PESHAWAR: The shortage of staff has been hampering the government’s plan to ensure strict surveillance of Sehat Card Plus (SCP) programme and put an end to pilferages and address the complaints of patients, according to sources.

They said that government had twice approved organisational structure with staff for free treatment scheme but could not enforce it.

Sources in health department said that the Khyber Pakhtunkhwa government was spending about Rs30 billion annually to provide free treatment services to people under the health insurance initiative but there was no check on the performance of empanelled hospitals.

“There are complaints on regular basis from patients regarding poor services in some hospitals. Some patients complain that they are sent to market by empanelled hospitals to purchase drugs illegally. However, we have no mechanism to check these and other complaints,” they said.

Policy Board member says health dept relies on SLIC to check performance of hospitals

The programme is totally run by State Life Insurance Corporation (SLIC), the executor of the cashless healthcare initiative, because there are less than 10 staffers deployed by the government at the project management unit of SCP. The existing staff remains busy in meetings and does not find time to carry out inspections of hospitals and address the complaints of patients.

“We need to ensure quality control at empanelled hospitals through field visits by the staff but despite our requests the government has yet to recruit people and strengthen monitoring of these health facilities,” said sources.

They said that the programme required a special monitoring unit to check hospitals and the treatment, surgeries and other procedures they were performing under SCP. A member of SCP’s Policy Board said that they had discussed the issue several times because they could save at least Rs3 billion per year by strengthening monitoring of the programme.

He said that government had approved recruitment of staff from the market after a proposal was sent to it in 2018 and 2020. He said that they required about 70 people to put in place a system of strong oversight and monitoring. He added that it would not only save public money but also ensure quality services to patients.

“The government is spending about Rs3 billion every month on free healthcare of 100,000 patients but there is no check from the government’s side and only SLIC is in the field. There is no loss to the insurance company and all the money for the programme is paid by the government,” said the Policy Board member.

He said that there was not a single person from the government in any district to check the empanelled hospitals and the services they provided to patients. He said that health department relied on SLIC.

He said that health insurance programmes were supervised by institutions and not the insurance companies everywhere in the developed world. “SLIC is calling the shots here,” he added.

He said that there should be enough staff to ensure a strong mechanism of check and balance. He said that the staffers would see that if the criterion set by the empanelled hospitals was met. He said that annual cost of a proper structure with staff was about Rs500 million. “If government is spending Rs30 billion annually on the programme, then there is no harm to hire staff and check the prevalent issues,” he added.

He said that the board wanted to persuade the government to order structure for the programme and do away with the problems regarding health services being provided to patients. He said that there were complaints from districts as well as Peshawar that some patients didn’t get full medicines but there was no one to check the same and take action accordingly.

“Since 2016, Rs70 billion has been spent on treatment of 31 million patients. Had the government a proper monitoring system, a lot of money could have been saved. SLIC is in the field but it has no fear of loss as all money is paid from government’s kitty,” said the member of Policy Board.

Published in Dawn, May 6th, 2024