The Telegraph
Wednesday , June 18 , 2014
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Here, free therapy comes with bills

Ranchi, June 17: Susanti Devi, a 21-year-old mother from Rahe village in Ranchi district, could do little but weep this morning near the neonatal wing of the state’s biggest hospital, Rajendra Institute of Medical Sciences (RIMS).

She and her husband Mukut Mahto (25) did not know what their 11-day-old infant was suffering from. But the young couple knew they had to pay Rs 2,500 for two units of blood, thanks to a paper slip that Mukut received last evening.

In the middle of frantic calls to his relatives requesting them to arrange the money, Mukut wondered why they needed to pay a single paisa as Susanti was a beneficiary of the cash-less central scheme, Janani Shishu Suraksha Karyakram (see box).

“We were referred from Bundu community health centre to RIMS on Saturday and told the infant’s treatment would be free. We also got an ambulance. But here, we have been paying money from Day One, though my wife is a beneficiary of the Karyakram (or JSSK),” Mukut, an employee at a cycle repair shop, said.

Like Susanti and Mukut, there were around a dozen young couples from villages of Simdega Sadar, Chaibasa and Hazaribagh whose newborn babies were admitted to the neo-natal wing.

They all wondered why nurses handed them the dreaded “silip”, which meant expenditure between Rs 300 to Rs 2,500 for pathological tests and blood transfusion, when they all came under the ambit of JSSK, launched nationwide on June 1, 2011.

A PG doctor at RIMS, treating an infant referred from Chaibasa with high bilirubin, provided a partial explanation. “For proper diagnosis, it is vital to get some pathological tests done the moment the patient is admitted. At RIMS, sample collection is done between 9am and 1pm. If a patient is admitted beyond these hours, we ask them to get the tests done immediately from outside, which incurs expenses.”

But on blood transfusion, also free under JSSK, he claimed he did not know why parents were being charged for units when supply was supposed to come from the blood bank at RIMS supposedly open 24x7.

“This is beyond my jurisdiction. I do not know why they (parents) have been charged,” he said.

At the RIMS blood bank, no one at the counters agreed to comment.

However, RIMS blood bank in-charge Dr R.K. Srivasatava stressed blood was absolutely free for both mother and infant for upto 30 days of birth.

“There is need for thorough investigation. Registers at the blood bank bear testimony to the fact that no money for JSSK beneficiaries is charged,” he claimed, but conceded that village couples often fell prey to touts.

“I’d appreciate if JSSK beneficiaries help us identify such people. Many persons claim to be relatives, give genuine requisition slips to procure blood free of cost from here but charge money from actual beneficiaries,” he said.

When asked, officiating director Dr S.K. Choudhary said he was new to the post.

“I cannot comment on what has happened in the past and what is the practice. I can only assure you that I will talk to the respective department (paediatrics) to ensure JSSK beneficiaries are not compelled to incur out-of pocket expenses,” he said.

A highly placed source in RIMS said in the 2013-14 fiscal, the state-run hospital got Rs 1 crore of central funds under the JSSK routed by the Jharkhand Rural Health Mission.

“It was an online transfer. In March 2014, when the Mission asked the RIMS accounts department for utilisation documents, it emerged that expenditure on JSSK beneficiaries was only Rs 45 lakh. The rest is being used now. This year, we are yet to receive the JSSK support amount,” the official said.

Officiating director Choudhary, prodded for comments on funds outlay and spending, said: “I agree funds should have been used judiciously. Proper planning could have avoided a situation where poor people are having to pay for a cash-less scheme.”