Privatization of health facilities in
Bhutan; not a correct shift
Over recent decades, the healthcare service
in many countries, both developed and developing, have been fundamentally rationalized
by two events: the re-direction of government policy toward the privatization of
publicly-funded institutions and a new interest in strategic investment from
the corporate sector in health services and products. Some might regard this
radical change as bringing forth the possibility of greater efficiency and
increased patient’s choice. Others may see privatization as a threat to the
large public institutions providing services and protecting the rights of the
under-privileged. Considering the
situation of Bhutan where 69% of the population lives in the rural areas depending
on subsistence farming (National
Statistical Bureau, 2005) and 12.4 percent
of its population under poverty (Dahal, 2012), it would be impractical to privatize
the medical facilities.
In the young
democracy like ours it is often difficult to understand the people prospective
about privatization. Privatization doesn't guarantee that the contracts will go
to the best companies; those that can do a better and cheaper job. Big
companies with good lobbyists and political influence often land the contracts.
This will lead to corruption and service provided cannot be guaranteed as the
best one. When private institutions agree the contracts from the government,
the institutions can begin to cut corners to increase profits. Unless the
contracts include specific reporting criteria, these businesses' modes of
operation may prove difficult to monitor leading to lack of transparency and accountability
which, in fact will result in birth of illegal market (Dorji, 2008).
The private for-profit health services need
nurses, doctors and other health professionals. They turn to the same nurses and
doctors who work in the public health system and poach them to serve people who
can afford to pay for private services. As the private system charges more for
its services, it often can pay more for health professionals. Moreover, country
already has shortage of medical professional and specialists. This “poaching”
of health professionals who have been trained by the public health system means
that there are fewer doctors, nurses and other professionals available to the
under-privileged ones (Canadian Health Coalition , 2009).
Recently, Bhutan has seen a private
diagnostic Centre in Phuentsholing which provides health care facilities such
as ultrasound, X-ray and Laboratory
tests run by just two trained technicians. Can all Bhutanese get satisfied with
the service provided by the Centre? With just two technicians it may be hard to
look after the customers and it results in getting the health professionals
from the public health care institutions (BBS, 2013).The visitors are not just
patients but they can be treated as customers. On the other hand, as the cost
for setting up the Centre is high and the fees for the facilities is not yet
decided, we cannot guarantee that the service provided can be reasonable for the
people.
I believe that many Bhutanese who are
dissatisfied with our present system of health care are among those who have
seen better-developed systems abroad and are able to pay for such services.
This group neither has the time nor patience to wait for services, nor do they
have much regard for the providers. Looking at the present scenario, to
privatize health service means to neglect the majority of the country’s
population and to have disparity between rich and poor.
To summarize, as
Wangchuck (2007) states, “people who can afford to buy sophisticated treatment
can live better even when they are struck by serious sickness but people in
rural areas may die from even curable diseases such as diarrhea creating a gap
between rich and poor”. So, being a developing country with most of its
population in rural areas and with poor financial background, it may not be a
right time for Bhutan to privatize the health services.
References
Bhutan
Broadcasting Service. (2013). First private diagnostics Centre in Phuentsholing.
Canadian Health Coalition (2009). Don’t Privatize our
Health Professionals. Retrieved on April
Dahal, R.C
(2013). Drastic poverty reduction reflects growth:NSB. Retrieved on May 15,
2013
Dorji, C. (2008). Bhutanese Health Care Reform:A Paradigm Shift in Health Care to Increase
Gross National
Happiness, Proceedings of the Fourth
International Conference on Gross National Happiness. Retrieved on April
23, 2013 from https://www.bhutanstudies.org.bt/pubFiles/20.GNH4.pdf
Kuenza.
(2013). Bhutan should not privatize health yet. Retrieved on May 8, 2013 from
National Statistical Bureau. (2005). Results of Population and Housing Census. Retrieved on
Ugyen, D. (2013). My views on
privatization of health facilities in Bhutan. Retrieved on May 8,
Wangchuk, S. (2007). Should Health Care in Bhutan
Privatized. Retrieved on April 23, 2013
from
http://www.kuenselonline.com
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