PESHAWAR: The health department has started categorisation of the empanelled hospitals offering free treatment under Sehat Card Plus (SCP) scheme to offer rates to them on the basis of the quality of their services being provided to patients.

“The categorisation of health facilities will give us an idea about their infrastructure including availability of doctors, equipment, human resources and other facilities there on the basis of which they would be offered rates for different operations, admissions and surgical procedures,” Dr Amir Rafiq, the director empanelment of SCP, told Dawn.

He said that so far they had empanelled a total of 1,115 hospitals including 861 private and 254 public health facilities across the country where 1.57 million families of Khyber Pakhtunkhwa and newly-merged districts were entitled to seek free treatment.

Of these, 203 including 149 private and 54 public sector hospitals are located in Khyber Pakhtunkhwa and 912 in other provinces where the people having the Computerised National Identity Cards of the province are eligible to avail treatment up to Rs1 million per year.

Payment to be made according to infrastructure, services

Dr Amir said that all those facilities had been selected for cashless services on the basis of their infrastructure and were given rates differently. “As empanelment of hospitals for the scheme is an ongoing exercise due to increase in the number of patients, therefore, we have undertaken the exercise to divide the health facilities into five categories from one to five and offer them rates accordingly,” he added.

The best facilities would be bracketed in the category-5, which will receive more amounts in lieu of treatment of patients whereas the remaining facilities falling in 4, 3, 2 and 1 categories will get low rates.

Dr Amir said that the categorisation would result in competition among the hospitals and they would try to move to better category by improving their quality of services. He said that presently some hospitals were also complaining about the lower rates compared to the ones that getting more amount for the same treatment and procedures but after categorisation, there would no complaint as the rates would be fixed in line with their services.

He said that the number of patients was increasing since the extension of the programme to entire population of Khyber Pakhtunkhwa in November 2019 due to which the department required to empanel more hospitals and cater to the needs of patients.

“We recorded 88,329 admissions in June, the highest number in one month, since the launch of the programme with 68 per cent in private hospitals and 32 per cent in public sector. Last year, we spent Rs20.108 billion on free treatment of 818,275 patients,” said Dr Amir.

He said that with passing of time, the government was including new procedures and treatments in the scheme like renal and liver transplants, costing Rs1.4 million and Rs5 million, respectively. He said that so far, 98 patients had undergone free renal transplants and 31 liver transplants. Other costly treatments included cardiac, gynea and oncology procedures, he said.

Dr Amir said that Health Minister Taimur Khan Jhagra constantly monitored the flagship initiative of the government to remove its weaknesses and further improve it to benefit more patients. “Khyber Pakhtunkhwa has given legal status to Universal Health Insurance Programme due to which we are motivating the hospitals to upgrade the quality of their services to get empanelled,” he added.

He said that since start of the programme in 2016, the government had spent Rs33.563 billion on the treatment of more than 1.375 patients. He said that the services had improved greatly during the past few years. He said that contracts of many hospitals were cancelled for violating the agreements. He added that new hospitals were empanelled to ensure that people receives quality treatment services under the programme free of cost.

Published in Dawn, August 15th, 2022