TRANSFORMING THE HEALTHCARE SYSTEM: THE PUBLIC-PRIVATE HEALTHCARE DICHOTOMY IN INDIA IN THE ERA OF DIGITAL HEALTH
Keywords:digital health, National Digital Health Mission, private healthcare sector, utilisation of healthcare service
Digital health initiatives have become popular in all jurisdictions across the globe. The
digital health move, though it is envisioned as a cost-effective way to ensure the availability of health
care services especially for the people who live in rural areas, its success depends on the response of
the health care system and the state control and regulation. India lacks a comprehensive statesponsored or state-regulated health care system and more than 70 percent of people utilise the private
sector medical services. In this backdrop, the implementation of the National Digital Health Mission
(NDHM), announced by the Government of India very recently, will be critical. Thus, this research
paper strives to bring out the public-private disjunction in the availability and utilisation of public
and private health care facilities, issues of health care financing and legal regulation of clinical
establishments in the public and private sector. This study uses the doctrinal method and analyses the
Five-Year Plans, National Sample Survey Reports, National Health Profile, National Health
Accounts Estimates for India and other Government Reports and independent studies to detail the
public-private dichotomy. However, this study finds limitations in presenting the current position of
private health care service providers due to the unavailability of updated authoritative government
reports/ studies/ surveys. On reviewing the currents trends in the public and private health care
sector, the study finds that the private sector has surpassed the public sector in all means, including
health provisioning, utilisation, and financing. The NDHM is a laudable initiative to ensure
affordable health care to millions of people in India. However, any move to implement it, leaving the
fundamental issue of deep-rooted public-private dichotomy existing in the healthcare sector will be
detrimental. It will result in a digital divide in the public and private healthcare sector and gross
violation of patients’ rights and mismanagement of health information.
Abidi, A. F. (n.d.). Does India need a digital health mission?. The Wire Science. Retrieved October 24, 2020,
Aryan, A., & Mukul, P. (n.d.). Jio 5G explained: What does the solution mean to Reliance, and its users?.The
Indian Express. Retrieved October 24, 2020, from https://indianexpress.com/article/explained/jio-5g-what-doesthe-solution-mean-to-reliance-and-its-users-6509088/
Bagchi, T., Das, A., Dawad, S., & Dalal, K. (2020). Non-utilization of public healthcare facilities during
sickness: a national study in India. Journal of Public Health: From Theory to Practice, 1–9.
Bhore, J., Amesur, R. A., Cotter, C. L. E., Dadabhoy, I. M. S. ; D. J. R., Bombay, M. R. C. P. O. B. E., &
Member, M. L. A. (1946). Report of the Health Survey and Development Committee. Retrieved February 12,
, from https://www.nhp.gov.in/sites/default/files/pdf/Bhore_Committee_Report_VOL-1.pdf.
World Health Organization, Current health expenditure (CHE) as percentage of gross domestic product (GDP)
(%) - Data by WHO region. (n.d.). Retrieved February 12, 2021, from
Telemedicine Practice Guidelines - Enabling Registered Medical Practitioners to Provide Healthcare Using
Telemedicine, (2020). Retrieved December 15, 2020, from https://www.mohfw.gov.in/pdf/Telemedicine.pdf.
Burde, H. (2011). The HITech Act—An overview. Virtual Mentor, 13(3), 172–175.
Central Bureau of Health Intelligence. (2019). National Health Profile (NHP) of India- 2019. Retrieved from
February 12, 2021, from http://www.cbhidghs.nic.in/showfile.php?lid=1147
‘Digital Health: The future series II- bridging the gap: A.I..’s role in combating inequalities in health’ webinar
organised - express healthcare. (n.d.). Retrieved October 24, 2020, from
Digital healthcare market in India 2019 - Research and markets. (n.d.). Retrieved October 24, 2020, from
Duggal, R. (2004). Tracing privatisation of healthcare in India. Express Healthcare Management. Retrieved
February 12, 2021, from https://www.researchgate.net/publication/236888943
Government of India. (1961). Third Five Year Plan (1961-66). Retrieved November 14, 202, from
Government of India. (2013). Twelfth Five Year Plan (2012-17). Retrieved February 12, 2021, from
Healthcare industry in india (n.d.). Retrieved October 24, 2020, from https://www.ibef.org/industry/healthcareindia.aspx
Kumar, S. (2015). Private sector in healthcare delivery market in India: Structure, Growth and Implications.
