Times of India
12 March 2011
By Umesh Isalkar
Pune, India

After Charity Commissioner’s Warning Five Fell in Line, Three Told to Show Cause, Two Faced Criminal Cases
When the Bombay high court framed the public benefit scheme for free and concessional treatment a few years ago, it was to help the poor gain access to the state–of–art facilities offered by private charitable hospitals.

An inspection of eleven private hospitalsin thecity by thejointcharity commissioner in the last six months has revealed that they had been violating norms and not extending the desired level of services to the needy. A few hospitals were found to be hiding their status as charitable hospitals, while medical administrators of some hospitals even asserted that they were totally unaware about the scheme.

While one hospital followed almost all the norms of the scheme, five others fell in line after the inspection.
In the action that followed against the rest, three hospitals were served show–cause notices, while two hospitals had to face criminal cases for not making sufficient arrangement for poor patients despite a charitable trust status and availing of governmentconcessions.

"Since August 2010, we have inspected a total of 11 private hospitals. Most were found to be violating the norms of section 41 AA of Bombay Public Trust Act, 1950 which aims at providing free andconcessionalhealthservices to poor patients through charitable hospitals. While a few hospitals complied after we carried out the inspection, a few were served show–cause notices for not adopting the measures. In the case of Sahyadri Hospital and Ruby Hall Clinic we had to file criminal cases as they ignored repeated warnings to render free and concessional medical services to the poor," said joint charity commissioner U N Dikkatwar.

Authorities of both hospitals said they did take in poor patients and provide them with treatment. Bhomi Bhote, CEO of Ruby Hall Clinic, said the hospital earmarks Rs 6 crore in its budget every year to be spent on charity. "We have been spending this amount on poor patients and their treatment. However, there is ambiguity in the indigent patients fund (IPF) scheme itself. We have written many letters asking for clarification as well as interpretation. We have not got any proper or satisfactory reply," Bhote said.

There are other pitfalls, he added. "One among them is that we don't get eligible patients with ration cards that indicate an income below Rs 25,000 per year for treatment. Most cases that we get are with forged ration cards. They are not eligible for the scheme at all," Bhote said.

TheCEOclaimedthatthey havebeen filing returns of the charity work done by the hospital every month. "We have been doing it diligently and they (charity commissioner's office) have never pointed out any mistakes. All of a sudden, they filed a charge sheet. We have replied to it, but there was no correspondence after that. We also send them the annual budget that slots the charity work scheduled for the year. The charity commissioner's office has never raised any objection."

When contacted,SadanandBapat,director (finance)of SahyadriHospitalsaid, "Thecharity commissioner'sofficefiled a criminal case against the hospital for notcreating IPF.WedohavetheIPF.However, the two per cent of revenue generated from the patients was not included in it."

The public benefit scheme was framed by the Bombay High Court and its implementation started in September 2006. Under the scheme, all charitable hospitals have to earmark and reserve 10 per cent beds for indigent patients and 10 per cent beds for economically weaker section; treatment for indigent patients is to be free. Two per cent of the gross billing of paying patients should be put aside to create Indigent Patient Fund (IPF) under the scheme.

The city has 49 private charitable hospitals. They get additional FSI, concessions in water, power, customs, octroi duties and sales and income taxes.

The inspected hospitals were found to be at fault on other parameters too. Most had not put up a display board abouttheschemefor the poor at vantage points.

Except for one hospital, none had a display board indicating occupancy of earmarked and reserved beds for poor patients. Many hospitals had not maintained transparency in funds created for free and concessional treatment of poor patients.They had not maintained a register marking the entries of such patients.Somewere noteven awareof such a scheme, officials said.

"Despite sending copies of the scheme, one hospital feigned ignorance about it. Another claimed that since its management has been transferred to another hospital,they wereexemptfrom it. We have asked them to fulfil the norms," said the official.