The SC ruling that private Delhi hospitals operating on subsidised government land must provide free treatment to ‘economically weaker’ patients, has left people divided. On the one hand, it is reasonable to assume that private hospitals that are taking advantage of government largesse should do their best to help patients in this economic category. Such a move will reduce the burden on the Capital’s already over-stretched government hospitals, provide shorter waiting times for patients suffering from serious ailments and help make healthcare more ‘democratised’. But while there are positives in the SC ruling, there are a great number of outstanding issues that still need to be tackled. Who are ‘economically weaker’ patients need to be clearly defined otherwise patients of various income categories will seek to avail of this system. 

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The second issue is who will check for fraud? If a patient claims he or she can’t pay what will the hospital do? The onrush of patients will make it impossible to verify each and every claim. If not handled properly, this can be a disaster in the making. Another major concern is that by making everything free, the apex court is potentially setting up private hospitals for ruin. X-ray machines and other medical equipment are expensive and hospitals need money to run them properly, money that can only come from charging a fee from the patient. If a large number of patients are suddenly able to avail of such tests for free it will lead to overuse and the spoiling of expensive equipment resulting in huge losses for the hospitals concerned. To make up for these losses, both equipment and staff are likely to be cut by the hospital ensuring a loss of quality treatment for the patient. This can be very dangerous. By coming down hard on private hospitals with a contempt order if they fail to comply, the apex court also runs the risk of frightening away other private players from the medical field. This has to be avoided at all costs by governments, both Delhi and the Centre.

Post the court’s ruling, the Delhi government needs to sit with the stakeholders and work out feasible plans by which everyone’s interests are safeguarded. It is all the more important to do this as the Capital is the ‘home’ for most of India’s poor patients and a wrong move will jeopardise everyone’s interests. For this, the government needs to work out steps that will encourage more hospitals to come up and the existing hospitals to be incentivised and ready to implement the court order. A regulatory mechanism where patients are screened through Aadhaar and other recognised IDs to check their economic status is one move to deal with this. Restriction of family members is another option that must be put in place to ensure security in a hospital that will already be over-crowded. Then, by maintaining constant communication between the hospitals to understand and deal with issues as they come up, the government can ensure the SC ruling will both benefit poor patients and keep private hospitals functioning normally. That is the need of the hour.