PESHAWAR, Jan 20: The NWFP government is likely to take an action against the doctors who are not complying with a notification of the health department aimed at reducing the consultation fee, officials said.

The health department had issued a notification to teaching and district headquarters hospitals (DHQs) some 15 months ago and told professors/consultants and district specialists to charge Rs250 and Rs150, respectively, as the consultation fee from patients. The cabinet granted approval to this move on Oct 1, 2003. But doctors in the NWFP say it is difficult for them to implement the decision.

According to them, they charged only Rs300 as consultation fee, whereas consultants in Islamabad, Lahore and Karachi charged Rs1,000 for a single visit to their clinics.

An official said: "We have established a health regulatory authority to check clinics, laboratories and other health outlets in the private sector."

He said that after the establishment of the regulatory body, the government would not allow overcharging of patients.

The notification had also asked the consultants not to charge hospital admission fee from patients at their clinics and told them to charge Rs10,000 for major and Rs4,000 for minor operations at private medical centres, but doctors still violate the order.

"This is extremely vague because often small surgeries are performed under local anaesthesia in a few minutes and it was unjust to charge Rs4,000 for these operations," said a senior surgeon.

He said the rate of major operations fixed was also unclear because all operations carried out under general anaesthesia fell within the purview of major operations. Some operations consumed over an hour of surgeons while some major operations carried out under local anaesthesia and took 5-15 minutes, he explained.

The official said the government had given Jan 31 as the last date for registration of clinics, after which the department would take a stern action against the clinics violating the notification.

The notification had also called for a ban on private practice of doctors in the public sector hospitals. But doctors say this condition will deprive patients in the DHQs of specialist doctors who remain available on call.

Asking the specialists to go outside for private practice would create shortage of specialist doctors for the patients admitted to the DHQs in the evening and night shifts, said a surgeon.

Though the notification had also pointed out that diagnostic facilities would have no monetary share for clinicians to perform tests, many surgeons, physicians, gynaecologists etc., are known to have installed ultrasound machines and received Rs300 for each test in addition to their fee.

Senior doctors said the government had banned the institution-based practice (IBP) on the persuasion of a group of doctors and now had announced the so-called relief package without consulting the stakeholders, doctors, patients and public representatives. They said the department had issued the notification in haste, therefore it would fail.