PESHAWAR: Public sector hospitals have started receiving their unpaid amount in lieu of free healthcare services on Sehat Card Plus from State Life Insurance Corporation after release of funds by the government.

“Since last month, the insurer has paid Rs4 billion to public sector hospitals after receiving Rs5 billion from government. All the main hospitals are treating patients now,” said officials.

They said that SLIC, which implemented SCP in the province, had stopped payment to hospitals after stoppage of funds by the caretaker government. However, the incumbent provincial government of Pakistan Tehreek-i-Insaf started payment to the insurance firm, which started full-fledged free treatment services on March 12 in the province.

Officials said that caretakers had stopped the programme and allowed only three emergency treatments, citing financial constraints. Public sector hospitals had also stopped receiving patients on SCP due to non-payment of their dues by the insurer. The province’s biggest Lady Reading Hospital had Rs2 billion, Peshawar Institute of Cardiology Rs1.5 billion, Hayatabad Medical Complex Rs600 million and Khyber Teaching Hospital Rs500 million in addition to the outstanding amount of district headquarters hospitals and other medical teaching institutions in districts other than Peshawar.

Govt has to pay Rs20bn to insurance firm for running the programme

Officials said that government had to pay a total of Rs20 billion to SLIC due to which it had stopped free treatment services. The government is likely to pay another instalment of Rs2.5 billion to the firm within few days for the month of April. Public hospitals would continue to receive the amount on a monthly basis and keep continue services, they added.

They said that government wanted to focus on public hospitals for treatment of patients on SCP with a view to strengthen the infrastructure as well as benefit doctors and other staff.

“The government has also restricted seven surgeries to public sector hospitals on SCP to put brakes on malpractices by private health facilities,” said officials. Only government hospitals are allowed to carry out common surgeries including caesarean delivery, tonsillectomy, cholecystectomy, appendectomy, cataract, angiography and septoplasty and submucosal resection (SMR).

Private hospitals have been barred from carrying out these procedures to stop malpractices and save the public money as well as health of people. “In some cases, it has come to the fore that private hospitals have conducted these procedures and surgeries unnecessarily due to which they have stopped them,” said officials.

They said that they removed 71 private hospitals from the list of empanelled health facilities for the programme. “There are now 118 empanelled hospitals including 60 public and 58 private. SLIC will pay to hospitals only when it gets funds from government. Earlier, the insurer paid the hospitals despite non-payment by the government,” they added.

With the decrease in number of empanelled hospitals in private sector and restricting common procedures to government hospitals, officials said, monthly cost of the programme would come down from Rs3 billion to 2.5 billion. “It is a major step towards sustainability of the programme. More private hospitals will lose empanelment as the criteria for selection for treatment of SCP has been tightened to ensure that the people get quality services,” they added.

However, public hospitals were required to provide prompt services to patients so that people don’t go to private hospitals for major treatments.

Published in Dawn, April 24th, 2024