India, Jan. 7 -- The Punjab government's recent initiative to empanel private specialists in public health facilities, offering Rs.100 per OPD patient and Rs.1,000 per emergency call, has sparked off a debate. While the administration views this as a solution to the chronic shortage of specialists, the Punjab Civil Medical Service (PCMS) Association sees it as a step toward privatisation. This experimental approach highlights a deeper systemic failure: The erosion of a once-robust secondary healthcare tier.

Punjab's healthcare structure is built on three levels, each facing distinct challenges. Primary care comprises sub-centres and primary health centres (PHCs), many of which have been rebranded as Aam Aadmi Clinics (AACs). While they h...