Title : Public Services Through Private Enterprise Author : Malcolm Harper Published by : SAGE Publications India Private Limited M-32 Market, Greater Kailash - I, New Delhi - 110 048 Publication Date : March 2000 Pages : 370 Price : Rs. 450/- (Cloth)

Cigarettes and soft drinks are available in just about every village, everywhere. Clean water, primary education, or health services are not. What has gone wrong? Why is it that so many non-essential or even harmful products are so effectively distributed to every community that can afford them, and to many that cannot, while the things that people really need are so often difficult to get, or are not available at all?
 
Well, if you want to get the answers to all these questions and join the developmental debate then you must get hold of a copy of Malcolm Harper’s "Public Services through Private Enterprise: Micro-privatisation for Improved Delivery. This latest book coming off the shelf of Vistaar Publications, a division of Sage Publications, suggests a strategy to overcome what appears to be an otherwise hopeless situation – ‘micro-privatisation’.
 
Micro-privatization seems to be a pragmatic solution for providing efficient delivery of public services, which the governments of most developing countries have failed to deliver. Governments can hand over this responsibility to small private or community enterprises. This will not only reduce the cost of the delivery but also improve its quality, efficiency and outreach.
 
Malcolm Harper has presented 24 real life case studies to prove the economic viability and pragmatic feasibility of micro-privatisation. He has picked up actual cases from the Developing World (Asia , Africa and Latin America) as well as examples from the Developing World ( like USA and Europe) to demonstrate the efficacy of the strategy.
 
This informative document covers a broad spectrum of successful micro-privatization ventures in delivering services including urban services, utilities, agriultural serices, health and hygiene, transport, welfare and education. The analysis accompanying the case studies identifies the problems encountered and the solutions adopted.
 
For example, the book demonstrates the success of micro-private enterprises in delivering health and hygiene services -like the success story of TB treatment in Hyderabad, india.
 
TB, or Tuberculosis,is responsible for more deaths worldwide than any other infectious disease. Each year, eight million people develop TB and three million people die of the disesae. And, more than a quarter of TB patients live in India. On top of it , the National TB control Programme(NTP) of the the government of India does not reach most people. Secondly, the private treatment is very costly. So, WHO now advocates the Directly Observed Treatment System or DOTS. The patient has to attend a hospital or other health facility to take the medicine under observation by a trained worker.The difficulty with this system is that large numbers of convenient locations must be easily available for the benefit of TB patients and there must be a system to contact the patient immediately if he/she is not able to turn up.
 
To bridge this gap between the public and private medical services, trust hospitals were tapped as they occupy a middle ground between the state and private sector. Their entire network of private doctors and their nursing homes is now used and DOTS treatment centres have spread all over Hyderabad. This partnership involves the private doctors, nursing homes, the trust hospital and the government. The doctors have excellent access to the community, and are able to refer suspected TB ptients to the hospital. The trust hospital provides high quality diagnostic tests, and organises the whole system, the nursing homes provide the DOTS centres, and the government provides a regular supply of free medicines. Hence, the new approach is known as PPM DOTS, or private Public Mix DOTS.This system is really effective as it not only saves the patient’s money, but also prevents the spread of TB. It is really a win-win situation.
 
All in all, this book is a must for all the development agencies, whether grassroots NGOs or international development agencies. It will also be of particular interest to those engaged in the fields of rural development, urban management, public administration, community development and enterprise management. 

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