presentation at iim

8/6/2019 Presentation at IIM

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G l


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Goal

To Raise the Infrastructure andServices in Health Sector to IndianPublic Health Standard.

Where we started


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Where we startedFull Immunization-11% (India 54%; Census-2001)

Maternal Mortality Rate-452 (India 407; NFHS-II)

Patient attendance at PHC - in Jan 2006 Avg.per PHC39 per monthMore than 85 % patients are going to Pvt. Sector

Recent Initiatives

Infrastructure Public Private Partnership/ Out Sourcing of Services Routine Immunization Drug Distribution

Average No. of Patients Visited Per Month Per


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gPHC

Average No. of Patients Visited

39

6481010 868

13031542

27273015

0

500

1000

1500

2000

2500

3000

3500

Jan-06 Feb-06 Mar-06 Apr-06 May-06 Jun-06 Jul-06 Aug-06

Month

A v e r a g e

N o . o

f P a

t i e n

t s

V i s i t e

d p e r

M o n

t h p e r

P H C

Why Private Investment in Health


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y

Sector ? Large no. of patients go out side for

specialized treatment. In the AIIMS, about 1.5 million OPD

and 80,000 IPD cases are treated

annually. According to un-official estimates up

to 50% of the patients treated in AIIMSare from Bihar.

Limited super Specialty Services

available

Private investment is


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Private investment isrequired in the State of Bihar

Govt. has adopted two mechanism to facilitate privateinvestment

1. Private Investment

2. Investment through Public Private Partnership

Ambulance Services


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Rogi Kalyan Samitis (RKS) to

arrange for ambulance in allthe hospitals.

Max. rate of Rs.500/day asrent Contract for one year.

Fuel Charges per Km to be

decided by RKS Ambulance User charges to

be decided by RKS

PPP

Pathology Services

Radiology Services

Hospital Maintenance

Ambulance Services

Mobile Medical Units

Operationalisation of APHCs

APHC- Outsourcing


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g

36 APHCs outsourced, another 50 on theanvil

Rs.6,28,906 per year per APHCService Package General OPD Immunization Gynae services. Routine pathological tests Minor operations

Family planning operation (with the helpof PHC) One ambulance for referring patientsManpower

One doctor and 5 para medics/assistants

PPPPathology Services

Radiology Services

Hospital MaintenanceAmbulance Services



FREE MEDICINE SUPPLY


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Free Medicine (13essential OPD drugsand 24 IPD drugs, alldrugs under nationalProgrammes) to be

given to patients.

From November 2006 allexpenses on Medicinesfor indoor patients willbe provided free of Cost.

Hospital Maintenance Services


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Hospital Maintenance Services

Maintenance of HospitalPremises.

Generator Facility. Cleanliness of Hospitals. Washing Diet.

Centralized rate contract finalizedand each district given three

parties to choose from.23 districts have already started

using these services

PPP

Pathology Services

Radiology Services




Investment already made for


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Infrastructural Development

Total15Referral Hospitals

27District Hospitals

23Sub-Divisional Hospitals

73APHCs

398PHCs

Up gradation of Health Facilities

76FRUs22ICUs

11District Hospitals

20Sub-Divisional Hospitals

62PHCs

751Health Sub-Centres

No.Construction of New HealthFacilities

Rs.222 CroresRs. 2.43 crores

Rs 95 Lakhs

Rs. 95 Lakhs

Rs. 24 lakhs

Rs 23 lakhs

Rs. 34 Lakhs

Rs. 6.42 Crores

Rs 4.91 Crores

Rs 60 LakhsRs 6.4 Lakhs

Unit Cost of Construction

Mobile Medical Unit (MMU)APAN ASPATAAL


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APAN ASPATAAL

Rajbhra Consultants Pvt. Ltd. NewDelhi @2.24 lacs/unit. Monitoringand Payment through DHS

Service Coverage General OPD, Gynae clinic Infant and Child Care Minor lab investigations,

Radiology Services Minor surgical operations (where

specialist is available) Emergency services

Man power- Total 13 staff including

(2 doctors and 11 Para medics andassistants)

PPP

Pathology Services

Radiology Services





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BACK

Promotional Policy for opening PrivateM di l C ll


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Medical Colleges Government will facilitate availability of land at Market rate .

50% concession on prevailing rates will be given onregistration fee & stamp duty .

Govt.will provide road, electricity and water up to one pointwithin the boundary of the Institution.

Govt. will provide 50% of the cost (maximum Rs.75,000) of preparation of DPR to the private party.

Private party is required to start construction within 6 monthsof allotment of land.


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Govt. has taken decision to open private Medical colleges ; 7proposals have already been received out of which NoC has beengranted in 2 cases

Locations No. of Proposals NoC provided

Saharsa 2 -

Bettiah 1 -

Sasaram 1 1

Arrah 2 1

Patna 1 -

Opportunity for Private Sector


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Opportunity for Private Sector

Investment

1. Land available for MedicalCollege/Hospitals with HousingBoard at Patna.

2. Land also available withBIADA at Patna, Fatuha,Hazipur, Muzaffarpur,

Darbhanga, Purnia, Bhagalpur,Katihar, Madhepura.3. Private land in the State is

available at much cheaper ratethan in other States

Private Investment

Investment through PublicPrivate Partnership

Opportunity of Investment in


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Pharmaceutical Sector In Bihar Total consumption of Drugs is worth Rs.

