PESHAWAR: The public sector hospitals in Khyber Pakhtunkhwa have reported an improvement in earnings from the Sehat Card Plus micro-health insuranceprogramme withdoctors and other staff members receivingthe stipulated share from that revenue.

The programme was launched in early 2016 covering 51 per cent of the province’s population.

Officials of the health department told Dawn that before November 2020 when the SCP provided services to only poor people selected on the basis of the data of the Benazir Income Support Programme, 70 per cent of the income from the SCP programme went to private hospitals (Rs4.4 billion) and 30 per cent to the government ones (Rs1.9 billion).

They, however, said as the SCP’s coverage was extended to the entire population of the province in 2020, earnings of government hospitals from the programme went up.

According to official documents shared by them, except for the period from November 2021 to June 2022 when 74 per cent of that income went to the private sector (Rs4.05 billion) and the rest (Rs1.43 billion) to the public sector, private hospitals earned more that government health centres.

Officials say special panels ensuring provision of due share in that income to staff members

Also, the public sector hospitals’ share in the SCP income was Rs6.2 billion(31 per cent)and that of private hospitals Rs13.7 billion (69 per cent) between July 2021 and June 2022 but it went up to Rs9.67 billion (38 per cent) compared to the latter’s Rs16 billion (62 per cent).

The documents show that overall, private hospitals got Rs38.2 billion (66 per cent) from the government’s health insurance programme and public sector ones Rs19.2 billion (34 per cent).

Health officials told Dawn that as the SCP’s coverage was extended to the entire population comprising 9.78 million families, government hospitals had begun receiving more patients than before.

They said two million people had received free services under the programme with 52 per cent of them being women.

Officials said under the programme, the government had empanelled 1,100 hospitals across the country and 189 of them were located in Khyber Pakhtunkhwa.

They said initially, public sector hospitals received fewer patients compared with the private ones due to a lack of incentives for the former’s employees.

The officials, however, said two years ago, the health department had introduced the ‘Fund Retention and Utilisation and Distribution Formula’ and asked government health centres to follow it to claim better share from the income of the health insurance programme.

They, however, said the formula wasn’t fully implemented by most hospitals.

The officials said private hospitals had already treated patients on payment and thus, generating more revenue from the SCP compared with their public sector contemporaries.

They said under the formula, the hospitals had to spend 25pc funds from the SCP programme to improve patient care and do repairs and maintenance, give 30pc to doctors and 15pc to nursing and paramedical staff, and spend 20pc on consumables and 10pc on administrative matters.

The officials said in the last one year, the health department had been trying to ensure enforcement of the formula aiming to give incentives to staff of government hospitals from the income generated by the SCP.

They said it was a matter of concern for the government that the lion’s share of revenue went to private hospitals, so it forced its hospitals to enforce the Fund Retention and Utilisation and Distribution Formula.

Officials added that after the initiative, many government hospitals began treating patients against the SCP

cards causing their income from the health insurance programme to increase.

They said the Peshawar Institute of Cardiology, Lady Reading Hospital and Hayatabad Medical Complex had drawn most of income from the SCP programme in the public sector since the the enforcement of that formula two years ago.

Officials said the hospitals had formed committees headed by medical superintendents to ensure the provision of the stipulated share in that income to staff members.

They said seminars were also being held under the SCP programme in public sector hospitals to rope in more and more patients.

Published in Dawn, April 25th, 2023