Why poor patients have a right to reputed hospitals
If your domestic help cant read this or doesnt know about this health scheme, you should tell her/him about it
Background:
In a stinging indictment of the health support system in the country, the Supreme Court in the case of Samira Kohli v/s Dr Prabha Manchanda and others, had drawn attention to the pitiable condition of the poor who need medical aid. In India, the majority of citizens requiring medical care and treatment fall below the poverty line, said the court. Most of them are illiterate or semi-literate…They do not have access to effective but costly diagnostic procedures. Poor patients lying in the corridors of hospitals after admission for want of beds or patients waiting for days on the roadside for an admission or a mere examination, is a common sight. For them, any treatment with rough and ready diagnosis based on their outward symptoms as well a doctors experience or intuition is acceptable and welcome so long as it is free or cheap, and whatever the doctor decides as being in their interest, is usually unquestioningly accepted.
The same issue came up before the Bombay HC in a public interest litigation filed by Sanjiv Gajanan Punalekar.
The court appointed a committee headed by the charity commissioner of Maharashtra to frame a scheme for treatment of poor patients in reputed charitable hospitals. The scheme was duly framed and approved by the Bombay HC in 2006, and is now monitored by a committee chaired by the joint charity commissioner. However, because many people are still unaware of the scheme and its benefits, a detailed enlisting of the scheme and how it holds hospitals duty bound to open their doors to the poor, is provided below.
Which hospitals fall under the scheme?
All hospitals run by state-aided public trusts. The Bombay Public Trusts Act defines a state-aided public trust as one which maintains a hospital, nursing and maternity homes, dispensary or other centre for medical relief, when such a trust has received a government grant for a land or a building, or a concession under the Urban Land Ceiling Act or the Development Control Regulations. Also, if it has received either recurring or nonrecurring financial assistance from the government or local authority, and the annual expenditure of the trust exceeds Rs 5 lakh, it is defined as a public trust.
Who is a poor person?
The scheme is applicable to (a) indigent persons whose total annual income does not exceed Rs 25,000 and (b) persons who are not indigent, but belong to the weaker section with income not exceeding Rs 50,000. For proof of in
come, a certificate from the tehsildar, a ration card, or a Below Poverty Line (BPL) card would have to be produced.What do hospitals owe the poor?
The scheme provides that 10% of the total operational beds must be provided free to indigent persons and those below the poverty line. Similarly, 10% of the total beds must be provided at a concessional rate to those belonging to the weaker section.
Where will hospitals get the funds to treat the poor?
To treat such patients, hospitals would be required to create a separate fund called Indigent Patients Fund (IPF), by crediting 2% of the gross billing charged, to the regular paying patients. Donations received by the hospital earmarked for treating such poor patients must also be credited to this IPF account. In the case of indigent persons, a notional bill would have to be raised for medicines as well as consumables at the same rate as charged to the lowest class and provided by the hospital. However, the patient would not have to pay the bill as it would be debited to the IPF account.
Poor patients would be entitled to medical services at concessional rates and would have to pay only 50% of the actual cost of medicines, consumables and implants. The remainder would be met by the IPF account.
What happens in an emergency?
In case of an emergency, hospitals would have to provide essential medical facilities as well as all life-saving emergency treatment and procedures till the patient is stabilised, without asking for a deposit. Such a facility would be available to all citizens, regardless of their income. After stabilisation, it would be open to the hospital to arrange the transport to shift the patient to a public hospital, if necessary.
Impact:
Most of us have domestic help or know of poor people around us who may be struggling to cope with their medical problems. We can bring this order to their notice and guide them. Doctors and hospitals would also do well to comply with the terms of the scheme, because failure to do so would make them liable under the Consumer Protection Act for deficiency in service.
(The author has won the government of Indias National Youth Award for consumer protection. E-mail jehangir–gai@indiatimes.com)