Defining the private health sector necessitates a clear understanding of the concept of service delivery, types of private health actors and characteristics of the private health sector. The private health sector is the individuals and organisations that are neither owned nor directly controlled by governments and are involved in the provision of health services. It can be classified into subcategories as for profit and not for profit, formal and informal, domestic and international.
There is increasing recognition of the private health sector within mixed health systems. However, private health sector recognition, scope, and definition are not consistent across health system stakeholders. The private health sector also referred to as ‘non-state actors’ — includes all actors outside the government. While the sector is used to distinguish public from private orientation, in practice the private sector is less bounded and “generally large, poorly documented, and very heterogeneous”. It consists of both formal and informal providers ranging from drug shops to specialised hospitals. The role of the private sector within mixed health systems can take a virtuous form, where competent health systems generate a “complementary, reasonable-quality private sector” in contrast, the private sector may take on less scrupulous forms, if left unregulated.
Consumers may also seek services outside of the formal health system, such as through informal static, itinerant or digital dispensers of health products and services. These forms of care challenge traditional boundaries of health systems, precisely because they are often unbounded or unrecognised by the government.
Characteristics of the private health sector
Common characteristics include:
• Ownership: The private health sector works outside the public health sector and outside the direct control of the state. They are non-state actors who are not owned or controlled by governments but instead owned by individuals, families, or corporations.
• Motive: The aim of the private health sector may be philanthropic or commercial and comprises of for-profit and not-for-profit entities. The not-for profit organisations further include faith-based organizations (FBOs), non-governmental organisations (NGOs) as well as civil society organizations (CSOs).
• Training: Based on the training that the service providers receive, the private health sector may include formally trained providers (pharmacists, doctors, nurses, and midwives) or informally trained providers (traditional healers, eastern medicine, alternative medicine, etc). Many countries rely heavily on informal providers and they tend to constitute a large group. For health interventions to be successful, it is important to understand and acknowledge their role within the health system.
Why do people prefer to go to private health?
In underdeveloped countries, the preference for private health facilities over public ones is driven by various factors that often relate to the quality, accessibility, and reliability of healthcare services. Here are some key reasons why people tend to favor private healthcare in these regions:
Quality of care: One of the primary reasons people prefer private health facilities is the perceived higher quality of care. Public health systems in underdeveloped countries often suffer from underfunding, leading to inadequate facilities, outdated equipment, and shortages of essential medicines. In contrast, private health facilities, though more expensive, tend to offer better-maintained infrastructure, modern medical equipment, and a higher standard of cleanliness and hygiene. For instance, many private hospitals in Pakistan are known for their superior diagnostic capabilities and treatment options compared to their public counterparts.
Availability of services: Public health facilities in underdeveloped countries frequently face issues such as staff shortages, limited operating hours, and lack of specialized services. Private health facilities, on the other hand, often provide a wider range of services, including specialized care that might not be available in public hospitals. For example, in countries like Pakistan, private hospitals often offer advanced treatments and specialist consultations that are not readily accessible in public hospitals.
Shorter wait times: Long wait times are a common problem in public health facilities due to high patient volumes and limited resources. In contrast, private health facilities usually have more manageable patient loads, allowing for quicker access to medical consultations and treatments. This is particularly important for patients needing urgent care or elective procedures. Patients might wait months for surgery in a public hospital, whereas private hospitals can often schedule surgeries within days or weeks.
Personalized attention: Private health facilities often provide more personalised and attentive care. In public hospitals, the high patient-to-doctor ratio can result in rushed consultations and less individualized attention. Private healthcare providers can afford to spend more time with each patient, ensuring thorough examinations and tailored treatment plans. This personalized approach can significantly enhance patient satisfaction and trust in the healthcare system.
