Finance panel for PPPs on health infra


The 15th Finance Commission has mooted a greater role for public private partnerships to ramp up health infrastructure and scale up public spending on health from 0.95% of the GDP to 2.5% by 2024.


  • While public outlays should focus on primary health care at the panchayat and municipality levels, private players should be relied on for specialty healthcare, he said, hinting that the commission has recommended steps to fix the skewed availability of healthcare across India as poorer States have the worst facilities.


National cadre

  • Substantial improvements in the working conditions for doctors in government hospitals, many of whom are hired on a contract basis by the States, and the creation of an Indian Medical Service cadre as envisaged in the Civil Services Act, 1951.
  • The total spending of around 0.95% of GDP is not adequate both in relation to our peer groups, and in relation to the commitments under the National Health Policy of 2017. 
  • There is no doubt that public spending, both by the Centre and the States, need to go up very significantly. And the endeavour must be to raise public spending from 0.95% of GDP to 2.5% of GDP by 2024.
  • Seeking greater attention on the role of paramedics and frontline health workers in countering the pandemic, the commission was amazed to learn that doctors in many States were engaged on a contract basis, and underlined the need to improve their working conditions.


Trust deficit

  • For that, a working relationship is needed and this relationship can be built only if, first and foremost, the trust deficit that exists [between industry and government] now is bridged. 
  • Private sector investment in health has an exceedingly important role to play.
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