The news of private and even charitable hospitals turning away poor patients, some even in a dire state of emergency, is not new. It is a fact that private hospitals make a number of promises when it comes to obtaining land from governments at throw-away prices. They also get a number of other benefits that other businessmen in the society do not get. In lieu, the state demands that a proportion of the care they provide to the society is free. The deal is simple and should be easily deliverable.
However, it will take nothing short of a Sherlock to find a free bed in many corporate hospitals today. First of all, no ordinary soul will dare enter these premises but if somehow they got in, they will never know there was something called a free bed in there. Many of these hospitals simply forget that they have any beds they are supposed to give out for free and since they are all doing it, it has become the industry norm, an accepted practice.
Yet, it cannot be impossible to set up mechanisms to use these beds. I have previously, in the context of a National Ambulance Service, argued that each city/state maintain a central triaging service that has an up-to-date record of all the government beds and those free beds in the private hospitals meant to be used by the government. In the absence of such a central triaging service, primary care doctors working in remote villages don’t know where to send patients; police and ambulance don’t know where to take the accident victims, and poor patients are often made to run from the pillar to the post at a time when they could do with some help. This means hapless villagers often turn up to a super busy government hospital in a city only to spend hours if not days on a trolley before a bed can be found for them. This is the best they can get in the largest democracy in the world.
If we want to say that only people below a certain monthly income can get free medical treatment in state owned or free private beds, let it be. Issue them with some sort of a document that they can take freely with them. Put a line on the Aadhaar card or do something else to identify these people so that they can go to any hospital in the country, private or public, and get free emergency care. Many hospitals, even the public ones, then expect patients to buy all the expensive consumables. Though one cannot expect that private hospitals will provide them for free, they could subsidise them for these patients and send the bill for the remaining to the state. As far as public hospitals are concerned, they should be funded adequately so that people don’t have to sell their houses to buy medicines and other medical supplies.
Currently, we have no such mechanisms and private hospitals obviously do nothing more than pay a lip service to their commitment to the people by placing a board somewhere on the premises. Ironically, hospitals with the most advanced software systems find it difficult to display a number at the reception that says how many free beds are empty. But to be completely fair, you can’t really blame them either. It is not really their responsibility to go looking for poor people to help; it is that of the government of the day. From the point of view of the private hospitals, it would obviously make sense that a bed is used by a patient rather than keeping it empty because a poor patient might turn up.
Following his graduation from Calcutta Medical College and post graduation from Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, Dr Kamal Mahawar is now a Consultant General and Bariatric Surgeon with Sunderland Royal Hospital in the United Kingdom. He is also an Associate Clinical Lecturer with Newcastle University and editor of renowned scientific journals. His recent book ‘The Ethical Doctor’ published by Harper Collins India examines some of the serious issues affecting Indian healthcare.