Retrieved November 20, 2020, from http://126.96.36.199/pdf/WP185.pdf
Labrique, A. B., Wadhwani, C., Williams, K. A., Lamptey, P., Hesp, C., Luk, R., & Aerts, A. (2018). Best
practices in scaling digital health in low and middle income countries. Global Health 14.
Liji Samuel / Transforming The Healthcare System: The Public-Private…………
Marathe, S., Hunter, B. M., Chakravarthi, I., Shukla, A., & Murray, S. F. (2020). The impacts of corporatisation
of healthcare on medical practice and professionals in Maharashtra, India. BMJ Global Health, 1-5.
Mathur, N. (n.d.). MeitY and Google tie up to build for digital India. Retrieved October 24, 2020, from
McGrail Samantha. (n.d.). 88% of providers investing in remote patient monitoring Tech. Retrieved October 24,
, from https://mhealthintelligence.com/news/88-of-providers-investing-in-remote-patient-monitoring-tech
Ministry of Health & Family Welfare. (2017). National Health Policy 2017. Retrieved February 12, 2021, from
Ministry of Health & Family Welfare. (2019). National Digital Health Blueprint (NDHB). Retrieved February
, 2021, from https://main.mohfw.gov.in/sites/default/files/Final Report - Lite Version.pdf
Ministry of Health and Family Welfare. (1983). National Health Policy 1983. Retrieved February 11, 2021,
Ministry On Health & Family Welfare. (2019). National Health Accounts Estimates for India 2016-17.
Retrieved February 10, 2021, from
National Health Mission: National Digital Health Mission rolled out on pilot mode in 6 union territories, Times
of India. (n.d.). Retrieved October 24, 2020, from https://timesofindia.indiatimes.com/india/national-digitalhealth-mission-rolled-out-on-pilot-mode-in-6-union-territories/articleshow/77565648.cms
National Health Portal of India, Gateway to Authentic Health Information. (n.d.). Retrieved October 24, 2020,
National Sample Survey Office. (2014). NSS 71st Round - Health in India.
NDHM. (n.d.). Retrieved October 25, 2020, from https://ndhm.gov.in/
NITI Aayog. (2019). Health system for a new India: Building blocks . Retrieved November 28, 2020, from
Schwab Klaus. (n.d.). The fourth industrial revolution: What it means and how to respond, World Economic
Forum. Retrieved October 24, 2020, from https://www.weforum.org/agenda/2016/01/the-fourth-industrialrevolution-what-it-means-and-how-to-respond/
September 2020 Healthcare data breach report: 9.7 million records compromised. (n.d.). Retrieved October 25,
, from https://www.hipaajournal.com/september-2020-healthcare-data-breach-report-9-7-million-recordscompromised/
Sharma Neetu Chandra. (n.d.). PM Modi launches National Digital Health Mission. Retrieved October 24, 2020,
Singh S. (n.d.). Philips’ 2019 future health index report: Digital health technology ups the game. Retrieved
October 24, 2020, from https://indiamedtoday.com/philips-2019-future-health-index-report-digital-healthtechnology-ups-the-game/
Swaniti Initiative. (n.d.). Health records system in India. Retrieved October 25, 2020, from
U.N. Office of the High Commissioner for Human Rights (OHCHR). (2008). Fact Sheet No. 31, The right to
health. Retrieved December 20, 2020, from https://www.refworld.org/docid/48625a742.html
Vaidyanathan Baru, R. (n.d.). Privatisation of health care in India : A comparative analysis of Orissa, Karnataka
and Maharashtra states. In CMDR Monograph Series (p. 43). Retrieved February 12, 2021, from
Proceedings of the 6th International Conference on Public Health, Vol. 6, Issue 1, 2020, pp. 18-31
WHO releases first guideline on digital health interventions. (n.d.). Retrieved October 24, 2020, from
World Health Organization. (2019). WHO Guideline: Recommendations on digital interventions for health
system strengthening. Retrieved December 26, 2020, from
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