Now, Hon’ble LG objects to “Quality Health for all” scheme
- Objections will render the whole scheme unworkable
- Like in the case of Doorstep Delivery of Services, objections on Quality Health for All, also based on lack of knowledge of ground realities
Given below is the detailed response of the elected Delhi government on the objections raised by hon’ble Lieutenant Governor of Delhi on the Quality Health for All scheme :
After rejecting the “Doorstep delivery of Services” scheme of the elected Delhi government, the hon’ble Lieutenant Governor has now raised objections to the government’s ambitious “Quality health for all” scheme.
Objections raised by the hon’ble LG are of such nature that if accepted, it will render the whole scheme unworkable. As in the case of “doorstep delivery of services” scheme, objections raised by the hon’ble LG in this scheme are also based on lack of knowledge of ground realities.
Like in the case of “Doorstep delivery of services”, in this case also, the hon’ble LG has raised objections without discussing either with the elected Chief Minister or the concerned Minister. If the hon’ble LG had discussed it with the CM or Minister, most of his objections could have been removed, thus saving precious time in sending files up and down.
Under “Quality health for all scheme”, the Delhi government has proposed that if any patient in any Delhi government hospital needs any diagnostic test to be done and if that hospital cannot do that test for whatever reasons, then the patient can get that test done from any of 67 private labs/hospitals which have been empanelled for this purpose, the Government will pay the costs to that private hospital or lab.
In a government hospital, if a machine not working or if that test facility is not available in that hospital, then a patient is presently asked to get it done from outside. Often, people can’t afford expensive tests and face difficulties. Likewise, in some hospitals, there are long queues for a test on some machines, then a patient has to wait for long periods. This affects their treatment when diagnostic test results are not available on time. To overcome these difficulties, Delhi government has proposed this scheme.
Likewise, due to huge rush, often patients requiring surgeries are given long dates in govt hospitals. This also adversely affects the treatment of patients who need immediate surgeries. Therefore, under the same scheme “Quality health for all”, it has been proposed that if surgery date is not given by a government hospital to a patient within a month, then he can get it done from any of the 44 private hospitals empanelled for this purpose. Again, costs for the surgeries in private hospitals will be borne by the government.
For this purpose, Delhi government has entered into agreements with several private labs and hospitals, which have been empanelled. These private labs and hospitals have agreed to charge either at CGHS rates or at fraction of CGHS rates (Already, CGHS rates are 50% of normal rates).
This scheme was passed by the Cabinet on 12th December 2017 and was subsequently sent to the hon’ble LG for approval. The scheme proposed that every person, irrespective of his income, who comes to any Delhi govt hospital for treatment shall be eligible under this scheme, if he is a resident of Delhi. However, the hon’ble LG has written that an income criteria should be introduced to avail benefits under this scheme.
Delhi government feels that if the income criteria was introduced, it will make implementation of this scheme extremely cumbersome due to the following detailed reasons :
1. Delhi government feels that introduction of income criteria is not required because in any case, only poor people come to Govt hospitals. There is automatic selection. Rich and super rich, in any case, go to private hospitals. Any further verification of patients’ incomes will increase paper work and make implementation difficult.
2. Let’s imagine a person who goes to a Delhi government hospital for treatment. The doctor advises him/her a diagnostic test, which is not available in that hospital. Under this scheme, the patient can approach any one of the empanneled labs/hospitals to get the test done immediately. In fact, the patient can straight go from the government hospital to the empanelled private hospital, get the test done and come back to government hospital to show the report to govt doc without wasting any time in between. However, hon’ble LG wants that an income criteria should be fixed for eligibility under this scheme. If that is done, then every patient would need an income certificate, which most people don’t have. So, a patient, who has been prescribed a diagnostic test, will first go to an SDM office to procure an income certificate.
3. If you need any certificate on an emergency basis from SDM office, one knows that you would end up paying huge bribes. Secondly, false income certificates are available at a “cost”.
