• PPP is an arrangement between a government owned entity on one side and a private sector entity on the other. There are various models like BOOT, Contracting, Joint Ventures, Mobile Health Units Telemedicine, Franchising, Social Marketing etc in health sector.
• McKinsey, World Bank and the World Economic Forum argued that the PPP model is indeed the way ahead to improve healthcare delivery in India. But, it is also important to get the design right to make the delivery cost-efficient, timely, affordable and profitable for all stakeholders.

PPP model can help in the following ways 

1. Better utilisation of resources, physical and human

• PPP model can better procure expertise in terms of staff,doctors,medical procedures etc

• Besides human resource, they can also have best infrastructure in terms of buildings,equipments, technologies etc

     2.Increaseing access

• There will be tremendous increase in the perimeter of medical industry which is wanting due to resource constraints in the public sector. 
• It is premised on the fact hat healthcare is a never dooming economic industry as recognised globally and more so in a country like India with huge population.
• Thus the private sector will always be eager to expand its frontiers in the healthcare.

    3.Efficiency

• The efficiency will be improved in providing services against the lethargic bureaucratic set up in public hospitals.

Challenges with PPP model

• The PPP framework has many in-built infirmities

1. Revenue and risk sharing 

• There are asymmetries in how the government and the private sector partner share revenue and risks.

     2.Profit dilemma in social sector

• There is another fundamental problem with PPPs in the social infrastructure space: the private sector partner needs to maximize profit, which is not always compatible with the stated objective of providing universal access to quality services.

    3.Low cost bids by the government

• Bids are usually evaluated based on the lowest cost to government. 
• The lowest cost bid mode is a slippery slope and prone to abuse and sub-optimal outcomes.

   4.Regulation

• The Indian healthcare industry is a prime example of how lack of sectoral regulation has resulted in government ceding space to the private sector, even in urban primary healthcare centres in some cases. 
• This has multiple consequences, especially with regard to levy of user charges which remains unregulated. 
• The regulatory role of the Ministry of Health and Family Welfare includes regulation of clinical establishments, professional and technical education, food safety, medical technologies, medical products, clinical trials, research and implementation of other health related laws
• National Health Policy 2017, while advocating a larger role for the private sector, has advocated reforms in the regulatory role for the ministry. 

Conclusion

• There is a need for urgent and concrete steps towards reforms in regulation of PPPs in healthcare sector. This will entail moving towards a more effective, rational, transparent and consistent regime.” 
• Even the Vijay Kelkar committee, set up to revitalize the PPP model in infrastructure, endorsed the setting up of independent regulators.