Right to free treatment for poor

In the past Delhi Development Authority and Land & Development Office of Govt of India had allotted land to the registered societies and trusts on concessional rates (predetermined and zonal variant rates) for establishment of hospitals and also stipulated the conditions that they would provide certain percentage of beds in the hospitals free for the poor/indigent category patients. Similarly in the OPD, it was stipulated that free treatment has to be provided to the patients belonging to the indigent category. These hospitals came into functional stages during different times and had the conditions varying from 10% of free beds in the IPD to 70% IPD beds in some of the cases, however in most of the cases it was 25% free IPD beds. A high power committee under the chairmanship of Justice A S Qureshi was also constituted in the year 2000 and the recommendations made by the committee regarding the conditions that there should be 10% free beds in the IPD and 25% of the patients in the OPD should be provided free treatment. It was also recommended that the conditions should be uniform and applicable to all the allottees with or without having conditions and the free treatment should be totally free. The Delhi Government found these recommendations reasonable and accepted the same and intimated the land allotting agencies concerned to solve this whole gamut of problems.

The Delhi High Court in Civil Writ 2866/2002 delivered judgment on 22.3.2007. The Delhi High Court pointed out as to how 20 private hospitals and nursing homes are unjustly enriching themselves enjoying conditional concessions given by the state without fulfilling those conditions such as providing free treatment to patients belonging to economically weaker sections. The court had also observed that only poor and poorer categories of patients go to the general public hospitals, and they do not go to the private hospitals due to which the earmarked beds in the private hospitals remain unoccupied. Therefore, the government hospitals should refer the poor patients to the private hospitals where the requisite facilities are available.

Several guidelines for providing free treatment facilities to patients of Economically Weaker Sections category in private hospitals in pursuance of directions were issued by the Delhi High Court. It stated: The hospital charging any money shall be liable for action under the law and it would be treated as violation of the orders of the court. The Director/M.S./member of the trust or the society running the hospital shall be personally liable in the event of breach/default. The hospital shall maintain the records which would reflect the name of the patient, father’s/husband’s name, residence, name of the disease suffering from, details of expenses incurred on treatment, the facilities provided, identification of the patient as poor and its verification done by the hospital. The records so maintained shall have to be produced to the Inspection team and monitoring committee constituted by the Delhi Government. Every private hospital shall have to establish a referral centre/desk functional round the clock, where the patients referred from Government hospital would be able to report. The referral desk shall be managed by a nodal responsible person whose name, telephone, e-mail address and fax number is to be sent to the Government Hospitals, DHS and should be prominently displayed. The hospital shall also display the facilities available at the hospital and the daily position of availability of free beds quota, so that the patients’ coming directly to the hospital would know the position in advance. The hospital shall send daily information of availability of free beds to the directorate twice a day. The patient referred by the Government hospitals/or directly reporting to the private hospital shall be admitted if required, and treat him totally free. As per court’s directions, these patients shall not incur any expenditure for their entire treatment in the hospital. After the discharge of such patients provided with the treatment, the hospital shall submit a report to the referring hospital with a copy to the DHS indicating therein the complete details of treatment provided and the expenditure incurred thereon. The criteria of providing free treatment would be such person who has no income or has income below Rs 5000 per month for the time being.

The hospital shall also provide OPD/IPD/Casualty treatment free to the patients directly reporting to the private hospitals and would inform the nearest government hospital and to the DHS within two days of his/her admission. Those hospitals which have the land allotted from the Government on concessional rates and have not yet completed the construction after taking possession shall be liable for not complying with the conditions and might be asked to repay to the authorities by a special committee constituted for this purpose. As per directions of the court, all the 20 hospitals stated in the judgment and/or all other hospitals identically situated shall strictly comply with the term of free patient treatment to indigent/poor persons. No benefits shall be applicable to such hospitals that had provided free treatment fully or partially in the past with the higher conditions as applicable for that time with regard to any set off of the expenses or otherwise on that ground.

Thus exercising its powers under Section 19(8)(a) of RTI Act, the Commissioner required all the private hospitals/nursing homes to furnish the information through the public authority, i.e., the respondent authority and if not, the Commissioner warned heads of hospitals and nursing homes to receive summons under Section 18(3) to come with documents/files/records which they are supposed to maintain about the free treatment to EWS sections and payment of money fixed by the committee as unjust enrichment. The Commission also initiated penalty proceedings against PIO and Medical Superintendent in charge of nursing homes. It is in public interest to check the manipulative tactics in depriving the people and maximisation of profits by some private hospitals taking the undue advantage of concessions given by the Government.