4. If any income criteria were introduced as suggested by the hon’ble LG, a whole industry of touts would spring up to produce income certificates. In addition, people would face endless harassment. Also, in many diseases, timely treatment is necessary. Precious time would be wasted in obtaining income certificate, which could be fatal in some diseases or could lead to irreversible medical condition.
5. The scheme had proposed a seamless arrangement between government and private establishments. They would compliment each other. However, if income criteria is introduced, a patient would first keep making several rounds of SDM office or pay huge bribes there, before he can actually get his test done in a private lab. Often, the amount of bribe would be more that the cost of test. Rather than face harassment, waste critical time and pay huge bribes, most people may not avail this scheme, thus rendering this scheme ineffective.
6. If a hospital would need to check the income certificate of each patient before referring him to private hospital, it would require a whole set of bureaucracy and creation of many new posts. Right now, all Delhi govt hospitals are facing huge shortages of doctors, paramedics, pharmacists etc. Repeated letters have been written to hon’ble LG to fill up these posts on an urgent basis. However, the hon’ble LG has failed to fill up these posts so far. One wonders how many years would it take to fill up new posts that would be required for verification of income certificates? What would happen to this scheme till then?
7. Delhi government is able to implement such welfare schemes for its people because it has been saving huge funds by reducing high level corruption in govt projects. The money so saved is now being passed on to its people. If Delhi government is not asking for any additional funds from the Centre to implement this scheme, then why should the hon’ble LG object to middle class people from taking benefits under this scheme?
8. Delhi government is committed to providing quality health services to all, whether rich or poor. All over the country, the govt hospitals have been reduced to such pathetic conditions that no one wants to go to govt hospitals. It is the poorest of the poor who have to visit govt hospitals out of compulsion. Despite pathetic services, most state govt levy user charges in govt hospitals. For the first time in the country, the Delhi government has come up with a completely new model. Most of the services have been made free in Delhi govt hospitals. At the same time, quality of services are being improved so that middle class also starts visiting govt hospitals. Delhi government is happy that middle class is already visiting its mohalla clinics and polyclinics in large nos. It is only when middle class starts using govt services that the services will improve. Delhi government is now trying to improve services in its super-speciality and multi-speciality hospitals also so that they become a viable alternatives for middle class.
9. In addition, the hon’ble LG has also introduced serious obstacles in the already successfully running mohalla clinics and polyclinics. Till now, all treatment including all medicines, tests and consultation was free for all patients, irrespective of income limit, in all mohalla clinics and polyclinics. Due to this and due to excellent environs at these centres, large number of middle class people were also visiting these centres. However, now the hon’ble LG wants income criteria to be introduced in mohalla clinics and polyclincs also for all tests. So, according to the hon’ble LG, all consultations and medicines would continue to be free for all patients but patients above a particular limit would be charged for diagnostic tests. Why? Is the hon’ble LG’s decision based on any data or is it simply arbitrary and whimsical? If the hon’ble LG’s decision was implemented, then all patients henceforth would need to carry income certificates to get treatment at mohalla clinics and polyclinics? Right now, no payments of any kind were accepted in any mohalla clinics and polyclinics. Now, additional staff would need to be deployed to recieve payments from “rich” patients for diagnostics tests. If the hon’ble LG has no problem in free consultation and medicines being provided to ALL patients, then what problem does he have in continuing with free diagnostics?
10. If income criteria were introduced as desired by the hon’ble LG, it will not only kill “Quality health for all” scheme, it will also kill already successfully running mohalla clinics and polyclinics.
11. For the Delhi government, every life is important, whether a person is rich or poor. Today, health services in pvt sector have become so expensive that even middle class people find it difficult to use them. This scheme will provide quality health services to all residents of Delhi, whether rich or poor. Why does the hon’ble LG want middle class people to be excluded from this scheme?
12. Governance across the country has become so bad that existing systems and ideas will not work. New ideas would need to be tried. Delhi government has been successfully implementing several new ideas like mohall clinics. If the hon’ble LG starts objecting to every proposal, it will become extremely difficult to govern and try any new ideas. We also urge the Hon’ble LG to at least have discussions with us before putting such objections on proposals of such critical importance.