Pharmacy was all owned by the government at the end of 1990’s. Constitutional democracy was established in 90’s. Second long term health plan was from 1996 to 2016 to promote the private sector. Nepali people are willing and capable to pay for it. This assumption is a world bank language.
People don’t value free things, it’s a saying. The cost of the private health sector is very expensive. Irrational use of services and technology and the gap between rich and poor. Srilanka has a public health sector which is very strong.
Private sector foot print in Nepal
The whole issue is very much focused on the private sector. Marketization in health in Nepal. In my generation when I was your age I never saw a private hospital in Nepal.
Everywhere you can see private hospitals in many other cities in nepal. How the private sector was settled in Nepal. Before Nepal shifted to a multiparty political system. In monarch time, Nepal was not open to the global market. We had health operative transport operative and collective health owned by the state even if the pharmacy were owned by the state. The service provided by the state was extremely limited. People used to go abroad for the services. A lot of people used to go to India, especially the Southern part. There were very few public facility institutions. There was no market and public escort was inadequate. Almost until the late 80 and the beginning of the 90s. Nepal was shifted and the monarch was brought in the constitution. The Constitution was active for the monarchy. We had political democracy liberty. Democracy in economy. The private sector was very active to establish themselves, this was the time to expand the international market. And that was the time when an NGO was allowed to establish in the company. Then we had to register for an NGO in the 90s. There was a huge massive growth of NGOs and the private sector. And the government very much promoted the private sector in health in Nepal. This was 20 years 2nd long term health plan. 1996 to 2016
was also the time to end MDG. These documents are very openly proved by the private sector.
How was the private sector justified in Nepal?
This is not the theory developed by one agency. The whole assumption and background was that Nepali people are willing and capable of purchasing health services. It has clearly prompted the private sector and this is a background on how private market health was established in the country. There was an interesting coincidence and internal Nepal was open to liberal economy, there was social, political and economic globalisation. Because technology was imported. There was one pharmaceutical industry owned by the public pharmacy. It produced medicine very cheap and powerful. In the mid 70s and late 80s diarrhoea was a problem and there was a debate about homemade med. They were almost trying to replace the market and this company produced a very powerful solution. It was 1rs per packet. Its name was jibanjal. Today we don’t know the number row pharmaceutical in Nepal. Market economy theory has taken the permission from the ministry and industrial sector like any industry. When the private sector is established the fundamental is that in Nepal the patients are converted into consumers. And health services are covered in commodities. The market does not recognize health right equity and social justice like any commodity health services are sold in the market to those who are capable of purchasing the services, those who cannot purchase the service they are not allowed to use the service and it has created the gap between rich and poor. The gap between urban and rural areas. It’s all because of market theory because the poor cannot afford it. State is not able to supply the demand of the people and that gap is filled by the market. Therefore, the market is increasing. The people have more fate in private compared to the public. There is increasingly consumerism. People go to the clinic and say prescribe me MRI. The death of people is increasing and this encourages the private sector to grow. The reason for that is the cost of services. Very high compared to the public sector, for delivery it cost 1 and 2 lakh or more. Dental is also expensive. Irrational use of services and technology. There is no standard protocol of treatment for any disease.
Open House Discussion
Health rights are violated by the government and as well as the people of the country.
If people are still paying for the basic services because it’s a violation of human rights. I think the court is not active in this case.
Regarding the medicine it’s not compulsory but they impose the trademark. They don’t prescribe from the general place. Those trademark medicines are only available in their company because of the trade mark of the company.
Date: 19th May 2023
Open House Discussion
What should be changed on policy level?
If there is a complaint in these hospitals where do they go?
CDO members will negotiate.