Diagnostic tests outsourced in rural areas: Firm appoints one pathologist for many labs, gets govt notice

“As per guidelines, they are supposed to appoint qualified pathologists for all labs. We have issued them a notice and asked them to comply with the agreement,” said Dr Pradeep Vyas.

| Mumbai | Published: June 28, 2017 2:52:29 am

Barely three months after the Maharashtra government entered into an agreement to outsource diagnostic facilities to HLL Lifecare Ltd, the laboratory service faces inquiry for flouting rules after it was found appointing a single pathologist for multiple laboratories in different districts to sign reports.

On Tuesday, the Maharashtra Association of Practicing Pathologists and Microbiologists (MAPPM) filed a complaint with the Maharashtra Medical Council (MMC), stating that documents from three laboratories in Jalna, Jalgaon and Nanded showed pathologist Dr Puneeth Sharma’s signatures on at least three lab reports.

Stating that it was practically impossible for one pathologist to remain present in three districts, the MAPPM asked the MMC to take action against the “malpractice”.

The state government has issued a notice to HLL Lifecare. “As per guidelines, they are supposed to appoint qualified pathologists for all labs. We have issued them a notice and asked them to comply with the agreement,” said Dr Pradeep Vyas, National Health Mission (NHM) commissioner for Maharashtra.

In February, the agreement to outsource all diagnostic tests for district and rural hospitals and for primary health centres was locked between the NHM, HLL Lifecare and Directorate of Health Services.

As per the agreement, HLL Lifecare will set up 100 Hindlab laboratories across 33 districts to provide fast diagnostic facilities for 25 tests such as blood, urine and common infections.

Currently, HLL Lifecare has set up 38 labs in Maharashtra. While they earlier planned to outsource diagnostic facilities to other labs to reduce infrastructure cost, the agreement condition barred them from doing so.

According to the documents with the MAPPM, pathologist Sharma signed a report on June 5 for Hindlabs Diagnostic Centre in Jalna for a four-year-old patient. Another report of Hindlabs in Jalgaon was signed by him on May 18 for a five-year-old infant. In Nanded, Sharma’s signatures are on a report for a 65-year-old male patient on 15 June.

“It is not possible for a single pathologist to travel to three districts for monitoring lab-testing,” claimed Dr Prasad Kulkarni, executive member of MAPPM.

In its complaint to additional chief secretary (health) Dr Vijay Satbir Singh, MAPPM states, “A pathologist sitting at one place has been validating reports of multiple labs without personal supervision, which is a violation of the Medical Council of India guidelines.”

The state government’s agreement with HLL Lifecare covers 1,181 government PHCs and 508 hospitals. The public health department aimed to bring diagnostic facilities to rural and remote stretches through this model. It would also shed the burden of conducting at least 22,000 tests per month. While the test is free of charge for patients, the state government pays Rs 79 for a set of 25 tests to HLL Lifecare for submitting the report within a day of collecting samples.

Over 6 crore patients visit the out-patient departments of rural hospitals and PHCs. Ten per cent of these require further investigation through tests.

According to Vyas, no payment has been made to HLL Lifecare since it began operations. “Currently, certain labs they run do not have a provision to provide all tests. Patients still have to spend from their pocket for one or two remaining tests,” he added.

There was no response from HLL Lifecare Ltd despite an email query and several phone calls.

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