Private Sectors in Mental Health Service System Essay
A human rights approach assumes that states are responsible for shaping and implementing the delivery of health services to assure consistency with human rights requirements. However, in the contemporary health landscape, health services are increasingly delivered through private health sector institutions, and governments lack direct control over some or many components of the health system.Private Sectors in Mental Health Service System Essay As the World Health Organization (WHO) observes, “Private provision is a substantial and growing sector that is capturing an increasing share of the health market across the world.”1 Today, private health institutions and providers play a major role in both developed and developing countries. Even the National Health Service in the United Kingdom, long an icon of state-funded universal health care, is currently undergoing major structural changes, opening services up to competition with the private sector, ostensibly to improve efficiency.2 Private provision of health services does not change the role of the state as the ultimate guarantor of the realization of health rights obligations, but it makes implementing its responsibilities more difficult. Fragmentation of the health system complicates oversight and the promotion of a rights-based approach to health. Segmentation of the health system, with a poorly functioning public sector catering primarily to the poor and better quality private health institutions catering to the more affluent, tends to undermine support for investing in improvements in institutions for the public provision and financing of health care and likely erodes commitment to the right to health as well. Additionally, the goals and priorities of private health care institutions tend to differ, often significantly, from the values and norms in the human rights paradigm. Working effectively with and through private-sector providers also requires management skills and complex health information systems that many governments, particularly those in poor and middle-income countries, often lack.3Private Sectors in Mental Health Service System Essay
To date, the issues that private-sector health provision raises for the right to health have received little systematic attention from those working on health and human rights issues. As will be discussed in a later section of this article, international human rights law does not specify how health care services should be delivered or paid for as long as the health care provision is consistent with human rights obligations. Although some UN human rights treaty body committees have acknowledged that reliance on private health care may be problematic, they have generally not been inclined to offer guidance at the level of depth and complexity it requires. The few human rights specialists who have addressed the subject have differed in their views.4
This article uses a human rights lens through which to evaluate private-sector health services provision and the privatization of health care. It explores the extent and ways in which privatization of health services potentially is and is not compatible with human rights commitments. It also considers other ways that an expanding or dominant role for the private health sector can complicate efforts to promote and protect the right to health. Additionally, the paper identifies factors and policies that can mitigate or exacerbate the impact of private health provision on the realization of the right to health.
Private health sector provision
Private-sector health delivery covers many different realities. It includes both for-profit commercial companies and not-for-profit actors and institutions. It incorporates faith-based and other non government non-profit organizations, as well as individual health care entrepreneurs and private for-profit firms and corporations.5 It may also entail private sources of financing, such as shifting from public funding of health to private health insurance. In some countries with well-developed public health systems, private health provision plays a relatively minor and supplementary role, but in some others there are extensive networks of private providers for ambulatory, hospital, and in-patient care. In developed countries, private provision usually entails care by well-trained medical professionals in settings with sophisticated equipment.6 In contrast, in many poor countries the private sector is diverse and fragmented. In these countries, the private health sector is likely to be dominated by informal for-profit and small-scale providers, most of whom who are unlicensed, unregulated, unsuspected, and frequently untrained in modern medical practice.7 In low-income countries in Asia and sub-Saharan Africa, small-scale private provision dominates outpatient care, while public provision tends to be the rule in hospital in-patient services. Individual entrepreneurship is also prevalent in middle income countries, but large private firms, including multinational corporations, are capturing a growing share of the market, particularly the high-income segment, and increasingly competing for contracts with public and social security systems.8Private Sectors in Mental Health Service System Essay