ISLAMABAD: Iftikhar Ahmed, a 42-year-old resident of Muzaffarabad who works in the local government office on a contractual basis, had a complicated heart disease for which doctors suggested open heart surgery.

“As I am a member of the Prime Minister’s National Health Programme, I decided to use it for the surgery because I knew that it would be totally free. Though I was operated upon free of cost at a hospital in Islamabad, I had to pay Rs150,000 for a number of tests before admission to the hospital,” Mr Ahmed told Dawn.

“Later, however, I came to know that even the tests would have been free had I done them after hospitalisation. In future, I can save more money by first getting admission to hospital because the programme covers only hospitalised patients,” he said.

“Though my family and friends are still of the opinion that Rs150,000 were not a big amount for such an operation, I cannot afford it. Now I am trying to get the amount reimbursed from my office,” he said.

However, another patient, Nisar Ahmed, 54, who works as a watchman in a government office and had to place a stent in his artery, remained a bit lucky because his son Waqas Nisar had gathered all the information about the programme.

A stent is a small tube which is placed in a blocked or weak artery to restore the blood flow.

Mr Waqas, who is doing a diploma in civil engineering, told Dawn that he knew that the scheme covered only hospitalised patients as he had read all the literature provided with the insurance card of his father.

“I got my father admitted to the Rawalpindi Institute of Cardiology after which all the tests were done there.” He said even he did not pay for the angiography which cost Rs20,000.

Earlier, an injection worth Rs 6,000 was also administered to my father free of cost,” he said.

Director General National Health Services Dr Asad Hafeez told Dawnthat he had also heard about such complaints but people should know that all over the world insurances do not cover 100pc cost of any treatment.

“Under the scheme, free treatment starts just after the admission of a patient and that coverage continues up to five days after the patient is discharged. Patients have to pay the fee and tests held prior to the admission in a hospital because the OPD treatment is not free,” he said.

“Some patients lack awareness of the programme and do not know what types of tests can be done after admission. But with the passage of time they will also learn and we are trying to make them understand that patients should avoid tests which can be done after hospitalisation,” he said.

As the programme is at its initial stage, such complaints are quite common but they will automatically be removed at a later stage.

Prime Minister Nawaz Sharif launched the programme on December 31, 2015, in Islamabad. Under the programme, a family gets Rs50,000 for a secondary care treatment which begins as soon as the patient is hospitalised. It includes all kinds of diseases, including maternity.

Moreover, each family can get treatment costing Rs250,000 under the category of priority diseases such as cancer, accident, burn injuries, diabetic complications, bypass heart surgery and infections. In total, a family can get a treatment of Rs300,000 per year and the amount can be doubled in case of an emergency.

According to documents available with Dawn, under the programme 2,374 patients were admitted to different hospitals in the federal capital so far and out of whom 2,316 were discharged.

The documents showed that 2,105 of the patients were from Muzaffarabad, Kotli and Quetta.

As many as 29 patients were admitted for an open heart surgery, 68 for angiography, angioplasty/stenting (49), cancer (82), dialysis (199), normal delivery (242), cesarean delivery (189), hernioplasty (135), appendectomy (119), cataract (69) and hysterectomy (78).

Dr Hafeez said the first phase of the programme would be completed in 23 districts within three years. From the next year, the next phase of the programme would also be launched simultaneously which would spread all over the country within five years.

“According to our estimates, by spending Rs30 billion almost 50pc of the population of the country will be provided decent health facilities.” He said because of the programme there would also be a competition between public and private sector hospitals as the former would be paid by the government for providing proper healthcare facilities to the patients.

Published in Dawn, August 19th, 2016