In a 37-page affidavit filed with the Supreme Court on Monday, a copy of which has been seen MintThe ministry said many states have their own healthcare programs while many people are covered under the Ayushman Bharat scheme.
Glaring discrepancy
The Supreme Court had earlier asked the ministry to hold a meeting with all state health departments after finding a glaring discrepancy in the prices of medical treatments between government and private medical facilities.
The Court had in February sharply criticized the Centre's inability to enforce the 14-year-old Clinical Establishment (Central Government) Rules, which aim to enforce standard rates for various medical treatments and procedures.
“A one-size-fits-all approach may not be feasible. This appears to be a difficult task for recommending rates,” the ministry said in its affidavit.
Following the Supreme Court's direction in February, the Health Ministry called for a virtual meeting with states, which was chaired by Secretary Apurva Chander in March. Currently, only twelve states and seven UTs have implemented the Clinical Establishments (Registration and Regulation) Act, 2010.
It has not yet been adopted by 16 states: Andhra Pradesh, Chhattisgarh, Goa, Gujarat, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Manipur, Meghalaya, Nagaland, Odisha, Punjab, Tamil Nadu, Tripura and West Bengal.
Serious compromise
States like Gujarat and Madhya Pradesh have said that any fixation of rates could seriously affect the quality of healthcare and treatment of patients, especially in the private sector, and could reduce the standard of healthcare provided. Uttar Pradesh also emphasized that fixing rates could lead to serious problems such as making healthcare institutions financially unviable.
Uttarakhand felt that the fixation of rates could make the healthcare sector uncompetitive given the economic dynamics and interaction of market forces. Bihar and Mizoram suggested that organizations like the IMA could potentially be involved in this process of such discussions.
States like Madhya Pradesh, Andhra Pradesh, TN and Delhi invited the guidance/cooperation of MoHFW in this regard to go further. West Bengal said that majority of the population is covered under the state law for quality and affordable access to healthcare through state schemes and therefore they have no intention of fixing the rates.
Ready template
Only the states and UTs where the clinical institutions are trading in 2010 are applicable – Uttar Pradesh, Bihar, Himachal Pradesh, Telangana, Uttarakhand, Andaman and Nicobar, Mizoram showed willingness for rounds of discussion with stakeholders and invited the guidance/cooperation of MoHFW in this regard out to continue.
The Ministry of Health has issued a 'Template of Costing of Procedures' prepared by the DGHS and approved by the National Council for Clinical Establishments (NCCE) to all States/UTs, suggesting that it can be used as a basic framework to to work out costs of medical procedures and services applicable in the States/UT by taking due account of various local factors such as location of clinical establishment, type of clinical establishment, qualification and experience of the treatment facility / healthcare staff etc.
The medical authorities and hospital associations expressed their satisfaction with the hearing. Harish Salve, senior lawyer appearing in the matter for NATHEALTH – Healthcare Federation of India, told Mint that it is not for the courts to decide the price of medical services but the duty of the legislature. “No mandamus can be given to the government in this regard. Price fixation of medical services, for all hospitals across India, is not possible. There is no one size fits all. “There is no comparison between a government hospital receiving various subsidies from the government and private hospitals, which are not beneficiaries of such subsidies, have no price restrictions for any other service sector in India as the same is not possible,” he said.
“We appreciate yesterday's observations in the proceedings that standardizing treatment package rates will have significant implications for the quality of healthcare services, patient safety, treatment outcomes, sustainability and the continued investments required to address the unmet infrastructure and the expansion of clinical capacity to healthcare for all. agenda. The government’s comments also highlighted these concerns,” said Abhay Soi, President of NATHEALTH.
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Published: Apr 30, 2024 7:10 PM IST