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The tall claims of the Chhattisgarh government that it would provide diagnostic facilities in tribal and remote areas through outsourcing seem to have fallen flat. No private party has shown interest in the proposal. Earlier, health activists had expressed doubts over the success of such a move and had demanded that the government reconsider the decision.
In December last year, the state government had issued request for proposal (RFP) and had invited private players to submit their bids. The government divided the state into four regions for the purpose: Raipur, Bilaspur, Bastar and Sarguja. Raipur and Bilaspur are well developed while Bastar and Sarguja are backward regions. Diagnostic firms bid for centres in Raipur and Bilaspur but the state governemnt did not get any bid for Bastar or Sarguja. The authorities have now issued fresh RFP.
One who caters to the rich shall cater to the poor
In its new RFP, the government has clubbed Bastar with Raipur region and Sarguja with Bilaspur to ensure that the bidding firms provide services even in remote and under-developed regions. Bidding is open till March 17.
When the state government’s decision was criticised by health experts, the government defended its decision of outsourcing diagnostic facilities, saying that it wanted to develop diagnostic facilities in the areas where they do not exist and went ahead with outsourcing.
As per earlier RFP, any bidder could have applied for any of the four regions, but now if a firm is applying for Raipur region, it will have to have to cater to Bastar division as well.
Experts say that the modification of RFP underscores the failure of the state government.
Member of non-profit Jan Swasthya Abhiyan (JSA), Sulakshana Nandi, says it is very clear that evidence shows outsourcing diagnostic services will not work, but the government is ignoring it deliberately or unwittingly. JSA is the Indian chapter of the People's Health Movement, a worldwide movement to establish health and equitable development as top priorities through comprehensive primary health care and action on the social determinants of health.
“The government's rationale for outsourcing diagnostic facilities was to provide health facilities in remote areas, which seems will be tough to achieve as bidders have no interest in setting facilities in those areas. This aim could have been achieved more easily if the government recruited people and gave them basic diagnostic kits and then provided diagnostic facilities,” she adds.
Now, money would be spent, but whether the people will get the facilities or not is not clear, she says.
Chhattisgarh's health commissioner Pratap Singh says the disinterest of private players in tribal and remote areas was the reason behind clubbing of the regions. “We have re-grouped these four regions into two. We feel that private parties will be interested to come in regions like Raipur and Bilaspur. By this clubbing will ensure that they go to remote area like Bastar also.”
Chhattisgarh government has decided to outsource diagnostic services at its public health facilities in spite of it being brought to its notice that a similar experiment did not work in Bihar.