‘By law, private hospitals that have purchased land from the government must provide free treatment to EWS’.
Some private hospitals have been named by residents of NCR as allegedly having a preference for patients who have cash available off-hand or are «insured» and thus can be admitted immediately.
Noorudin, an NCR resident, waiting in the OPD of a big hospital, said: «Private hospitals first ask the status of a patient and provide the cost estimates and if a patient is capable of affording, he gets admission, but when the patient comes from the Economically Weaker Section (EWS), to whom by law private hospitals must provide 25% OPD and 10% IPD to EWS completely free of cost, the process to get a bed becomes so complex that most of them don’t finds beds as some private hospitals refuse to admit them. They don’t prefer EWS patients even if they desperately need the treatment. Since 6 am, I am waiting here and now its 2 pm.”
“We come here because we have disease and not because we want to visit the hospital. We are also humans, can an old man sustain without food?” he asked. The Sunday Guardian visited several private hospitals to see whether EWS patients are given their due right under the law that says: private hospitals that have purchased land from the government must provide free treatment to EWS. There are 61 private hospitals identified with more than 900 beds for EWS and must give required free treatment.
The Sunday Guardian was told that those people who build legal pressure or have connections and references get the beds easily—the beds were not given on a note of severity of disease. A citizen said: “My brother was brought here in a serious condition and the hospital didn’t even give him the necessary injection due to which he has become serious which could have been avoided,” she further said not disclosing the name of the hospital. “I was told to first pay for the treatment because there are no EWS beds.”
A doctor who has recently quit a big private hospital and wished anonymity told The Sunday Guardian: “Guards are instructed to send back the EWS patients though beds are available; they have to maintain the ratio but they don’t. Generally, those who are unknown to the hospital and have no connections, find it difficult to get a bed.” The doctor recalling one incident said; “When I was on duty I told the HOD that there is an acute pancreatitis patient in dire need of a bed, but he said to tell him that we don’t have bed, and when I went there, the guard had already warded him off.”
Another former doctor said: “There used to be brawl between the patients and the Fortis staff, for they would deny them beds even though they had them, the reason being they could derive no profit from them.”
Ashok Agarwal, an advocate who first filed PIL in 2002 against the hospitals who purchased government lands, and presently a member of High Court constituted free bed instruction Committee, told The Sunday Guardian: “Fortis is not doing any surgeries, they are delaying the surgery of EWS patients, there are 200 to 300 patients lined up.” He further said: “I think they favour local MLAs, that’s why they know there will be no action against them.”
When The Sunday Guardian tried to reach the Nodal Officer of a major hospital, Fortis, for an admission of a patient, the office informed that there is already a long waiting list. The response was: “We haven’t even touched the 2021 list yet; we are still treating 2019 patients.”
Agarwal further added that there is a need to pressurise these corporate. “People still come to me and I prepare them legal notice but everybody doesn’t come to me.” He continued: “There is priority given to those who have influence and connections, people don’t complain against them, we can take its management to task if they are found not complying with the laws.”
Agarwal lamented that throughout Covid-19, there were 85% beds available and not given to EWS and today, “I can make a statement that more than 50% beds are available.”
Agarwal also said: “There are some rogue hospitals where 99% beds are vacant and government doesn’t take any action.” The information collected from two doctors: “There are hospitals who will tell everyone to bring along the documents, but when you go there with a patient, they will blatantly refuse to admit them, saying they don’t have beds.”
The Sunday Guardian visited Max smart hospital, and was told by an official “they don’t usually take patients from far off places”. There is no such criteria to be followed; anyone who has a below poverty line family income, can take treatment from enlisted private hospitals. Later when the hospital was contacted by The Sunday Guardian, the officials told to bring the required documents along and said: “We will see what is to be done.” A doctor wishing anonymity in a large hospital said: “Although I don’t have much dealing with EWS, but by not giving beds to those who can’t pay is how their business runs—the one who pays is important.” He further said that there was an old patient (EWS) who was suffering from a certain illness; when he died his family blamed the doctors and said he could have been saved had the doctors been sincere.
After visiting Ganga Ram hospital, The Sunday Guardian found that the patients were satisfied with the treatment of doctors and that separate beds were kept for the EWS patients. Those who were attending the emergency patients also affirmed that the doctors are operating and taking care of patients sincerely. Amit Kumar, a patient at the Ganga Ram, said: “Since I have been here, the treatment to us couldn’t have been better, everything is being taken care of by the hospital.” An attendant of a person in ICU in the same hospital said: “I have been here for three months and yet, every required treatment is being given by the hospital.”
