Civic hospitals in Mumbai may soon charge user fees

Healthcare at public hospitals may soon cost you more. The Brihanmumbai Municipal Corporation (BMC), which runs most public hospitals in the city, plans to start charging for medical services being offered at its hospitals.

Currently, patients are charged nominally for consumables, but not for medical services, which come free-of-cost in most cases. But Dr Sanjay Oak, director, medical education and public health, feels that the model of 100% subsidy was no longer viable.

He said that the financial burden faced by the BMC health department on account of the subsidy was indirectly affecting the quality of the healthcare being offered.

To start with, the department has proposed to levy service charges on surgeries performed at hospitals. Depending on the nature of the surgery, the charge could range from Rs2,000 to Rs8,000. “A minor surgery will cost Rs2,000, for intermediate-level and major surgeries, amounts of Rs5,000 and Rs8,000 will be charged,” he said.

The proposal, if and when approved, will affect the middle and upper middle classes, which cannot afford sky-high prices for similar procedures performed at private hospitals.

Oak, however, said that patients are unlikely to complain. “Through experience, we have learnt that patients will not mind the charges if quality services are delivered in return.”

The BMC absorbs an average cost of Rs1,538 per patient admitted.

The department has proposed to first pilot-test the charging model at the King Edward Memorial Hospital (KEM) in Parel, before extending it to other civic hospitals.

Applications (expressions of interest) have been invited from banks interested in collecting charges from patients.

“One of the banks has already responded, and others have made inquiries, too,” says Oak. A formal proposal seeking permission for charging patients for surgeries will soon be tabled before the BMC political leadership. Oak is hoping that it will be approved. “While all the patients will be charged, the hospital management will have the power to waive charges for those found below the poverty line,” Oak said.

Advocate Kamayani Mahabal, an activist of the Jan Swasthya Abhiyaan, which pitches for health rights, has ridiculed the move to charge for services. She said that access to health care should be available free-of-cost. “We are against charging of user fees,” she said. Mahabal demanded that instead of charging patients, the BMC should allocate more funds towards improving the healthcare infrastructure.

Most medics at civic hospitals, including Oak himself, believe that acceptance of the proposal will only come if municipal hospitals become more “patient-friendly” in their outlook. The transformation, however, could be around the corner. As the first step, “May I help You” counters will soon be guiding patients and their relatives at civic hospitals.

As for the BMC, if the proposal is approved, the cash-crunch will cease to be an issue. KEM hospital alone witness 192 surgeries daily, including 90 major ones.