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Privatisation of hospital cleaning, Orissa
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Subject Area="Infrastructure and Equipment." Objective="Clean and hygienic health facilities."
Details for Reform Option "Privatisation of hospital cleaning, Orissa"

Background: Cleaning of hospitals by government class IV staff has often been unsatisfactory. It involves huge personnel costs, with unmotivated cleaners and poor outcome, and has compromised hygiene. Action: Government of Orissa contracted private providers for cleaning services in a few hospitals. In the beginning, this option involved higher than average costs as existing workers could not be dismissed, but the outcome was well received and more hospitals are now demanding privatisation of their cleaning services. As a consequence, vacancies of class IV staff have been frozen, and staff are being re-deployed to prepare the way for more outsourcing. Results: Proper maintenance of hospitals; proper management of waste and better care for patients and their attendants.

Place Selected government hospitals in Orissa, from July 1997. Firstly as a pilot project in Capital Hospital, Bhubaneshwar, later at SCB Medical College, Cuttack, MKCG Medical College, Berhampur, and subsequently at 4 other district hospitals.
Time Frame Several months, depending on time taken to identify and engage contractor.

Cleanliness: More hygienic conditions leading to fewer hospital infections. Cost-effective: More cost-effective method of cleaning because of the introduction of competition.


Costs: May involve higher personnel costs in the beginning due to re-deployment of existing class IV staff. Supply: Possibility of insufficient contractors in the remoter areas. Conflict: Possible union opposition.


Sufficient funds to cover initially elevated personnel costs if current cleaning personnel cannot be re-deployed. Sufficient local skills to negotiate and manage contracts. Establishment of a tender procedure to ensure the best contractor is selected.

Who needs to be consulted

Hospitals, unions, state government.



It will sustain if funds are available to pay the contractors.

Chances of Replication

This scheme is currently (August 2004) being extended on an experimental basis in more districts of Orissa and security services in Capital Hospital, Bhubaneshwar, and several other larger hospitals have also been contracted out.


Orissa State Government has now decided (August 2004) that the costs of cleaning and sanitation are to be made out of user charges. It is proposed that catering and laundry services should also be contracted out.


Submitted By

Dr. Matthew Jowett, Former Programme Adviser, European CommissionTechnical Assistance Office, New Delhi. July 2002. Updated August 2004.

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