In the age of technological advancement, collaborative E-healthcare emerges as a transformative system eliminating traditional location and accessibility barriers in healthcare services. Here, Searchable Encryption (SE) plays a key role in enabling healthcare providers to outsource encrypted medical data and search services to third parties like cloud servers, thereby reducing storage and management expenses. This intermediary approach poses challenges of single-point failure, privacy breaches, and potentially untrustworthy results. State-of-the-art public key-based SE methods use a cloud-assisted architecture that doesn’t support reliable and practical searches with fine-grained permissions. Also, such systems require additional support to address potential privacy leakages and ensure data availability at the storage server. To address these concerns, we propose a B lockchain-assisted E fficient and S ecure K eyword S earch (BESKS) scheme to enforce fine-grained keyword search privilege control while achieving practical search complexity. Our scheme employs a ciphertext policy attribute-based keyword search mechanism where keywords are encrypted using expressive access policies to build an inverted index structure. The encrypted indexes are stored on the blockchain while encrypted medical documents are stored on InterPlanetary File System (IPFS) nodes to enhance availability and ensure the reliability and scalability of our approach. Our scheme utilizes blockchain-based smart contract for efficient, secure search operations and ensures financial fairness in fine-grained searches. Search tokens are generated based on user attributes and query keywords to facilitate private searches on-chain. To enhance the search process, our secure index enables exact match for a query keyword in constant time to ensure expensive authorization operations are performed only once. Theoretical analysis suggests that our BESKS is more efficient and secure than state-of-the-art schemes. Prototype implementation results on the Ethereum blockchain network further validate its feasibility for real-world applications, demonstrating the scheme's practical applicability in collaborative E-Healthcare systems.