Perceived reliability and trust: In many underdeveloped countries, public health facilities are often perceived as unreliable due to frequent issues such as corruption, mismanagement, and inconsistent service delivery. Private health facilities, driven by profit motives and competition, often strive to maintain higher standards of reliability and trustworthiness. For example, in countries like Pakistan and Bangladesh, private hospitals are often viewed as more dependable for critical and emergency care.
Better infrastructure and amenities: The infrastructure and amenities available in private health facilities are often superior to those in public hospitals. Private facilities typically offer more comfortable accommodations, better food, and a more pleasant environment, which can be crucial for patient recovery and overall experience. This is particularly appealing to middle and upper-class individuals who can afford to pay for better services.
Access to international standards: Many private health facilities in underdeveloped countries are affiliated with international healthcare organisations or follow international standards of care. This affiliation can provide access to advanced medical practices, training, and technologies that are not available in the public sector. For example, some private hospitals in countries like Kenya and the Philippines are part of international healthcare networks, offering world-class treatment options.
Public health facilities
While public health facilities are essential for providing affordable healthcare to the broader population in underdeveloped countries, the advantages offered by private health facilities make them a preferred choice for those who can afford them. The combination of higher quality care, better availability of services, shorter wait times, personalized attention, and overall reliability contributes to the preference for private healthcare. However, it is crucial to address the disparities between the public and private sectors to ensure equitable access to quality healthcare for all.
In developed countries, the preference for private health facilities over public ones is influenced by several factors. These factors often revolve around the quality of service, efficiency, and overall patient experience. Here are some key reasons why people tend to favor private healthcare:
Shorter wait times: One of the most significant advantages of private health facilities is the shorter wait times for consultations, treatments, and surgeries. Public health systems, despite their extensive resources, often face high demand, leading to longer waiting periods. In contrast, private facilities can offer quicker access to medical services, which is particularly crucial for patients requiring timely interventions.
Advanced technology and facilities: Private health facilities often have the financial capability to invest in the latest medical technologies and state-of-the-art equipment. This access to advanced technology can lead to more accurate diagnoses, more effective treatments, and overall better outcomes for patients. The allure of receiving care in a technologically advanced environment is a strong motivator for many individuals.
Personalised care: In private healthcare settings, patients frequently experience a higher level of personalized attention. Doctors in private facilities often have more time to spend with each patient, allowing for more thorough consultations and tailored treatment plans. This personalized approach can significantly enhance patient satisfaction and trust in the healthcare system.
Choice and flexibility: Private healthcare offers patients more choices regarding their healthcare providers. Patients can select their preferred doctors, specialists, and hospitals based on their specific needs and preferences. This flexibility extends to scheduling appointments at convenient times, which is particularly appealing to those with busy lifestyles.
Comfort and privacy: The environment of private health facilities is often designed to provide a more comfortable and private experience for patients. Private rooms, better amenities, and a more pleasant atmosphere contribute to a more positive experience, which can be important for both physical and mental well-being during medical treatment.
Efficiency and management: Private healthcare providers often operate under business models that prioritize efficiency and high standards of service. The competitive nature of the private sector encourages continuous improvement in service delivery, management practices, and patient care standards. This focus on efficiency can lead to better overall patient experiences and outcomes.
Perceived quality of care: There is a common perception that private healthcare offers higher quality care compared to public health systems. This perception is fueled by the factors mentioned above, as well as the reputation of private institutions for providing top-tier medical services. While public health systems are often highly capable, the perception of superior care in private facilities can drive patient preferences.
While public health facilities play a crucial role in providing accessible and affordable care to the broader population, the advantages offered by private health facilities in developed countries make them an attractive option for those who can afford it. The combination of shorter wait times, advanced technology, personalized care, and overall efficiency contributes to the preference for private healthcare. However, it is essential to recognise the value of both sectors in creating a comprehensive healthcare system that meets the diverse needs of the population.
The author, Nazir Ahmed Shaikh, is a freelance writer, columnist, blogger, and motivational speaker. He writes articles on diversified topics. He can be reached at nazir_shaikh86@hotmail.com