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THE AAP government has issued an advisory to private hospitals “to avoid accepting income certificates” furnished by the economically weaker section (EWS) to avail of free medical treatment as directed by the Delhi High Court in 2007.
The move comes even as the Delhi government recently announced free medical tests for low income group residents of the city at 21 private laboratories and 30 surgeries “free of cost” at 41 private hospitals for patients referred by government hospitals.
The Directorate General of the Health Services, in its advisory, has asked the nodal officers of private hospitals to “avoid accepting income certificates”, sources said. Under the rules framed by the Delhi government for free treatment for EWS patients – those patients “who do not have proof of income such as BPL cards or income certificates can give undertaking regarding their income status and that is more than sufficient”. However, a communication dated February 22 by the Directorate of Health Services, states that private hospitals should “avoid accepting income certificate as far as possible since these are based on affidavit filed by the individual and not based on inquiry conducted by SDM on his side”.
In its defence, the department has said that “complaints are pouring in that rich people have got free treatment based on income certificates”. Under the EWS scheme, the Delhi High Court has directed to provide free treatment that is — 10 per cent of total in-patient department beds and 25 per cent of out-patient department services. Incidentally, it was on February 22 that Delhi Health Minister Satyendra Jain had announced that residents of Delhi will be able to undergo medical tests such as MRI (Magnetic resonance imaging), PET (positron emission tomography) and CT scan free of cost at 21 private laboratories across the city.
Sources said the advisory issued by the government is in non-compliance with the Delhi High Court guidelines. “The EWS patients fill the performa provided by the hospital, which is an income affidavit as prescribed by the court. If false details are furnished, it is contempt of court and recovery can be made. But one cannot avoid accepting income certificates,” said Advocate Ashok Aggarwal, a member of monitoring committee for EWS treatment in Delhi.
“When EWS patients are rushed to emergency, in such situations, not every patient will have an income certificate. If hospitals cannot accept the affidavit, where will the poor patients go in cases of emergency?” Aggarwal asked.
Under the existing rules, the income levels are linked with minimum wages of unskilled labour. At present the minimum wage for unskilled labour stands at Rs 9,568 and the number will be revised to Rs 13,350 from April 1.
However, the advisory states that only PR-S category (those who are entitled to 1kg of rice/member ; 6 kg sugar/card and 4 kg wheat/member) and those who have Antyodaya Anna Yojana (AAY) (the poorest of poor) are the “EWS families” eligible for free treatment. The order, however, does not mention, the minimum wages as mandated by the court.
“The order is creating confusion. It has mentioned only two categories of people who are entitled under the food security act. While it does not exclude the eligibility under the minimum wages, its absence in the order, has led to private hospitals not accepting those patients who don’t have national food security (NFS) cards,” sources said.
Aggarwal said, “Yes, the order has created confusion and there is an increase in the number of complaints from private hospitals. It is unfortunate that many private hospitals are sending back patients because the advisory does not mention that free treatment is linked to minimum wages. As per existing norms, the eligibility is linked with minimum wages of unskilled labour.”
What the old order states: EWS patients who do not have proof of income can give undertaking regarding their income status and that it is “more than sufficient”.
What the new order states: “Avoid” accepting income certificates “as far as possible”, since they are not based on inquiry by SDM or DM.