Govt rates unhealthy, claim irate hospitals

Doctors across country say payments under CGHS are unrealistic, ask Centre to revise rates or threaten to stop cashless treatments

The Central Government Health Scheme (CGHS), started to provide comprehensive medical care facilities to Central government employees and pensioners, has run into difficulties again, with hospitals saying rates under the scheme are “ridiculously low". After a recent meeting in Hyderabad, the Association of Healthcare Providers India (AHPI) has given an ultimatum to the Centre to revise rates, threatening to stop cashless treatment of patients if it does not do so.

Dr Alexander Thomas, CEO of Bangalore Baptist Hospital and vice president of AHPI, said, "We are having discussions with the government and so far it is looking positive. The rates they are offering us are extremely poor and less than cost prices in some cases. If this continues, we will stop cashless treatment under CGHS."

Dr Mangesh Lingayat, director of Noble Hospital in Hadapsar, said, “A consultant gets Rs 58 per patient in the OPD and Rs 70 per surgery. For all surgeries, the rates are only 30–40 per cent of the actual cost. For instance, the normal price of an X–ray is Rs 350 — the scheme offers us Rs 70. Electricity costs, consultant fees, helpers fee apart, the Xray film itself costs Rs 90," he said.

The recent meeting was attended by representatives of over 400 super speciality hospitals from 23 states, including city–based Ruby Hall Clinic and Jehangir Hospital. Besides the low rates, hospitals also reported delays in payments and huge pending dues. Rates were last revised in November 2010. At present, the government owes Rs 3 crore to Ruby Hall Clinic, Rs 1.75 crore to Jehangir Hospital and Rs 52 lakh to Noble Hospital in Hadapsar. “Doctors don’t want to operate on these rates, but they still do," said Bomi Bhote, CEO of Ruby Hall Clinic. Raju Pardeshi, recovery head at Jehangir Hospital, said, “We do not refuse to treat patients, but meeting expenses is a problem."

Bhagali Hospital and Nursing Home in Bibvewadi has surrendered its CGHS empanelment. “The pay consultants get is even lower than an electrician or a plumber. The scheme is a farce," said Dr Nitin Bhagali, the hospital’s owner.

A CGHS offical in Pune agreed, saying, “Hospitals here so far have not filed any complaints but rates are highly unrealistic. A superspecialist doctor is given just Rs 58, whereas his fee is anywhere between Rs 700–1,500," he said, on condition of anonymity. R K Jain, additional secretary and director general of the CGHS Ministry of Health and Family Welfare, had no comment.