Regulate private health sector, check alleged profiteering by hospitals
A bill of ₹18 lakhs for the 15-day treatment of dengue at the intensive care unit of a private hospital in Gurgaon seemed absolutely outrageous, till I came across an even more shocking account of a bill of ₹55 lakhs presented to the parent of a 31-year-old, again for the treatment of dengue. In this case too, like seven-year-old Adya, the patient did not survive and all that the private hospital handed over was the fat bill. I am sure in the coming days, more consumers will share such bitter experiences, underlining the urgent need to regulate the private sector, bring transparency and accountability into their costing of goods and services and put a cap on their profiteering!
With inadequate funding limiting the resources and capacities of healthcare services in the public sector, consumers are forced to go to the private sector, estimated to cater to about 60-70% of the population. But in the absence of stringent regulation, consumers are at the receiving end of all kinds of malpractices. Unnecessary and excessive tests, use of most expensive brands of medicines and implants, exorbitant consultancy fees, unnecessary surgeries to make a quick buck, are all indicators of crass commercialisation of the private health sector, at the cost of patients.
Consumers, as patients, have a number of rights, including the right to be protected against unscrupulous exploitation and the right to grievance redress. It’s imperative that state governments enforce and protect these rights. First and foremost, they need to urgently ensure standardisation and transparency in the health service deliv- ery and rationalisation of the cost of healthcare.
The Central government rules drawn up under the Clinical Establishment (Registration and Regulation) Act 2010, mandates (as part of the conditions for grant of registration) that clinical establishments shall charge the rates for procedures and services within the range of rates determined by the Central government from time to time in consultation with state governments.
The rules also demand that clinical establishments prominently display, in English and in local language, the details of rates charged and facilities available. Similarly the law requires the government to bring out a registry of private hospitals, to help consumers compare facilities and rates and make an informed choice. But for these to become a reality, state governments must enforce them.
Responding to Adya’s par- ent’s cry for justice, the Union ministry of health has written to all state governments urging them to enforce the Clinical Establishment Act, bring transparency and accountability in the private health sector and ensure that they follow standard treatment protocols. The ministry needs to pursue this to its logical end. Side-by-side, the government also needs to increase and upgrade health facilities in the government sector so as to reduce consumers’ overdependence on private hospitals. This will also give consumers a better bargaining power when it comes to the private sector.
Unethical practices are so well entrenched in the private health sector by now that they will not accept strict regulation without a fight.
We have already seen how the private sector responded to the Karnataka government’s proposal to amend the law regulating private hospitals and clinics. I also recall the massive nation-wide protests launched by medical professionals against bringing the medical sector under the purview of the Consumer Protection Act, when the law was first enforced. But eventually, consumers won because they got together as an even more formidable force. Today, that is exactly what is required — a strong consumer demand for stringent regulation of the private health sector. And unlike those days, today, consumers can get the support of doctors who are committed to ethical practices and this, I am sure will lend lot of strength to this demand.