‘The privatisation of medical facilities in Bhutan will ensure prompt health services.’

 Our country, Bhutan, has been concerned about the health of citizens and striving to attain the goal of Gross National Happiness. The health services are free of cost and the coverage and efficiency of these services has been notably good. Few issues rise with the demographic change and privatisation of health services surfaced for study. The paragraphs below will discuss the advantages and disadvantages of the privatisationto decide whether current or private health system will ensure prompt health services.

The privatisation would offer faster access to the medical services. This would reduce the pressure of increasing patients standing in queue being faced at the hospitals. The number of patients exceeds the number of doctors which has limited the quality services to the former and privatisation of medical facilities would ease the pressure on the doctors, thus availing by the patients the best services the doctors can offer (Wangchuk, 2007). A health official opined that this measure would “offer alternate option to the public” and reduce “waiting time in the hospitals” (Wangmo, 2011).

Our government spends huge amount of revenue in referring the patients outside the country, which would be instantly minimized by the privatisation and the country’s standard of medical facilities would drastically rise. A specialist suggested the 90 million spent this way for the medical services that can be provided in the country could be quelled if “own specialized private hospital” is instituted and this would even render tertiary level of medical service which the country presently is incompetent in (Wangchuk, 2007). If the fully fledged private health care systems are not permitted, a doctor suggested of allowing the doctors to “practice privately at the public hospital after their duty”. If not addressed, the services would be worsened.

If the privatisation is not considered by the Ministry of Health, the incumbent doctors would be demotivated and the public health service, the country presently boasts of, would suffer in coverage and quality. The doctors weren’t given desired avenues or paid fat enough by the Ministry to take care of their needs that a senior doctor feared losing the doctors where income is high (Wangchuk, 2007). The Health Ministry’s indecision to allow private clinics would lose “good doctors and health workers” as well (Wangmo, 2011).

The outsourcing of even a few medical services would promote the effectiveness of our current system. National Health Policy has a provision stating “The Ministry of Health shall continue to outsource non-clinical and selective diagnostic services”, so the public health providers need not deal with these outsourced services. With pressure reduced and extensive focus given to treatment and care, a Ministry official said that only then would these services see “a change in the effectiveness” (Wangmo, 2011). The diagnostic services and laundry services were advertized for privatisation.

However, the positive points for the privatisation are irrevocably countered by the negatives. The idea of privatizing the health service not considering the ground realities is inhuman. The privatisation would welcome unprecedented irrational delivery of medical services. The living standards of the people as a whole needs to be seriously deliberated. Dasho (Dr) Gado Tshering, the health secretary, opined that the privatisation would give rise to “two levels of health care systems” where the poor would suffer with poor medical facilities and rich would enjoy the advanced ones (Wangchuk, 2007). Even Lensing, in Prizzi, Ross (2005), observed:

Privatisation encompasses a wide range of social consequences. For example, a privatized hospital in the USA, gave rise to “prestige medicine” for the rich and “no care zones” for the uninsured working poor, chronically ill and disabled.

Large section of our country’s population falls under working poor and these people has high probability of resorting to the health services. If these people can’t avail the private health services, little use is the private health services towards serving the people, a noble cause. China, though economically revered, 35-40% of people having illness couldn’t avail privatized health services due to financial inadequacy (Whitehead, Dahlgren, & Evans, 2001). Our country, a developing country, is no exception would experience the same fate.

The privatisation would cause brain drain in the current health system and this would further lead the uncertain private health system and the former to underperform. Dr. Kubota, in Wangchuk (2007), said the time was inappropriate for this movement and would drain the “manpower in the public hospitals into the private health systems” which would harm rural people.

The doctors and other manpower may drain into private health system but their prospect is vague. The Ministry of Health received 10 proposals on setting up private clinics but only 6 were passed after EMTD screened under the grounds of infeasibility in the market (Wangmo, 2011). This confirmed the unprepared market for the private health services. Dr. Gado further reminded the existence of only 10% of our population comprised rich and questioned this drained population’s living (Wangchuk, 2007). Then the possibilities of induced demand by the doctors from the private clinics would surface to raise the income needed to meet the needs (Wangmo, 2011).

Private clinics means money, unlike the current free medical services, and for money, the health of the people would be generally affected and unethical practices will arise. Whitehead, Dahlgren, & Evans discovered “two-fold” negative effects of this: “poorer health and increased medical expenditure” (2001). They even observed rife undiscriminate prescription of injections and drips in India, sale of drugs without prescription by unqualified people and untreated sickness among poor. The expansion of clinic results in “fragmentatin of healthcare system” and increase in problems of “recruitment and retention of professional staff” (Allen, 2011).

The privatisation, besides the few mentioned advantages, will negatively affect almost all people with weakening of manpower, high charge on services, unethical practices in the service delivery, deterioration of health and so on. The current health system has issues but it can be addressed and reformed to deliver the services ‘freely’ and equally treat the Bhutanese. Therefore, the privatisation of medical facilities in Bhutan will not ensure prompt health services.

References

Allen, D. (2011, October 5). Privatization of Clinical Services. Retrieved from globalresearch.ca: http://www.globalresearch.ca/medicare-the-privatization-of-healthcare-in-canada

Prizzi,R. (2005). An International Perspective of Privatization and Women Workers. International Women's Studies.

Wangchuk, S. (2007, September 20). Should health care in Bhutan be privatised? Retrieved from kuenselonline.com: http://www.kuenselonline.com/modules.php?name=News&file =article&sid=9091

Wangmo, L. (2011, November 12). First step towards privatization of health services. Retrieved from businessbhutanl.bt: http:www.businessbhutan.bt/?p=8265

Whitehead, M., Dahlgren, G., & Evans, T. (2001). Equity and health sector reforms: can low-income countries escape the medical poverty trap? The Lancet .