Critique on the Private Health Sector Regulatory Framework in Sri Lanka

Abstract

Introduction: Many governments have permitted private providers to invest in health care, as a cost sharing effort. However, it is essential to assure the reliability, quality and safety of their service provision. Therefore, Regulations have been set out and supervised by regulatory bodies to improve quality, safety and effectiveness of care. In this regard, Sri Lanka has enforced the “Private Medical Institutions (Regulation) Act- No 21 of 2006” which is the foundation for the private health sector regulatory framework. Description: Private Health Services Regulatory Council was formulated for the regulation, registration, monitoring and inspection of private medical institutions and facilitate their development. Many functions are in operation to accomplish its objectives. Feeling: I feel contented about the well formulated and enacted regulatory framework; and rapid expansion of private health sector in infrastructure and in high technology; however, I feel unhappy about not having a proper mechanism for performance evaluation and disciplinary actions for any malpractices; and about weaknesses in coverage of registration. Evaluation: Presence of a Private Medical Institutions (Regulation) Act, regulatory framework and a Regulatory Council; clear objectives, multidisciplinary stakeholders; involvement of the Provincial Director and Regional Directors, formulating guidelines, Quality Assurance programs, and Health Information Management System were identified as good. Monitoring for registration of GP centres; dealing with malpractices; attending public complaints; performance evaluations; fulltime medical staff and Health Information System seemed to be not satisfactory. Analysis: Some factors such as legislative power; participatory decision making; improved accountability and responsibility; availability of network of field officers; and aiming at a standardized system have positively impacted on the performance of private sector. At the same time, inadequate fulltime medical personal, resistance of labor unions; taxation issues; inadequacy of resources and coordination have negatively impacted. Conclusions: Private health sector regulatory framework has shown both strengths and weaknesses in implementation. Recommendations: Recommendations were suggested to strengthen development of permanent medical staff, monitoring over registration and operations, performance displaying, implementation of penalties for malpractices, maintenance of Health Information System, and price stability.