lai, minister of Health, Malaysia.
Malaysia has around 7000 government general practitioners supported by 3000 private practitioners that together reach out to the wide demography. Malaysia is also banking on medical tourism and is seeking support of private health companies to attract the world attention.
“Philippines has allocated a fund towards public private partnership and the nation is working with different private organizations to utilize it more effectively. However, the challenge that public sector faces in partnering with private bodies is that the prime intention of the private partners remains to attain profitability from the deal which is many times not possible in the case of healthcare service,” explained Mr Nemesio Gako, assistant secretary of Health, Department of Health, Philippines.
Indonesia is also facing a similar dilemma. Ms Nila Moeloek, special envoy of the President of Indonesia on Millennium Development Goals, Indonesia said that the country encourages public-private partnership but sometimes the intention of private bodies is to churn out profit. The private bodies must act passionately to give education and primary care to the public for prevention of diseases and getting benefits should not be the only agenda.”
PricewaterhouseCoopers (PwC), a global professional services firm, mentions that PPP can be used to construct or upgrade facilities across the entire care network, adding much needed capacity and raising quality. They also have the potential to fund a far broader range of clinical services that stretch a long way beyond infrastructure to bring efficiency and additional capacity.
To attract better healthcare system, Malaysia has taken some open minded initiatives. The country allows foreign general practitioners to practice in the country and the specialists are welcome to operate. On the other hand, Philippines and Indonesia does not have a very open attitude towards foreign medical experts. They have to first apply for a licensing approval and undergo certain regulations that end in a time consuming process.
Mr Lai, minister of Health, Malaysia mentioned that the countryis working on the same model of ‘Medisafe’ as Singapore. Medisafe is a saving account for Singapore citizens to save money for future healthcare needs. Malaysia is promoting people to save money for their healthcare needs. Currently Malaysian government is providing healthcare services at prices as low as 1 Malaysia Ringgit (0.3 cents). Malaysia is now seeking and engaging public in enhancing healthcare services. The minister insisted that the public has to realize that to meet the healthcare needs, one has to pay.
The developing countries are now aiming to shift the focus from treatment to early diagnosis in order to build preventive healthcare system.
Indonesia not only faces the challenge of health awareness but also a healthy lifestyle. 33 percent of women in Indonesia face non communicable diseases and the country has appointed volunteers to assist in preventing Hep B and C. In order to improve the situation, Indonesia is building a universal health insurance system for its citizen to safeguard from health expenses.
Philippines is looking at decentralizing the healthcare system to reach out to remote areas in a effective manner but it has its own disadvantages as the system gets influenced by politics and healthcare service looses out its priority. In most of the countries, health is a problem but it never gets priority and the budget allocation is not enough to provide healthcare services.
Public private partnership can be enormous phenomena. The PPP should not be for profit but for public concern. Malaysia is working closely with private sector that not only provides healthcare services but also infrastructural support. Indonesia is also looking at adopting PPP more actively but the country is often distracted by the profit-making intention of the private hands. To work without political influence, Philippines is working with non-profit organizations or NGOs who act as official partner for delivery healthcare services and share the resources.
Under a public-private partnership deal, Malaysia is building a large teaching hospital with the private funding initiative of US$130 million called International Islamic University Malaysia (IIUM) teaching hospital with 300 beds and capacity for 735 students. The new facility is to feature various medical disciplines including surgical and medical sub-specialties such as medicine, surgery, oncology, cardiology, neuroscience and others. IIUM will be developed by Peninsular Medical, a wholly owned subsidiary of Ahmad Zaki Resource.
PwC suggests that what the government of the emerging countries need to do is to review their healthcare systems. They have wide geographic and socio-economic differences for which there needs to be a tailor-made funding system that suits the needs of the locality. A crucial step to be done in these countries is to build a sound regulatory framework, fair and transparent bidding process, reliable health insurance scheme and an adequate supply of well trained doctors and nurses. All these components build together can help in attracting the investors and fuel fund in the system.
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