A “white paper” exploring how India and the UK can work more closely together as a partnership of equals to improve primary healthcare for both nations is published on bmj.com today.
It sets out a number of opportunities for collaborative action of benefit to both nations, that build on India's plans to achieve Universal Health Coverage: strengthening primary care in India and bringing expertise and innovations from India to improve care in the UK.
The paper will help guide the India-UK CEO Forum, established by the British and Indian prime ministers in 2010 to help increase trade and investment between the UK and India and promote greater collaboration.
Health was identified by the Forum as one of the priority areas for the two countries to work more closely together and today’s paper builds on this approach. It has the support of several leading organisations including the Government of India Ministry of Health and Family Welfare, and the UK Department for International Development.
In the paper, Mala Rao, Professor of International Health from the University of East London and David Mant, Professor of General Practice from Oxford University outline a strategic analysis and then a set of partnership opportunities, which include:
Collaborative training in primary care across health disciplines
Enhancing the status of primary healthcare in India using the experience of the UK’s Medical and Nursing Councils and the Royal College of General Practitioners
Developing affordable medical technologies that draw on the respective strengths of India in technological innovation and the UK in technological assessment and evaluation.
Developing public-private partnerships using the experience of the UK National Health Service which has always commissioned primary care from independent contractors.
Helping develop quality standards and governance arrangements for primary care with inputs from organisations such as the UK National Institute for Health and Clinical Excellence and the Department for International Development
Collaborative research and development of primary healthcare models, staffing solutions and technologies
They end by suggesting specific actions for the Forum, including the development of primary healthcare exemplars with UK support in a small number of Indian states, and building on existing strengths such as India's present health delivery infrastructure as well as its world leading generic pharmaceutical industry. The exemplars could then be used to guide scale up across other states, and joint exploration by the India and UK governments of collaborative and commercial opportunities that could arise from the partnership.
In an accompanying editorial, Professor Lalit Dandona, Director of the Wellcome Trust Capacity Building Programme at the Public Health Foundation of India, and Professor Jagdish Prasad, Director General of Health Services at the Government of India, say it is essential that primary healthcare in India is strengthened “because many basic health indicators continue to be poor.”
They believe that a UK-India partnership “offers promise if it connects with existing efforts and stakeholders” but say those involved in implementing the proposed activities must keep several issues in mind.
For example, the need to complement existing efforts and to assess the benefits of these activities to society, the need to engage the medical and academic communities as well as private providers and policy makers, and the need to explore commercial opportunities wisely “so that commercial interests do not outweigh the partnership’s goal of working for the public good.”
Finally, they say the partnership has to be one of equality. “The Indian and UK parties will have different, probably complementary, skills to offer to the partnership, which if harnessed with mutual respect would have the best chance of successful outcomes,” they conclude.
Analysis: Professor Mala Rao, Institute for Health and Human Development, University of East London, London, UK
Editorial: Professor Lalit Dandona, Public Health Foundation of India, New Delhi, India