As per the bill, all residents will be entitled to emergency treatment and care without prepayment of any fee or charges, and the hospital can’t delay treatment on grounds of police clearance if it is a medico-legal case.
Right to Health (RTH) was passed by the Rajasthan Assembly on March 21. The bill gives every resident of the state the right to avail free Out Patient Department (OPD) services and In Patient Department (IPD) services at all public health facilities and select private facilities.
As per the bill, all residents will be entitled to emergency treatment and care without prepayment of any fee or charges, and the hospital can’t delay treatment on grounds of police clearance if it is a medico-legal case.
The free healthcare services, including consultation, drugs, diagnostics, emergency transport, procedure and emergency care, will be provided subject to conditions specified in the rules.
The legislation says that “after emergency care, stabilisation and transfer of patient, if patient does not pay requisite charges, the healthcare provider shall be entitled to receive requisite fee and charges or proper reimbursement from the state government”.
As per the bill, anyone found in contravention of the Act will be punishable with a fine of up to Rs 10,000 for the first contravention, and up to Rs 25,000 for the subsequent contraventions. However, many have pointed out that the penalty may be too low for hospitals.
On this Association of Healthcare Providers India (AHPI) says, “no consultation was done with private sector, which provides more than 65 per cent of healthcare services in general and 85 per cent of critical care related services. Hospitals have represented to government but there is no respite. We have now decided to approach Hon Governor to withhold the passage of bill as it will destroy the fine fabric of trust between patient and healthcare providers.”
“To begin with let us point out that Government of Rajasthan has Chiranjeevi Scheme which has cover of 5-lakhs like AYUSHMAN BHARAT and which was raised to 10-lakhs some time back and recently raised to 25-lakhs. This is nothing but simple election agenda with no logic. For example, the rates at which reimbursement is given under Chiranjeevi scheme are not at all based on any scientific basis. Most rates are below operating cost. Someone made calculation for hypothetical case that if a patient undergoes all possible procedures including cardiac by-pass, joint replacement and renal transplant, the total bill will not go beyond 10-lakhs. Then what is this 25-lakhs?
Secondly when we already have Chiranjeevi Scheme then why bring Right to Health? Consider a trauma patient landing at Women and Child hospital, what treatment could be imparted? Same way a serious pregnant women comes to cardiac specialty hospital, how can hospital be made accountable to provide treatment. Over and above hospitals cannot claim any fee if patient is not in position or refuses to pay. The hospital will be paid at Chiranjeevi rates even if the hospital is not empanelled under the scheme. This will make industry financially unviable”, AHPI added.
AHPI statement also says, “Right to Health should be brought only if government has its own infrastructure. But if government does not have adequate services, then it can buy from private sector at cost arrived at scientific basis. AHPI takes serious view of such an ACT and would appeal to government to reconsider the provisions of bill. Failing which industry would be constrained to approach Hon Governor. Till then hospitals have decided to suspend services.”
Sharing his views, Dr Ashutosh Raghuvanshi, President, NATHEALTH said, “The National health policy 2017 unveiled the intent that India would like to deliberate and enact a universal health policy with the universal right to health for its citizens. After over 5 years, Rajasthan is the first state to legislate such a policy. There have been deep protests among private providers and clinicians cutting across public and private lines since this act was passed by Rajasthan legislature last week. This shows that rights and obligations have to be carefully balanced and an operational framework needs to be established with accountability on each counter parties. This has to be deliberated upfront and agreed upon between major stakeholders. This is a prerequisite and not an afterthought of such a major bill and five years would have been a fair time horizon, yet it has not been done. The bill raises significant questions that weigh in on private providers around operational viability, financial sustainability, patient privacy and the increased legal and criminal cases that will be lodged against doctors who are already victims of physical violence.”
“NATHEALTH believes that UHC is a laudable objective that can only happen with the active participation of public with private sector . But it requires serious commitments – political, financial, technical and operational and involves consensus building upfront among key stakeholders. UHC has never been achieved anywhere in the world where the private sector fears that public good will be delivered at private cost and we sincerely request the Rajasthan Government to put this bill on abeyance till a consensus is achieved and an operational framework is established. NATHEALTH stands ready to support all governments- central and state, to outline the positive role the private sector can play in such a UHC framework and work collaboratively to help build consensus”, he added.