Kerala Association of Small Hospitals and Clinics, a brave model to challange Corporates in Health Sector – Sandhya S.N & Praveen Pilassery


Another brave Kerala model to fight corporate giants in Health sector broods to prosper. 2000 small hospitals, clinics and specialized clinics decided to form Kerala Association of Small Hospitals and Clinics. The studies in the field revealed that since 2005 around thousand clinics were closed in Kerala due to cut throat competition created by big hospitals. Around five thousand beds were lost due to this closure. These hospitals played a vital role in ensuring health facilities in non-urban areas of the State. The loss is suffered by the common people as the customers of these hospitals are primarily from the middle class section. .

Kerala is recognized for its developments in the health and education sector. It is usually told that within a Kilometer area, Kerala has 2 hospitals and educational institutions. The clinics and small hospitals though limited in the facilities were the only option of the people in the rural areas for their health issues. Doctors in these institutions guided them to specialty clinics or medical colleges when needed.  The treatment charges in these small clinics and hospitals were affordable to the common people.  As most of these hospitals were run by family or employees trusts, profit was comparatively a lesser objective to them. They acted as referral centers to Govt. hospitals in an emergency  Often State recognized the importance of these hospitals too. Health Department ensured the participation of these small hospitals and clinics in all their campaigns.

Globalization over the past two decades has affected a wide range of sectors, directly or indirectly. The process of globalization has led to the emergence of new forms of business opportunities, processes, and organizations.  Public health is an obvious casualty of this process. There is a clear contradiction between the principals of public health and neo-liberal economic theory. Public health is a “public good”, i.e. its benefits cannot be individually enjoyed or computed, but have to be seen in the context of benefits that are enjoyed by the public. Thus public health outcomes are shared, and their accumulation lead to better living conditions

But the globalized economic policies rather viewed health as a private good that can be accessed through the market. This market oriented policies attracted corporate giants to capture the health section to a large level. Huge multi-specialty hospitals were established in all parts of Kerala. These hospitals hired experienced staff from government as well as small private hospitals. As a commodity to advertise, hospitals were largely advertised in large banners in highways and tv channels. Through advertisement they attracted customers. Corporate hospitals offered special package schemes for treatment which included diagnosis, lab testing, treatment etc. Also health insurance sector largely supported the business of corporate hospitals which created a unhealthy situation of high jacking the public health sector of Kerala.

The conventional hospitals in the rural areas declined in this corporate health commodity service storm. Several small hospitals in the vicinity of corporate hospitals were either closed down or starved to death. This situation emerged to a new platform of consortium of small clinics and hospitals and decided to join hands and operate as a single entity. To be frank they hardly had any choice.

Though the association of these hospitals to fight corporate giants and to strengthen the health sector by making it affordable to common man is largely appreciable, it should be reminded that it would not be so easy. These hospitals need to provide uniform charges for treatment and the facilities they offer. Sharing of staff and facilities and simultaneous sharing of revenue, digital networking to make online the treatment reports etc. should need better planning.

Ensuring absence of groupism and lobbying would be a great challenge to the organizers as in every struggle against corporates. They need a third eye to spot the infiltrate in the movement. Finally co-ordination of these thousands of clinics and hospitals across the State is a tedious task. But if it succeeds, it would be a model to the entire world to demonstrate.