First, Do No Harm: Examining the impact of the IFC’s support to private healthcare in India

By Anjela Taneja and Amitabha Sarkar, Oxfam International, 26 June 2023

This report examines the support to private healthcare provision in India by the World Bank’s private sector arm, the International Finance Corporation (IFC). Despite supporting private healthcare in the country since 1997, no healthcare results for lending and investments have been disclosed since the start of these operations over twenty-five years ago.

The IFC has overwhelmingly invested in high-end urban hospitals which are out of reach for the majority of Indians. Several have consistently failed to provide free healthcare to poor patients despite this being a condition under which free or subsidized public land was allotted to these hospitals. Supporting private healthcare in a context where 37% of Indians experience catastrophic health expenditures in private hospitals appears to run counter to the World Bank Group’s focus on poverty reduction. These investments do not contribute to the building of stronger healthcare infrastructure or respond to unmet healthcare needs.

Only 14% of IFC-financed hospitals are located in the 10 states ranked lowest in terms of the overall performance of the health system. Furthermore, we found many instances where regulators upheld complaints pertaining to violations of patients’ rights by these hospitals including overcharging, denial of healthcare, price rigging, financial conflict of interest and medical negligence. The IFC does not acknowledge or engage with these recurring and systemic problems in its public disclosures. The report recommends that the IFC immediately stop all new investments in private hospitals and clinics in India until existing investments and operations in this sector are independently reviewed and a robust, transparent, and accountable framework is put in place to ensure that all projects and investments are equitable, geared towards meeting unmet healthcare needs, promote, and protect patients’ rights and strengthen the public system.

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