October 18, 2002	Friday	Sha'aban 11, 1423

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RAWALPINDI, Oct 17: The implementation of institution-based private practice has become a contentious issue and the hospital administrations are finding it difficult to reach a mutually acceptable working formula, sources in the hospitals said.

The Punjab government had banned the private procedural practice of clinicians at the government-run hospitals. Similarly, a complete ban was imposed on the private practice of the members of the hospital administration and certain other cadres in January. Instead, the doctors were offered to do private practice at the institution after the office hours.

The health department had planned to start institution-based private practice with a view to optimizing utilization of hospital equipment, helping junior doctors benefit from the experience of their seniors and increasing the finances of the hospitals through enforcement of ban on private practice.

The boards of governors and the administrations of the hospitals concerned were to work out finer details, including the service charges, working hours and fee-sharing formula.

In this regard, the Rawalpindi board of governors, according to the sources, has started consultations with the senior doctors. However, instead of reaching a consensus, the views of the parties concerned appear to be greatly divergent on the issue.

A senior doctor, associated with the on-going consultations, said any positive outcome was not expected. A source, however, claimed that working committees had been formed and any further progress would be made in the light of their findings.

Talking about the nature of differences, she said some consultants wanted the institution-based private practice for a short duration from 3am to 5pm, while others wanted it for a longer period. Some, she said, preferred that there should be no break.

The rates being formulated, she said, were also too high. The health department had earlier announced a reference price for different services to be offered under the institution-based private practice. The hospital administrations were to work out their own plan of charges accordingly.

The plan proposed by the health department had suggested that the patients would be charged Rs1500 to Rs 20,000 for various types of operation; Rs300 per visit as consultancy charges; room charges at the rate of Rs2,000 per day for airconditioned rooms, Rs5,000 for VIP rooms and Rs500 in general ward.

The consultants at hospitals in Rawalpindi are of the view that the fee plan is unacceptable, it has been learnt. Besides, sources said, there have been differences over sharing of the fees collected from the practice.

According to the formula proposed by the health department, the doctor treating a patient would be entitled to the fee. The hospital would charge for accommodation, food, medicines, operation theatre fee, commission and miscellaneous fees.

The collection of miscellaneous fees would be distributed among senior registrars, registrars, senior medical officers, medical officers, demonstrators, house staff, nursing staff and paramedics. But, this, too, is not acceptable to most of the doctors.

A source claimed that there was a strong lobby of senior doctors, who opposed the idea of giving level playing field to the juniors in the institution-based private practice.