Times of India
17 April 2010
By Kanchan Gogate

The state government is set to make it mandatory for private hospitals to treat the poor free of cost. Some city hospitals say they are already doing it. However, healthcare activists are skeptical over effective implementation of the policy
Many of us might have had painful experiences of hospitals. Even cases of hospitals refusing to admit emergency cases sans down payment are not unheard of. Higher middle and higher classes apart, most sections of the society are deprived of basic healthcare facilities. While health–care is becoming a vital business, this disparity remains a reason to worry about.

Now, private hospitals would not turn out the poor. The state government is set to make it mandatory for them to treat the poor free of cost or at concessional rates. Hospitals can– not anymore find legal escape routes, says Bhaskar Jadhav, minister of state for law and judiciary. “Already, it was mandatory for hospitals registered under the Bombay Public Trust Act, which enjoy various government facilities such as getting land at cheaper rates. Private hospitals found an escape route earlier, wherein they would register themselves under the Bombay Public Trusts Act and later change it to the Companies Act. Now we are contemplating making an amendment in the act after which, hospitals registered under the Companies Act will also have to treat the poor free of cost or at concessional rates,” Jadhav explains.

How will the government go about its implementation? “When the law comes into effect, all hospitals will have to follow it. We will take stringent action against those flouting the rule. It's not something new that we are introducing. We are only widening its ambit. However, the plan is in a nascent stage and it's too early to discuss details. Once we come up with the law, we will think of implementation and monitoring. Under the Jeevandayi Scheme, charity hospitals are already doing it and we have ensured its successful implementation,” Jadhav says.

The state will set up a committee to monitor records at charity hospitals, Jadhav informs. “Doubts are raised over functioning of some charity hospitals. We will look into it through the committee,” he says. The issue was discussed in the state assembly where an MLA took up the matter of performance of charity hospitals alleging malpractices and tampering of records.

Meanwhile, healthcare activists in the city have hailed the move. It is responsibility of private hospitals to lend a helping hand to the poor, says Dr Vinay Kulkarni, trustee and medical director of Prayas Health Group. “Healthcare has become a business these days. Cases of some hospitals refusing patients, who are unable to pay, are quite common. Hospitals have social responsibility and let it become obligatory. At the same time, care should be taken that it is not harassing for doctors,” he says.

Some private hospitals in the city are already doing it. “I am attached to a leading hospital and have never witnessed any problem pertaining to poor patient. We must appreciate the efforts of those dong it. However, once the law comes into effect, there has to be proper monitoring and auditing,” Kulkarni says.

The government should check if all charity hospitals are doing it, feels Dr Abhijit Vaidya, cardiologist and national chief of Arogya Sena. “Charity hospitals get a lot of concessions and in return, they are supposed to do charity. But is there a tab on whether they are really doing it? There are incidents of records being tampered. The government should effectively implement the existing law before bringing private hospitals under its purview. It's government's responsibility to provide health care to the poor but I know some good doctors treating the poor free,” he says.

Over 80 per cent of country's populace is deprived of healthcare facilities, Dr Vaidya says. “The Union health minister recently went on record saying the country was short of over 20,000 primary healthcare centres. We have been ignoring public health for decades. That it is becoming a private business is alarming. It's high time the government acts. If private hospitals shoulder social responsibility, it's welcome.”

The poor are always deprived of facilities, says Sanyogita Dhamdhere, project coordinator with Centre for Advocacy and Research. “To avail the facility, they have to produce below poverty line (BPL) certificate. However, many of them don't figure in the BPL lists while many, who actually are not poor, do. The poor have no documents to support them. The government should consider this. Secondly, why give anything for free? Even healthcare should come at nominal charges,” she says.

Some private city hospitals claim they are already doing charity. We have a special charity department, says a medical social worker at Deenath Mangeshkar Hospital.

“Many poor are treated free. Admitting a poor patient has never been an issue with us,” she says.

Genuine cases are always considered, says a medical social worker at Ruby Hall Clinic. “We have medical social ward. When patients say they don't afford treatment, they are diverted to us. If the case is genuine, we consider for concession. Moreover, we have done deliveries of women in slums at nominal rates and also free,” she concludes.