Telangana to make small hospitals fall in line

Hyderabad: A drive is on to register all small hospitals and nursing homes in the state to get them in the ambit of regulation whereby the exact number of patients, surgeries, type of equipment, cost of diagnostics, pharmacy and also labour issues can be monitored. All 2,500 hospitals in the state were issued a second notice recently to register with the Central Excise department.

The government wants to regulate nursing homes so that municipal taxes, fire regulations, service tax, labour and pollution issues and also diagnostic equipment and treatment costs can be monitored.  A senior government officer said, “Presently small hospitals are registered with the district medical and health office where their standards of medical treatment are monitored. But small hospitals are indulging in ‘commercial business’. There are varying charges in every hospital, right from diagnostic costs to surgery costs. There is a need to streamline it.”  Meanwhile, Dr D. Narayana Rao, president of Telangana Hospitals and Nursing Homes Association (THANA) said, “We are not going to register with the government. We do not want regulation by so many departments. We are already being assessed by municipal, fire and labour departments. Why should commercial taxes be added?”

THANA had approached the courts on the issue of luxury tax, which the government had imposed on patients from August 2015, and a stay order for the same has been procured till February 20.

Doctors state that this is one more method to pressurise them in the name of monitoring and give rise to corruption. A senior doctor said, “Once we register with the department than we have to invest in manpower to maintain those records and also update them from time to time. Any officer from all these departments can come and check our records and ask for explanations. It will be unnecessary harassment.”

The other problem that doctors state is that it will increase the costs and they will have to pass it on to patients, which might lead to many small hospitals, nursing homes shutting down.

Another senior doctor said, “In housing colonies, the business of nursing home is in treatment of small ailments like fever, cold, cough, dehydration cases and minor general surgeries. For major diseases and also life-threatening situations, doctors have to refer patients to corporate superspeciality hospitals where all equipment are available. If we are not allowed to practice even basic medicine how will we survive?”

But the state government claims that these are ill-found fears and it is in the larger interest of patients.

A senior officer said, “Compilation of proper data will help in tracking, which is very important. Issues of grievances, varying costs and charges require to be tackled effectively. Registration is the first step in that direction. Why are they resisting when they claim that they have nothing to hide?”

The agony with patients so far has been that they complain at the counter of the hospital desk, complain to the Telangana Medical Council and seek legal action in consumer courts and state human rights commission.

Forum for Better Health’s Ravindra Sharma said, “The major problem with patients is that they try to get the bill reduced by 20 to 30 per cent at the hospital level when they have to pay in cash. When it is an insurance claim most of them do not say anything. In corporate hospitals, luxury tax is covered in the insurance amount. It is only those who have to pay cash who raise a hue and cry. But so far no one has come forward to complain.” With 80 per cent of patients visiting hospitals covered under insurance, corporate hospitals have so far been charging the patients luxury tax and adjusting the same in the insurance bill. But in the case of small hospitals, in-patients of minor cases like general surgeries, deliveries and also common cases will have to be charged tax on the total bill which is making many doctors nervous.