Govt should help patients, sort out cashless mediclaim issue

The cashless mediclaim issue hogged headlines in 2010. Maj. Gen. (Retd) Vijay Krishna, CEO of Breach Candy Hospital and president of Association of Hospitals (AOH), discusses the need for the government to step in to solve the vexed problem. He also puts his thought on healthcare services and AOH’s plans this year.

Some of the private hospitals recently entered the preferred provider network (PPN) list. What is AOH’s stand on it? When will the cashless issue be resolved?
In July, the General Insurance Public Sector Association (GIPSA) decided to fix rates for 42 surgeries based on the data available with them. So far, there has been no progress in the terms and conditions. AOH’s stand is very clear; we will send our existing rates to GIPSA. Because of this issue, the policy holders are at stake as they cannot opt for hospitals of their choice with major hospitals out of the preferred provider network list. We feel the government should step forward and find a solution which is acceptable to all.  

Many new hospitals are mushrooming in the city. Will this increase competition and see a dearth of experienced doctors?  
It is a very positive trend. Communication and transportation is a big problem in the city. More hospitals will ensure that there is a hospital nearby your residence and you don’t have to travel far for health care services.   

Many new hospitals are running for Joint Commission International (JCI) accreditation to attract foreign patients. Do you think more focus is given to treatment of foreign patients? 
Mumbai is seeing a boost in medical tourism. Medical tourism is flourishing as health care in European countries is costly and the procedures there are time consuming. Here, they are getting the same health care at a cheaper rate. It is good for the image of India. But it should not be at the cost of Indian patients. 

There are very few hospitals going for National Accreditation Board for Hospitals & Healthcare Providers (NABH) accreditation. What is the reason?
Going for NABH accreditation is an individual choice. NABH is an Indian version of JCI. An accreditation helps improve the functioning of the hospital as overall quality control is followed under quality control of India. I personally feel NABH is good.

The difference in surgery rates from hospital to hospital has always been talked about.
In all hospitals there are different classes of rooms and the charges are according to the kind of room the patient selects. As far as the outdoor patient department is concerned, the rates are always cheaper for in patients. The charges differ from class to class and it is the method of cross subsidisation. 

The state government had formed a committee to visit hospitals on a regular basis. Does this intervention affect your work?
We don’t have any problem with committees visiting hospitals as we have nothing to hide. The information sent to the charity commissioner is authentic. It is a wrong perception that hospitals like Breach Candy and Jaslok do not treat poor patients. We have 10 per cent beds reserved for poor people and the treatment provided to them is absolutely free. We also subsidise rates to 10 per cent. We believe medical treatment should be made available to both poor and it should be affordable too.

What is your take on the Bombay Hospital fake doctor issue? 
It is a serious issue. A person worked as a doctor for six years in the hospital and no one could figure it out. However, such cases are rare. There should be a senior most doctors in the interview panels while recruiting doctors and the hospitals should make it a point to cross check the details with the Medical Council of India, and if possible, the institution from which the doctor has passed out. 

Unions have been an issue of concern with many hospitals. How do you think the hospitals can deal with that?
Every organisation has unions. However, the union which claims the majority can seek recognition from the labour court and bargain for collective grievances with the organisation. So far, we have not had any problems with unions as they too understand that we are a health service provider and an issue will directly create problem for patients. 

After the 26/11, what steps have been taken by the hospitals for security?
There has been security alerts for hospitals as they remain soft targets. All hospitals have taken basic security measures like keeping security guards, metal detectors, CCTV cameras etc. Apart from this, hospitals have a security cabin at the entrance. They are in regular touch with the local police stations. We are confident on measures taken by the government.