In a conversation with Raelene Kambli, Sabu Jose, GM – Government, OEM & Corporate Accounts – India Cluster, Carestream Health, explains the challenges related to effective management of PPPs in healthcare
How are public private partnerships designed in healthcare?
PPPs in healthcare are mostly designed in a way where the government’s role is such that it is involved in developing, financing and providing health infrastructure and services. Whereas the private sector player provides medical equipment or operates the healthcare facility.
Given the backdrop that PPPs in healthcare don’t seem to be very successful. What is your view on the same?
When we thought of PPPs last year, we realised that many companies are withdrawing from these models of partnership with the government. States such as Gujarat, Madhya Pradesh are some states that withdrew from this model. And that is when we decided to go very slow in terms of partnering with the government. We also identified the reason behind the failure of such models. It is not just the money involved but it is about the operations and especially managing the manpower deployed on such projects.
Do you think it is a lack of competency that is causing this problem?
It is not only about competencies. They find it very difficult to retain people. One of my associate shared his experience working in a PPP and said that his team found extremely difficult to find people who would work dedicated in these project. The attrition rates are very high in such models. Moreover, most of these PPPs are done with equipment players and these players are not good with talent enrollment and do not have those strategies to retain people.
So, what approach would you take in this regard?
In my view, we need to split the component wherein the labour management should be dealt by the government.
But do you think that the government is equipped to hire and manage specialised technicians especially the ones who operate high-end radiology imaging system?
When a technician is hired by the government there is more responsibility involved. Employees understand that they cannot just quit and that they are been monitored as well. When hired by a private player they do not show that commitment.
Apart from this, what is your opinion on rising import duty for medical equipment?
Last year, the government introduced eight per cent tax on import duty and at the sametime they asked us to cut down on our price. If taxes are high, how will we be able to cut down on cost.
Which are the states that you have partnered so far?
We have partnered with Kerala, Telangana, Maharashtra and Gujarat.
And which state according to you offers a better business environment?
Telangana offers a better business environment. Apart from this, Kerala also offers a good business environment for us.
What is different in these states?
These states are different in their style of working as they always adapt what is new.
Do you think there should a governing body that will look after PPPs and liaison between the government and the private sector?
There are bodies such as HLL who are doing well but yes there should some sort of understanding between the two parties to make PPPs work.