Govt flags 'no-target' hospital as model

New Delhi, April 14: Union health minister Jagat Prakash Nadda wants the private healthcare sector to adopt government-run hospitals and replicate a model practised by a six-decade-old private hospital in the capital that makes rich patients subsidise the poor.

The minister, speaking at the 60th foundation day of the 675-bed Sir Ganga Ram Hospital, today said the model practised by this private healthcare institution needs to be replicated elsewhere through public-private partnerships.

"Models presented by private institutions like the Sir Ganga Ram Hospital should be enunciated, elaborated and emulated," Nadda was quoted by PTI as saying. "We want institutions like (yours) to adopt may be a small public health institution and replicate the work."

The minister's comments come amid long-standing concerns among sections of health sector analysts about the steady unregulated growth of the private healthcare sector, inadequate public investments in health, and rising costs of consultations, diagnosis and therapy for patients.

Several studies have suggested that nearly 70 per cent of the expenditure on healthcare in India comes from personal household funds. A draft health policy released by the government in December has pointed out that lack of financial protection for health pushes about 63 million people into poverty each year.

Senior doctors at Sir Ganga Ram Hospital - named after a British-era Indian civil engineer who set up a hospital of the same name in Lahore in 1921 - say their institution, supervised by a trust, is primarily managed by medical professionals. "This is what makes the hospital different - no corporate-style managers and no targets fixed for doctors," said Devinder Singh Rana, head of nephrology and chairman of the hospital's board.

The hospital says it adopts a rich-subsidise-the-poor model through its distribution of beds.

Healthcare services to patients admitted in the hospital's 167 single rooms are charged at 100 per cent profit, while patients in 167 semi-nursing homes are charged at 50 per cent profit. The other beds in the hospital are charged on a "no-profit" basis or are free, a hospital spokesperson said.

The hospital also does not pay salaries to doctors, but expects them to return 10 per cent to 15 per cent of their earnings from patients to the hospital. "Many corporate hospitals pay salaries to their doctors and expect them to generate revenues for the hospital," a senior surgeon in Mumbai told The Telegraph.

At times, doctors experience subtle pressures to earn revenue for the hospital. In a commentary in the journal Current Medicine Research and Practice, Samiran Nundy, a senior gastrointestinal surgeon, had last year raised concerns about such practices.

"Senior doctors, we are told, are visited by financial experts at the end of every month with sheafs of financial data and asked to justify whether they deserve the salaries... especially when the revenue they have generated... falls short of certain set goals," Nundy wrote.

A surgeon in a Mumbai hospital who requested not to be named had said last year that for several months when she was handed her salary cheque, she was also shown a document that outlined the difference between what the hospital paid her and what she had generated for the hospital.

Nadda was also quoted by PTI as saying that the health ministry wants private healthcare institutions to become a partner in the nation's growth. He said the adoption of a small public health institution by the hospital would be a "real public-private partnership".

"Just adopt one small government health institution and do the same work with the same efficiency," Nadda was quoted as saying.


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