Development of the capacity of the government health service infrastructure as reflected in strategy No. 1 does not mean that the government should continue to be responsible for the overall health care system of the country. It is timely that the government reorientate its role to that of policy maker whose major task is to monitor health development to ensure that it is proceeding in the desirable direction. Following this principle, the government should limit the growth of its health service infrastructure and reorientate its role as follows :
1. Developing mechanism for health policy formulation and monitoring its implementation in the desirable direction
The government should strengthen intersectoral collaboration for overall national development (not just the health sector) with the aim of incr
easing the quality of life of the population. It should also set desirable directions for the public and private health care authorities in providing essential services for the benefit of the general public.
This includes formulating guiding principles for utilization of medical technologies and equipment and criteria for their use, strategies for appropriate distribution of medical equipment based on real needs and problems in order to make the best use of expensive technologies without affecting the overall national economy. Most importantly care must be taken to avoid a burden being placed on the people by the unnecessary use of expensive technologies or equipment.
2. Reorientate the role of the government in regard to the national health expenditure
To control the rapidly increasing health expenditure and make sure that health services are cost-effective, the following actions should be taken :
- reorientate the government budget allocation system for health care services, which used to follow programme budgeting principles, and make it more effective by taking into consideration the achievements against target of each health care organization as one of the criteria for budget allocation.
- Enhance the role of the government in monitoring the cost of health care services provide by both the public and private sectors by developing an accountable system to designate ways and means to purchase services whose costs are to be covered by the government while stipulating precise guiding principles for services whose costs are to be covered by the patients themselves.
3. Reorientate the role of the government in monitoring its own health service institutions.
Government hospitals and health centres should be given more freedom in managing their own operations which could help increase efficiency in financial and personnel management while continuing to render essential health services in accordance with the national health policy and receive a regular government budget. If the government could reorientate it role from health service provider to purchaser of quality services, it would then create healthier competition between public and private hospitals with respect to quality and efficiency.
