Sarbat Sehat Bima Yojana: Referral from govt doc a must for emergency treatment at private hospital
For planned treatment also, in case the treatment is not available at the nearest government facility, the patient will first be sent to a higher government facility. In case the treatment is not avaialble there, only then he or she will be referred to a private facility, the letter states.Updated: Aug 26, 2019 01:11 IST
The state health department has put a condition in the Sarbat Sehat Bima Yojana that a patient seeking emergency treatment under the packages meant exclusively for government hospitals can opt for private option only after acquiring a referral from the SMO or on duty medical officer.
Punjab Health System Corporation (PHSC) managing director has cited this condition in a letter dated August 18, which was sent to all civil surgeons, conveying that for emergency treatment under the 126 packages of ailments listed exclusively for government hospitals, a patient will have to first show referral slip from a government hospital to avail treatment at a private facility.
The emergency facilities mentioned in 126 packages listed only for the government hospitals include: acute colic, high fever, cut, stitches, soft tissue, single bone fracture plaster, nebulisation for asthmatic attack, moderate dehydration, hypoglycaemia in a diabetic, dengue without complication, syncope, food poisoning, etc.
Senior medical officer (SMO) or the on-duty medical officer will sign the referral slip with official seal and cite the reason why the patient could not be treated at the government facility. The patient will have to show that slip at the private hospital to get treatment under the Sarbat Sehat Bima Yojana.
The government has listed trauma and cardiac-related emergency packages for treatment at the private hospitals as per the package rate fixed in by the insurance company.
For planned treatment also, in case the treatment is not available at the nearest government facility, the patient will first be sent to a higher government facility. In case the treatment is not avaialble there, only then he or she will be referred to a private facility, the letter states.
Move raises questions
The move to have referral slip from government hospital mandatory for admission to a private hospital has come under criticism from different quarters.
“Suppose a patient is admitted to a civil hospital and the emergency treatment required is not available there, the patient will first be referred to medical college in Faridkot or Patiala and if the facility is not available there, only then the patient will get treatment at a private hospital. Isn’t it a joke with the patients?” says Vikas Chabbra, president of Bathinda chapter of Indian Medical Association (IMA).
The letter also states that SMO or on-duty medical officer in the referral slip will also mention the name of the private empanelled hospital where the facility required for the patient is available.
“Will the authorities refer the patients to private hospitals with all fairness is under question. A patient should be given the right to have treatment wherever he or she wants,” a senior medical functionary in the health department said.
PHRC managing director Amit Kumar, who is also the CEO of state health agency implementing the insurance scheme, couldn’t be reached for a comment.
RIDER The scheme lists 126 ailments which need to be treated at government hospitals only and the option of private treatment opens only if there is a referral from a government doctor
First Published: Aug 24, 2019 20:36 IST