Private hospitals in KP set eyes on health insurance scheme

Updated 24 Aug 2020

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Officials say health facilities fulfilling the criteria will be selected for SSP after assessment. — Dawn/File
Officials say health facilities fulfilling the criteria will be selected for SSP after assessment. — Dawn/File

PESHAWAR: The health authorities have warned private hospitals against offering bribe to get registered for free treatment of people under Sehat Sahulat Programme (SSP) and said that the facilities fulfilling the prescribed criteria will be selected after complete assessment process.

As the health department is preparing to extend SSP to the whole province in a phase wised manner, private hospitals have been using political influence to get empaneled and earn money, according to sources.

The SSP, started with the support of German Bank KfW in four districts in 2015, kept extending to more population. It will start to cover the 6.6 million population of Khyber Pakhtunkhwa from late November. By February, it will be implemented in the entire province.

The government has spent Rs11billion on free treatment of 270,000 patients so far. Seeing the income received by many private hospitals from the programme during the last few years, they have set their eyes on getting empaneled with the programme after its extension.

Officials say health facilities fulfilling the criteria will be selected for SSP after assessment

Last week, the SSP issued a warning stating that the hospitals trying to get contract for patients through illegal means would get their outlet back-listed. The hospitals have been asked the access the website and fill the forms, which will be followed by assessment prior to registration for the programme.

Officials said that the private hospitals, which did not get registered with the SSP, would lose their utility as 100 per cent people would go the health facilities registered by the SSP to get free admission services on national identity cards, therefore, all were trying to get on the panel of the programme.

“Our system will identify the hospitals getting involved in malpractices and admitting patients unnecessarily for investigation and surgeries. There is a complete monitoring system, which is being further strengthened,” SSP director Dr Mohammad Riaz Tanoli told Dawn.

He said that KfW was supporting the government by providing Rs1.5 billion each for outpatients and digitalisation services. “We have been urging public hospitals to give share to its staffers from the SSP’s income to pave way for competition with the private hospitals,” he added.

A formula has proposed to grant 10 per cent share to the administration and 15 per cent to nurses and paramedics from the income generation from the SSP’s patients.

Dr Riaz said that under the programme, each of the 6.6 million families in the province would be eligible to get free hospitalisation services up to Rs1 million per year. He added that hospitals got the amount from State Life Insurance Corporation, which was implementing the programme on behalf of the government after one month.

The SSP director said that the process of hospitals selection was a continuous exercise. “So far, we have registered 31 hospitals in Malakand, the first division to benefit from the services. About 150 health outlets will be selected on the basis of their infrastructure, equipment, staff and related medical facilities,” he added.

He said that in some districts, they didn’t have good hospitals in private sector and needed to upgrade the government hospitals.

“The programme offers big opportunities to the public and private hospitals to compete for more patients on the basis of their quality of services and ensure better investigation and treatment. We will be entering to contracts with hospitals in the light of patients’ flow to cater to patients’ load,” he added.

In KP, 87 hospitals including 14 in Peshawar have been registered for the scheme.

Dr Riaz said that many health facilities were upgraded due to their income from the SSP’s patients and a competition among government and private hospitals would further improve patients’ care.

The district and tehsil level hospitals have better equipments and qualified staff that can be used for improving services and getting lion’s share in the programme, which carried Rs18 billion per year.

“We are also establishing offices in Swat, Abbottabad, Mardan and Bannu districts to select hospitals in a transparent manner,” said Dr Riaz.

Agreement with Nadra is being inked to make sure that patients at the hospitals get facilitated promptly and their complaints are managed accordingly.

Published in Dawn, August 24th, 2020