Treatment for poor not free: Study….Kanchan Srivastava
Benevolence of duty officer in public hospitals determines cost, says study
Benevolence of duty officer in public hospitals determines cost, says study
This should be a shot in the arm for those health activists who have for long been demanding that user fee at all public hospitals be scrapped to ease access to health activities. A study by a city-based NGO, CEHAT (Centre for Enquiry into Health and Allied Themes) has found that in 2007-2009, the salary of the staff of a public hospital, appointed solely for collecting user fee, was more or less the same as the collections.
In fact, this administrative cost was so large in 2007-2008 that it exceeded the collections, claims a report based on the study, conducted by CEHAT researchers Oommen Kurien, Suchitra Wagle and Prashant Raymus in 2011 at a public hospital.
Below the poverty line (BPL) patients, the aged and students should not be charged at all at public hospitals, but only a handful of them get this benefit, alleged Kurien. About 85-90% of patients at public hospitals are underprivileged. But whether they can get treatment for free depends upon the benevolence of the duty officer.
Besides, the user fee collected from 10-15% of patients who are comparatively well-off is less than 1% of the hospitals total expenditure, found the study. These patients may be above the poverty line, but they go to a public hospital as they cant afford the facilities at a private hospital, said Kurien, who is the chief researcher.
He pointed out that user fee collection has increased in the last three years, thanks to more such patients queuing up at public hospitals. Moreover, people who dont carry BPL cards may also have to pay. Figures prove him right. The collection went up from Rs45lakh in 2007-2008 to Rs72.9lakh in 2010-2011. Considering that the state government hiked the fee only in 2011, the jump in collections prior to this was primarily because of an increase in the number of patients who had to pay such a fee.
Kurien suggested, The state government should abolish the user fee so that all those in need have better access to health services.
But health practitioners think otherwise. The report is wrong. About 85% of the patients are poor and we dont charge them. If we dont charge people who can afford, how will we able to serve the poor? The salary of the staff is paid by from the government and the user fee is used by a hospital to run diagnostic machines, clarified Dr TP Lahane, dean of JJ Hospital.
KEM Hospital dean Dr Sanjay Oak could not be reached for comments.
Dr DK Mangal, the state head of the United Nations population fund who is assisting the state government on various health projects, said, The user fee collection was started 20 years ago to run hospitals in a better way while also helping the poor. But now, it is evident that the implementation has gone wrong. It is also strange that authorities are clueless about the expenditure and collection ratio.
He insisted that the state government should take health expenditure as an investment and not charity.
The CEHATs report is expected to be released soon.