Effective public-private partnership in healthcare: Apollo as a cautionary tale
Very few in the medical fraternity, if any, would have been surprised by the Delhi High Court panel finding that Apollo Indraprastha Hospital, New Delhi was not honouring its mandate to provide 33% of its beds free of charge to the poor and indigent. In 1986, the Delhi Administration invited proposals to establish a multidisciplinary, super speciality hospital on “a no profit no loss” basis. Two years later, the government leased prime property to the Apollo Hospital Group (AHG) on a token payment of one rupee a year, to set up the Indraprastha Hospital. The hospital is a joint venture with the Delhi government. By the terms of this agreement, the government provided 15 acres of land and Rs 16 crore. In return, the AHG agreed to provide free services to patients occupying at least one third of its 600 beds and to 40 per cent of those seeking outpatient care . A landmark public-private partnership (PPP) was thus embarked upon. A review of the terms of agreement clearly indicates that the expectation and agreement were not for the AHG to render “charity” or even to engage in corporate social responsibility. Rather, the Delhi Administration had established a legal obligation for the AHG to provide certain clearly specified services for its citizens in return for a substantial financial subsidy to the company. In practice, the AHG failed to provide any such service.
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