While the Health Ministry is still delaying or dilly dallying with the National Medicinal Drugs Policy (NMDP) to provide quality drugs at affordable prices, we wish to spotlight today another grave or deadly scandal in the private health sector.

The process of channelled practice was a social welfare measure intended to ease the congestion in public hospitals and for the convenience of those wishing to see a specialist of their choice at a convenient time. This process was also intended for the government medical specialists to earn something extra even though at the sacrifice of his or her leisure time.

The channelled practice was introduced in the 1965-70 era, under the then UNP government, after the previous SLFP government did away with private medical practice for government doctors.

This was a welcome decision, both for patients and doctors and generally it appeared to be a sort of a social welfare activity. The fees were regulated -- the patient paying only Rs.25, of which the doctor was paid Rs.20 and the private hospital, getting Rs.5 for a patient. The entire mechanism was handled by an office in the national hospital and was called the “channel office”.

Some time after 1977, with the onset of the open economy, the regulatory function of the government was scrapped and the doctors and private hospitals were allowed to charge as they wished.

It is all too clear as to how this well intended facility has been abused by unscrupulous private hospitals and some doctors too to plunder the helpless patients. Although a good section of the high income public has taken this lying down, it has hit really hard the middle and lower income class of patient. The private hospitals have been increasing their levy regularly and the doctors have had to follow suit with corresponding increases. Today most private institutions charge more than Rs.500 for a patient as their institutional fee, just for providing the out-door facility. Accordingly if the initial scale of proportions agreed 1:4 were to be operative today, then the doctor’s fee would amount to more than Rs.2000, but it is known that the vast majority of the specialists do not charge anywhere near this fee. It is also known that channel fees charged by some specialists are less than the institutional levy.

This shows clearly how a somewhat modified social welfare system has been abused by unscrupulous private medical institutions to make unconscionable profits from channelled-patients for whom they only provide a consultation room for the duration of the consultation, levying separate fees for laboratory tests and indoor treatment. Considering the escalation of costs all round, could not some consensus be reached for Rs.100 for the institution and Rs.400 for the specialist (a 20 fold increase), so that each patient pays a round sum of Rs.500- a great boon to patients who have no choice but to seek medical advice when ill.

In our Health ministry, there is a deputy director who is in overall charge of private medical institutions in the country and every now and then it is flashed in the media that the fees levied by private institutions would be controlled, but soon forgotten and things go on regardless. Here’s one instance highlighted for action by the deputy director, as well as volunteer activists like the People’s Movement for the Rights of Patients, to take up the matter on behalf of patients.

Source: Daily Mirror - Sri Lanka