Making Private Health Care Accountable: Mobilising Civil Society and Ethical Doctors in India

Abstract

Though the private sector dominates health care in India, it lacks social accountability and effective regulation. Hence, health activists and health-care professionals have adopted a three-pronged approach of mobilising civil society for patients’ rights, networking with ethical doctors towards social responsiveness, and advocating with government for accountable regulation. Health movement strategies adopted mainly in Maharashtra State include organising a regional public hearing in collaboration with the National Human Rights Commission; developing ‘Citizen–Doctor Forums’; mobilising citizens around patients’ rights through a ‘people’s poll’; and campaigning for people-oriented regulatory legislation. A national network of doctors is also being developed to promote ethical health care. Key lessons include: identifying patient rights as popular idiom for citizens’ mobilisation, relevance of ethical voices within the medical profession to complement social accountability of private health care, potential of moving beyond citizen–doctor adversarial positions to promote accountable health-care options, and placing participatory social regulation on the agenda.