It was found in another hospital that the paid section had a very “sweet cooperative tongue” but an employee at the EWS section dealt with a patient rudely, refusing to answer a query when asked the second time. There are some private hospitals who show lesser attention towards weaker section of the society and no action is taken against them. The Sunday Guardian found that there are many EWS patients who claim that they do not get beds in the private hospitals. A patient who doesn’t wish to be identified said in a particular specialty hospital, “Sometimes, an EWS patient needs to pay Rs 30,000-Rs50,000 to get a bed in the hospital. Though beds are available, the authorities refuse to provide beds to the patients.”
A patient complained, “The authorities say that the beds are not available, but when you go to the designated floor, the section where EWS patients are admitted, you will find plenty of beds available but only 1-2 patients are admitted.” Another patient at the same hospital said: “I had a heart operation. Earlier, I was denied a bed, but somehow my children managed to arrange a bed for me. When I was downstairs, I heard that the authorities were denying beds to the other EWS patients and saying that the beds were unavailable. When they took me upstairs, I saw many beds were vacant. This is how I came to know!”
Sources close to the government said, “Sometimes, many EWS patients take regular paid treatments and later on, they come with all the documents and reveal that they are in the EWS section. There are several cases, where the EWS patients have all the papers and documents. However, some private hospitals deny them beds, and they go to other hospitals. Several local MLAs help out the EWS patients with bed availability. There is a lack of transparency on data regarding bed availability. The nodal officers keep the calculation of the beds, but are constantly under pressure by the government and the hospital authorities. The government inspects whether the beds are available for EWS patients or not, whereas, the private hospitals pressurize the officers not to reveal the actual number of beds.”
Pratyush Kumar from New Delhi Children’s Hospital & Research Centre (NDCHRC), who helps out many EWS patients with bed availability, said, “Poor people are not aware of the proper procedure and requirements in the hospital. Hospitals are not very co-operative; many hospitals do not pass on the right information to them regarding bed or whether any specialist is available or not.”
He also said that though rules and regulations are there, the implementation is lax, there must be proper channels through which the right information about the procedure and the bed availability is transparent. As per the notification provided by the Health and Family Welfare Department of the Delhi government, i.e, 25% OPD and 10% IPD are completely free of cost. The names, phone numbers and the mail ID of the nodal officers must be displayed and updated on the webpage. The webpage must update the status of the availability of the free beds for critical and non-critical persons around the clock.
The notification also states, “It may be assumed that the patients having either BPL card, AAY card, or a valid income certificate issued by the office of Dy. Commissioner, SDM, Tehsildar concerned fall under the eligible category of EWS patients i.e. their monthly family income is less than the minimum wages of an unskilled worker, hence, such patients may not be asked to fill an undertaking and a copy of any of the above-mentioned documents would suffice for their eligibility for free treatment.” There are still many EWS patients who claim that they do not get bed from the hospitals.
The Sunday Guardian sought response from three hospitals regarding the alleged discrepancies in their hospitals, and received the response from only two hospitals—Fortis hospital and Max Saket. The response from Fortis (Okhla) said: ”We categorically deny any form of ill treatment towards EWS patients. As per our hospital policy, each patient is treated equally, and we don’t differentiate between patients based on payor category. As a patient-centric healthcare service provider, we strongly condemn rude behaviour towards any patient. Please help us with the date and time when such an incident took place at the hospital premises, and we will take appropriate disciplinary action, as necessary.”
“As you know that the government has given directions for reserving beds for COVID treatment, which has necessitated us to allot beds specifically for COVID patients. The requirement for COVID beds mandated by government has ranged from as high as 248 beds to 31 beds currently. This mandate sometime has forced us to prioritize COVID admission over elective procedure, irrespective of payor category as we have total 310 beds in our hospital. We have taken these mandates seriously as our solemn duty towards the nation during this crisis and focused more on COVID treatment.”
“Any patient, who is brought to emergency, is assessed by doctor and if it is clinically necessary to admit him/her, we do so. We cannot comment, unless we have the specific details for denial of admission, to respond to your query.”
Max Saket responded to The Sunday Guardian through a text message: “We are fully compliant with the Delhi Govt norms and a daily report is shared with the authorities concerned.”