Name of Presenter: Ajay Bhattacharyya

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PUBLIC PRIVATE PARTNERSHIP (PPP) MANAGEMENT UNIT
INWEST BENGAL

• Name of Presenter Ajay Bhattacharyya
• Position
• Deputy Secretary-Medical Services Branch
• Health Family Welfare Department
• Government of West Bengal, India

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Overview of PPP initiatives under Government of
West Bengal

• Onset of PPPs was in the mid nineties at the
  Secondary and Tertiary health care. However,
  structured PPP initiatives started only from 2003
  under KfW funded Basic Health Project in West
  Bengal
• PPP Policy officially launched in Jan 2006 for
  improved health care services for the community
  at large
• PPP Cell was also formed subsequently at the
  State and District level to develop, implement,
  monitor and coordinate all PPPs.
• More recently, a high powered Committee has been
  formed at the Apex level to explore the
  possibilities of new areas of PPP initiatives.
• For implementation, West Bengal Medical Service
  Corporation would be the entrusted agency.

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Type of PPPs

• Primary Health care level
• Initiated under KfW funded Basic Health Project
• Ambulance Services in Rural Hospitals (RHs) and
  Block Primary Health Centers (BPHCs) through
  operational management by NGOs/CBOs under PPP
• Diagnostic Services in RHs and BPHCs by Private
  Sector Partners/NGOs under PPP
• Planned Preventive Maintenance (PPM)
• Other Initiatives by the Department
• Running of Training Schools for Auxiliary Nurse
  Midwives (ANMs)-need based.
• Mobile Healthcare Services in Sunderban riverine
  area.
• Secondary Health care level
• CT Scan services through Private Sector Partners
  in District Hospitals
• Disposal of Bio-medical waste
• Tertiary Health care level
• CT Scan and MRI Services in Medical Colleges
  through Private Sector Partners
• Mechanized Laundry Services (in selected
  facilities)

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Partnership/Actors Involved

• PUBLIC PARTNER
• Health Family Welfare Department and its
  various wings
• Government of West Bengal
• PRIVATE PARTNERS
• NGOs, CBOs, Trusts, Social Welfare Organizations
• Private Sector Organizations
• Corporate Bodies
• Support from Consulting Organization in
  effective implementation

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Project Objective

• Improved and increased access of the community
  at large for quality health care services
• Supplement the ongoing efforts of the Government
  of West Bengal
• Affordable cost/rate for services under PPP
• Proper safety net for the Below Poverty Line
  (BPL) population
• Optimum utilization of scarce public resources
  targeting the poor.
• Consolidating the strengths of both the partners
  on mutually beneficial terms to achieve the
  desired health outcomes
• Involving NGOs/CBOs and Civil Society for
  ensuring better access to services by reaching
  the community at large

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Project Set-Up and Arrangements

• Consultations with stakeholders on structured
  check-list to find out issues and addressing of
  these issues before designing of scheme
• Designing of schemes, agreement and Standard
  Operating Procedures
• Selection of Partners based on eligibility
  criteria and Expression of interest (EoIs) and
  subsequent bidding
• Necessary measures and support to selected
  partners for setting up and launch of services
• Post operationalisation administrative support
  and troubleshooting
• Monitoring for strategic intervention for
  compliance of SOPs and greater utilization of
  services

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Key Milestones

• Ambulance Services
• Round the clock emergency transportation
  facilities through NGOs in remote places at user
  charges fixed by District level Authorities
• Transportation of delivery cases facilitating
  institutional deliveries
• Adequate and proper Safety net for the poor
• Facilitating development of ambulance network in
  rural areas
• Diagnostic Services
• Providing essential Pathology and Radiology
  services at low cost with
• quality assurance at Primary Health Care
  level
• Safety net for BPL category of patients with
  free services

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Challenges and Mitigation Plans

• Challenges
• Changing mind set of the stakeholders on PPP
• Resistance from the stakeholders of prevalent
  practice.
• Capacities of both the partners on management of
  PPPs
• Compliance of SOPs by the operating partners and
  quality assurance
• Initiating proper safety net and monitoring its
  utilization
• Mitigation plan
• Consultation with stakeholders on issues before
  designing of scheme
• Advocacy initiatives and Capacity Building
  programme were planned after launch of services
• Administrative support and trouble shooting by
  the department
• PPP cell at the state and district level for
  better monitoring

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Progress to Date

• Ambulance Services in BPHCs
• Round the clock services through out the State
  by133 ambulances provided under KfW funded
  project initially and subsequently 201 ambulances
  by DFID funded project
• Subsequent introduction of safety net through
  cashless delivery transportation under NISCHAY
  JAN Scheme
• Ensuring availability of Ambulance through
  Dial-up tool free networking system.
• Diagnostic Services in RHs and BPHCs
• 64 such centers could be established till date.
  Others are in progress.
• Other PPP schemes
• Inspired by the success, other PPP Schemes e.g.,
  Dialysis services, CT Scan and MRI facilities
  have been introduced in secondary and tertiary
  sectors.

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Lessons Learnt

• Formulation of schemes under PPP requires
  involvement of all stakeholders in general and
  people in particular.
• Need for greater understanding of the PPPs at
  the Peoples representative level (e.g.
  Panchayeti Raj Institution)
• Need for Advocacy for PPP initiatives at the
  initial stage
• Initiatives for capacity building and change of
  mind set for both the partners at the operational
  level immediately after signing of agreement
• Protocol for quality assurance needs to be put
  in place
• Periodical financial analysis required for
  sustainability

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THANK YOU