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HindustanTimes Wed,20 Aug 2014

Untrained staff, bogus claims: Reality of relief fund hospitals

Vishav Bharti, Hindustan Times  Chandigarh/Amritsar, April 19, 2013
First Published: 23:40 IST(19/4/2013) | Last Updated: 09:26 IST(20/4/2013)

Hospitals being run from small houses to ayurvedic practitioners doing the super-specialist job of chemotherapy - that's what patients get in the name of treatment from institutions empanelled under the Mukh Mantri Punjab Cancer Rahat Kosh Scheme (MMPCRKS). An expert committee constituted by the state government has now asked for canceling empanelment of 11 of the 36 hospitals, besides asking for improvements at nine.

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The committee - constituted in December under Dr JS Thakur, additional professor, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh - found only 17 of the 36 hospitals offer complete cancer treatment. Though a memorandum of understanding (MoU) was signed with each hospital, "the committee couldn't find the definite criteria for empanelment" nor was the copy of any MoU provided.

Officials said the 28 private hospitals had simply approached the health department to get empanelled in 2011 after a newspaper ad sought applications; the department itself empanelled eight government hospitals. And since the scheme's beginning in June 2011, around Rs. 75 crore have been released to the hospitals for around 7,000 patients.

As per guidelines, 50% of the maximum Rs. 1.5 lakh per patient is to be given upfront, while the remaining is subject to submission of utilisation certificates. But these norms were not followed, as HT exposed on April 19. CM Parkash Singh Badal has now promised to start direct payment to the patients.

'Probe the procedure'
However, a member of the committee termed the very empanelment "scandalous". The committee found unqualified staff providing treatment for cancer at some of these hospitals - a fact corroborated by HT's first-hand visits. "The situation was worse where personnel from alternative system of medicine were managing cancer with chemotherapy, under guidance of unqualified personnel," the report said, adding that only a third of the private hospitals had requisite manpower.

"It was common phenomenon observed among various private hospitals that a single specialist was on board of number of hospitals. Many of the hospitals were functioning as nursing homes being operated by single person. The facilities of chemotherapy and surgery were provided by person on call and [by] referring to other institutions," it added.

Dr JS Thakur, chairman of the committee, refused to comment beyond saying that the report had been submitted to the government, "and now it is their call".

State of affairs
The HT team visited three of the 11 hospitals recommended for cancellation of empanelment.

Delwyn Hospital in Chandigarh's Sector 46 is run from a house, with a hoarding calling it a super-specialty hospital. Its medical director, Dr Neetu Bedi, has an MBBS degree, but four doctors with bachelor degrees in ayurvedic medicine run the show. Asked how an ayurvedic doctor could administer chemotherapy, one of them said it was routine here.

The hospital doesn't have an operation theatre or radiotherapy unit. So patients are referred to Government Medical College and Hospital, Sector 32.

Amritsar's Shergill Multi-Specialty Hospital has a general surgeon but no full-time oncologist, nor any radiotherapy facility. Surjit Multi-Specialty and Cancer Hospital in the same town has a doctor with a diploma in surgical oncology, but it sends radiotherapy cases to Guru Ram Das Medical College and Hospital run by the Shiromani Gurdwara Parbandhak Committee (SGPC).


Asked to be taken off panel
*Shergill Multi-Specialty Hospital Amritsar
*Surjit Multi-Specialty and Cancer Hospital, Amritsar
*Bajwa Hospital, Amritsar
*Amandeep Hospital, Amritsar
*Dhaliwal Hospital, Amritsar
*Nulife Hospital and Cancer Centre, Ludhiana
*Sharma Hospital, Ludhiana
*Kiran Maternity Home and Surgical Centre, Bathinda
*Delwyn Hospital, Chandigarh
*Sri Guru Teg Bahadur Multi-Specialty Hospital, Anandpur Sahib
*Government Multi-Specialty Hospital, Chandigarh

What expert committee says
Only hospitals with facilities of radiation oncology, medical oncology, chemotherapy and surgical oncology under one roof be empanelled
Cancer management facilities in public sector need to be strengthened as a long-term, patient-friendly, cost-effective measure
Government Medical College and Hospital, Amritsar, is the only public-sector institute in region to cater to common people, so facilities of cancer care be strengthened there

Hospital responds, HT replies

*Surjit hospital: On the April 19 report about hospitals pocketing benefits of the CM cancer relief fund, Surjit Multi-Specialty Hospital from Amritsar wrote to HT that though the sanction of Rs. 1.5 lakh was obtained for patient Manohar Lal in December 2012, no money was actually obtained as the patient never turned up for the treatment.

*HT reporter: It was indeed mentioned in the report that only sanction had been obtained. However, as for Surjit hospital's contention that Manohar Lal had not turned up after December, his wife Mamta Rani said that since he needed radiotherapy, which Surjit hospital did not provide, Manohar got it done at Guru Ram Das Medical College and Hospital against full payment in January. "The fund was useless for us as it was sanctioned to a hospital that didn't have complete facilities," she said.

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