PESHAWAR: The caretaker government of Khyber Pakhtunkhwa has decided to restrict seven surgeries to public sector hospitals on Sehat Card Plus (SCP) to put brakes on malpractices by private health facilities, according to official sources.

“The provincial cabinet has granted approval to the new mechanism of co-payment for treatment on SCP. We are in the process to enforce it by end of November. About seven procedures/operations will be conducted only in government hospitals as per the new plan,” Dr Mohammad Riaz Tanoli, the chief executive of the free treatment scheme, told Dawn.

According to him, only the government hospitals will be allowed to carry out common surgeries including caesarean delivery, tonsillectomy, cholecystectomy, appendectomy, cataract, angiography and septoplasty and submucosal resection (SMR).

He said that private hospitals had been barred from carrying out those procedures to stop malpractices and save the public money as well as health of people.

Official says new criteria for empanelment of hospitals will be approved next week

“These procedures have been included in the cashless healthcare scheme in the light of past experiences where hospitals subjected patients to various procedures without any need,” he said.

Dr Riaz said that a meeting of policy board would take place next week wherein new criteria for assessment of the empanelment of hospitals for SCP would be approved to make sure that facilities with high standards were selected and the people received quality services.

“So far, the empanelment of the hospitals was carried out by State Life Insurance Corporation (SLIC), the implementer of SCP in the province, but now we have planned to include Health Care Commission (HCC) in the process,” he said.

He said that a committee would be notified for the purpose after the meeting of policy board.

He said that SLIC and HCC would carry out assessment and SCP would play oversight’s role. He added that criteria for selection of hospitals had also been tightened owing to which they assumed that many private hospitals would lose empanelment.

However, it remained to be seen after assessment, said Dr Riaz. “Currently, we have 192 hospitals, which are providing treatment to patients on SCP. These include 129 private and 63 public hospitals,” he added.

He said that as per assumption, half of the private hospitals would be out of the SCP-approved list but it would be decided after new assessment of the facilities. “There will be no reduction in the number of government hospitals and they will continue to facilitate patients,” he said.

Dr Riaz said that the adviser on health to caretaker chief minister along with health secretary had been working to ensure the implementation of the co-payment system under which 65 per cent population of Khyber Pakhtunkhwa would receive totally free medical services on SCP while the remaining 65 per cent would contribute from 25 to 90 per cent for their treatment under the free health initiative.

He said that about 10 per cent of the patients would pay 90 per cent cost of their treatment on SCP that was unlikely to impact the general population.

“In the past too, these rich people did not avail free health services on SCP because they preferred to get executive services in high standard hospitals whereas as per the SCP’s criteria, the patients are admitted to general wards and only in the empanelled hospitals,” he added.

Dr Riaz said that so far they had been relying on the data of National Database and Registration Authority (Nadra) for provision of free services to all the population of the province.

“Now after the co-payment system, we will be using the data of Benazir Income Support Programme, based on the poverty. So, BISP is going to transfer data to Nadra before launching the co-payment system,” he added.

Published in Dawn, September 18th, 2023