Miscellaneous
Medical sector a lure for pvt players
The non-government sector, mainly private and community, is investing more in health care in the country, resulting in a consequential growth of new hospitals post Jana Aandolan II.Manish Gautam
A Central Bureau of Statistics (CBS) census shows a huge surge in the number of non-government hospitals after 2006, with the numbers of private and community hospitals increasing almost two fold in the 2006-2013 period. The country has a total of 301 hospitals.
According to ‘Census of Private Hospitals in Nepal 2013’, out of the total 190 hospitals established in that period, 145 are private hospitals, 28 community hospitals and the remaining are operated by NGOs
and charity organisations. Interestingly, 135 of the small private and community hospitals, with a capacity of 15 beds, are located outside the Capital.
Health care service in the public sector has expanded along with the private and community sectors over the period, said the CBS data, which were collected between July 2011 and
July 2012.
Only 15 government hospitals were established in that period, the Ministry of Health and Population data suggests. The majority of the government hospitals, however, have been upgraded from Primary Health Care to 15-bed sub-regional and regional hospitals. After 2006, government hospitals were established in Tikapur, Kavre, Malakheti in Kailali. Dadeldhura Hospital was upgraded to a sub-regional hospital while Rapti Zonal Hospital was also established. Baglung Hospital was also upgraded to Dhaulagiri Zonal Hospital.
The growth of private hospitals began after the introduction of Health Policy 1991 (recently replaced by National Health Policy 2014) which acknowledged the role of the private sector in health care as state-owned hospitals and health institutions alone were unable to cope with the growing needs.
Dr Laxmi Raj Pathak, former director general at the Department of Health Services, said that people want prompt service, be it a surgery or general check-ups. Long waiting lists at the government hospitals and bureaucratic hassles for procuring any equipment have fuelled the growth of private hospitals.
According to him, the availability of more hospital beds in private healthcare institutions has helped lower morbidity. “Private institutions can be credited to bringing in innovative technologies.
They are also working closely in the maternal health and other public health programmes of the government,” he said.
During the boom of nursing courses, Dr Pathak explained, the Council for Technical Education and Vocational Training required each nursing college to have its own hospital which also contributed to the growth of new hospitals.
Many health experts share Dr Pathak’s thoughts, saying that private hospitals promised a good and fairly quick return on investment. “Because of that more people, including influential figures in the country, were attracted to this sector,” said Dr Yasobardhan Pradhan, a public health expert.
Seven medical colleges have been established since 2006, while the remaining 13 have started producing doctors. The majority of first batch of doctors produced by medical colleges established around 2006/07 were attracted to the private health sector, noted Dr Pradhan adding that a trend of established specialised service hospitals have begun. He said many orthopaedic, neuro and cancer hospitals among others have come into operation.
Officials at the Health Ministry lamented the registration of new private hospitals has dipped following the introduction of new regulatory mechanisms. The ‘Directives on Establishment, Operation and Upgrading of Health Institute 2013’ stipulate the hospitals to be earthquake resistant, have health care waste management facility and environmental assessment which the majority of the hospitals were likely to skip in the past. “In an economically liberal society, the private sector is encouraged to invest. The new regulatory mechanisms are introduced to safeguard patients’ rights to quality health care,” said Dr Gunaraj Lohani, chief of curative division at the ministry.