At question hour session of the National Assembly yesterday, Panbang MP Dorji Wangdi said that according to the Economic Development Policy (EDP) 2016, privatisation of public health services is not allowed but allows participation of private sector or foreign companies and hiring of expatriate medical, and health professionals.
“This gives the impression that while privatisation of public health services will not be allowed, private health services will be allowed henceforth,” MP Dorji Wangdi said.
Lyonpo Tandin Wangchuk said that there is no major difference between the EDP 2010 and 2016, and added that clauses like ‘encourage and facilitate establishment of private medical colleges’ that was reflected in EDP 2010 has been removed in the EDP 2016 under health section as it is covered under education section in EDP 2016.
Lyonpo stressed on the difference between privatisation of public health service and private sector engagement in delivery of healthcare services. Privatisation of public health services, he said, would mean privatising all the healthcare services that is currently provided free by the government. Private sector engagement in health sector means allowing private sectors to engage in delivery of selective health care services to compliment and supplement the already existing services currently delivered by the ministry.
“Therefore, as per the EDP 2016, the areas that are open to private sector engagement are high-end luxury medical facilities, selective diagnostic centres, an in the area of medical tourism,” Lyonpo said. “However, the ministry haven’t receives a single proposal on this.”
Lyonpo said that the ministry would ensure all regulatory systems are in place.
The National Health Policy (NHP) 2011 allows private sector engagement such as high-end luxury medical facilities and selective diagnostic services such as endoscopy, radiology and laboratory.
Lyonpo said that the health ministry suspended the issuance of licences for private diagnostic centres in the country for the past two years because of lack of regulation.
“A regulation has been finalised,” Lyonpo said. “The suspension will be lifted once the regulation is endorsed and comes into effect.”
The first private diagnostic centre was started in Thimphu in 2012. There are 13 private diagnostic centres in the country today.
Lyonpo said that while the government will continue to provide free healthcare to the people, privatisation of public health services would depend on the people’s capacity to afford it.
“We have to promote private sector, but it is also the government’s duty to protect the interest of the majority,” Lyonpo said.
Kengkhar Weringla MP Rinzin Jamtsho said that regional referral and the national referral hospitals are facing acute shortage of medical equipment and specialists.
“As a result, patients have to travel and often have to be flown to Thimphu where there too is shortage of medical equipment and specialists,” MP Rinzin Jamtsho said.
The health minister said that the government has always accorded high priority to improving diagnostic services that facilitate the provision of timely, cost effective and high quality diagnostic care in a safe and secure environment.
Lyonpo said that annually, about Nu 90M (million) is allocated to the health sector to procure medical equipment. He added that the budget allotted for the procurement of medical equipment by the government in the 10th FYP was Nu 466.43M. Nu 504.4M has been spent till now in procuring the equipment.
“As of 2016, 769 pieces of common medical equipment were supplied to the hospitals in the country,” Lyonpo said.
Currently, patients from across the country are referred to the national referral hospital in Thimphu for a computerised tomography (CT) scan.
“The increasing number of patients referred to the national referral hospital annually for CT scan has overwhelmed the workload of the radiologists at the hospital, which has ultimately resulted in the increase in waiting time,” Lyonpo said.
Lyonpo informed that recognising the issue and also in line with the 11th Five Year Plan (FYP), the ministry will upgrade 16 slice CT scan to 64 slice at the national referral hospital. “The existing 16 slice CT scan will also be in function, to improve access and delivery of health services.”
A 16 slice CT scan facilities each will be established at the two regional referral hospitals in Gelephu and Mongar in 2018 with support from Japan International Cooperation Agency (JICA).
A 64 CT scan costs Nu 67.5M and a 16 slice costs Nu 30M.
Lyonpo said that in addition, JICA will support procurement of equipment such as spirometer, digital X-ray and mammography worth USD 5M.
More than 2,177 patients were referred from the regional and district hospitals to the national referral hospital in Thimphu last year.
“With the installation of the equipment, the number of referrals from the districts to the national referral hospital is expected to reduce,” Lyonpo said. “Meeting the health workforce number is one of the main priority of the ministry.”
The government allots about Nu 75M annually to enable the national doctors to undergo specialisation courses. The country currently has 14 super specialists and 36 specialists.
Of the 17 foreign specialists that the government had approved to recruit, five are already in the country. The specialists will be paid monthly salary of USD 3,000 or less depending on their experience.
Lyonpo said that the ministry would propose for more expatriates recruitment if necessary.
“The health services in the country had gone up over the years in the country,” Lyonpo said.
The number of doctors in the country increased to 299 in 2016 from 203 in 2013.
The number of nurses in the country increased from 799 in 2013 to 1,185 last year. There was also increase in the number of pharmacists and other health workers.
The number of functional ambulance in the country has increased to 124 from 87 in 2013.