PESHAWAR: The new decision of health department that makes it binding upon the referred patients from districts for tertiary care treatment under Sehat Sahulat Programme to visit public sector hospitals has paid off, according to officials.

They said that owing to the decision, the gap between public and private hospitals regarding number of patients narrowed down. “Last year, most patients visited the private hospitals compared to governments due to the latter’s unpreparedness to devise proper mechanism for the people holding Sehat Insaf Card (SIC),” they added.

The government had started the programme with an outlay of Rs5.4 billion in January last year. It aims to provide free treatment to1.8 million or 51 per cent of the population at the 100 designated hospitals, both public and private, through State Life Insurance Corporation.

However, the last year’s statistics showed that 75 per cent patients had sought treatment at the private hospitals and 25 per cent at the government healthcare outlets.

Officials say more people visit govt hospitals for tertiary care treatment

It had worried the health department, which wanted the public hospitals to generate revenue from the mega health project.

In January this year, the government decided that the patients, who were referred from district hospitals for tertiary care treatment to Peshawar or Abbottabad, would be taken to the public hospitals to enable the government sector to draw its share from the programme.

Officials said that last year, about Rs1.8 billion had been spent on the free treatment of 75,000 patients.

The lion’s share of the revenue was pocketed by the private hospitals. The private hospitals attracted more patients as they campaigned heavily and entertained the SSP’s beneficiaries promptly whereas the government’s hospitals didn’t have proper system for them.

Under the new mechanism, the patients with cardiac and other chronic and multiple health issues were required to visit Khyber Teaching Hospital, Lady Reading Hospital and Hayatabad Medical Complex in Peshawar after their referral from the district level hospitals.

“The patients’ ratio between public and private hospitals is now 52:48 because the private hospitals cannot take referred patients anymore,” said the officials. They said that the new arrangements were also benefiting patients as they were subjected to angiography or angioplasty for heart ailments in their bid to earn more money.

They said that such patients needed baseline investigations, such as ECG and ETT prior to angiography and angioplasty. They said that at the start of the programme, private hospitals received 91 per cent patients but later the authorities took notice of it and directed the government hospitals to improve the system to give quick services to patients, which led to increase in patients.

Last month, the health department asked LRH for decline in the number of SSP’s patients due to a decision under which the Board of Governors had decided that doctors wouldn’t take share from the income generated through the programme. LRH had so far provided treatment to 6,138 patients under the programme, which the health department argued, was far lesser than its capacity. The hospital, the biggest in the province, had got 30 specialties and patients wanted to be treated there.

The BoG is likely to review its decision and revert to government’s policy of awarding proper share to the staff involved in treatment of SSP patients.

Early this year, the government enhanced SSP’s coverage to 2.5 million families or 69 per cent population and allocated Rs1.69 billion more after evaluation which showed that people were benefitting from the scheme. Under it, a family of eight members can avail treatment expenses up to Rs540,000.

Published in Dawn, March 6th, 2018