1500 Crores The value of Drugs Manufactured by

Pharmaceutical Companies in Bihar is Rs. 50Crores. (Including Aurvedic & Homeopathy)

There is huge gap in consumption of drugs in thestate & present manufacturing capacity.

Untapped potential exists for setting up pharmaceutical firms in the state.

Pathology & Radiology-PPP


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District hospitals to have Labs

Collection Centre at PHCs

Reports within 24 hours

Sen Diagnostics & Central Diagnostics -19 districts each

Radiology- all 38 districts IGEMSSilvassa

All units to be functional by Dec2006

Space being provided to them againstrent, no Investment by Government

Govt. patients to be charged for

identified tests as per the prefixed ratesfor both pathology & radiology. Partyfree to charge as per their rates for other tests.

Party free to charge for all the tests asper their rates from other patients

PPP

Pathology Services

Radiology Services

Hospital Maintenance

Ambulance Services



PPPWe want the doctors/paramedics to be free from the


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We want the doctors/paramedics to be free from the

management of support services, so that they canconcentrate on providing the specialized services theyare meant for.

Pathology Services. Radiology Services

Hospital maintenance Ambulance services

Mobile Medical Units Operationalisation of APHCs

Recent Initiatives

Infrastructure

Public Privatepartnership/OutSourcing of Services

Manpower

Routine Immunization

Drug distribution

Setting up super specialty center through PPP mode


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Projects are invited for setting up superProjects are invited for setting up superspecialty centers on Govt. lands/hospitalsspecialty centers on Govt. lands/hospitalsthrough PPP, employing competitive biddingthrough PPP, employing competitive bidding

process.process.

Locations for Super Specialty CentersLocations for Super Specialty Centers --

Patna Medical College , PatnaNalanda Medical College, PatnaS.K.M. Medical Collage, Muzaffarpur

A.N. M. Medical College, GayaJ.L.N. Medical College, Bhagalpur

IGIMS, PatnaJay Prabha Hospital, PatnaGuru Govind Singh Hospital, Patna CityPilgrim Hospital, Gaya

IDFC has already been contacted for preparation of DPR & bidding documents.

Private Investment

Investment through PublicPrivate Partnership

Routine Immunization in Bihar


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Year 2006 declared as RoutineImmunization Year by Chief Minister.

Alternate vaccine delivery system tothe Sub- Centre through PrivateCouriers instituted

In addition to Wednesday, Saturdaydeclared as regular RI days

Full Immunization increased from11% to 43%

Recent Initiatives

Infrastructure

Public Privatepartnership/OutSourcing of Services

Manpower

Routine Immunization

Drug distribution


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MAJOR INITIATIVES IN RURALDEVELOPMENT

BELOW POVERTY LINE (BPL) LISTEarlier BPL list very defective


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Special Gram Sabhas held on same dates throughout Statefor intensive verification of Household Survey list.

Spot verification again of all families in draft lists withscores between 0 and 20, and SC, ST and Extremely

Backward Caste families scoring above 20.State-level Observers deputed for spot verification

Appeals decided by SDO & DM on basis of this process

Final computerised list ready (will be placed on website after cut-off is decided)

Ranking as per numerical scores with poorest at top andless poor below

Two reputed local institutions, AN Sinha Institute & ADRI,doing random sample verification

BPL list will ensure targeted delivery of basic necessities of ration, education, health services including free medicinesto poorest

INDIRA AVAS YOJANASeveral complaints about corruption & ineligible families being


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given IAY

IAY allotments now strictly as per prioritised BPL waiting list after verifying that family is really houseless or has kuccha house

Minimum 60% for SC, ST

Accounts opened in Banks in name of beneficiariesPayments @ Rs.24,000 each out of Rs.25,000 so beneficiaries donthave to approach authorities repeatedly

Payments not to individuals but to groups of beneficiaries throughconsolidated cheque for whole group to Bank along with advice slipwith names of beneficiaries

Beneficiaries being made into Self Help Groups so that they can go

to Bank as group & buy house construction material collectivelywith greater bargaining power

Beneficiaries also advised about programme & warned not tomisuse the money

New process eliminates discretion of officials in selection &payment

SWARNAJAYANTI GRAM SWAROZGAR


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YOJANA

Monthly meetings & joint reporting by DRDA & Banks at

Block & District levels

Stress on Self Help Groups

GRAM VIKAS SHIVIR


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Like Janata ke Darbar mein Mukhya Mantri, Gram VikasShivir takes entire Block-level Govt machinery of alldepartments to Gram Panchayat

Every Wednesday, BDO, Revenue Officer (Anchal Adhikari),Block Medical Officer, Animal Husbandry Officer, other Extension Officers of all departments, Officer-in-Charge of Police Station camp on rotational basis in different GramPanchayats and dispose of work thereGram Sabhas held, Govt schemes explained, inspectionsconducted, pending revenue cases disposed of, publicgrievances attended to

All Gram Panchayats in Block will be covered in 10 to 20weeks depending upon number of Panchayats in Block

This will also activate & institutionalise Gram Sabhas

RURAL EMPLOYMENT GUARANTEE


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SCHEME

Out of 38 districts, Centre notified 23 under National Rural

Employment Guarantee Act

Bihar covered remaining 15 districts under State Rural

Employment Guarantee Scheme identical to NREGS

Centre requested to permit merging Sampoorna GrameenRozgar Yojana (SGRY) into SREGS

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