Consulting a doctor in India is an expensive routine unless you opt for the public hospitals functioning under the government. I’ve been working at such a government hospital for the past 3 years now. Things were running smooth until the hike in the consultation fee. This article explains the reasons for the sudden hike in the fee and why it is necessary in almost all the government hospitals.
Our Primary Health Centre (PHC) started functioning in 1973. Since then, the Out-Patient Department (OPD) has been providing basic curative and preventive healthcare services at a nominal fee of just 1 Rupee. This has been the norm till the inception of the medical laboratory at the PHC on the first of October, 2015.
The Hospital Management Committee (HMC) is responsible for taking the big decisions concerned with any kind of developmental activities at the PHC. The HMC consists of political leaders, and representatives from the Panchayath (our LSGD). Meetings of this committee are held at the PHC every 3 months.
The last meeting of the HMC was held just before the inauguration of the laboratory on the 24th of September, 2015. In that meeting, a decision was taken to increase the OPD fee to 5 rupees. The reasons for the hike has been explained below. It has to be understood that the increase in the OPD fee is not applicable for all the patients alike. Those poor patients belonging to the “Below Poverty Line” category need to pay just the 1 rupee. Fee is not collected from old patients who attends the OPD for a review.
The news of the fee hike was met with mixed reactions from the community. Many people started asking questions at the OPD counter. Some of them not only just responded, they started retaliating in all the ways they possibly could. Some of the protesters were demanding to shut down the laboratory.
The common man can spend thousands of rupees in private hospitals for investigations, consultations and medicines. But, when the government-run public hospital asks for 5 rupees, they can’t tolerate it!
Most of the patients who visit our Primary Health Centre takes an auto-rickshaw for commuting. There are many others who park their air-conditioned cars just outside the hospital and some of them don’t even bother to turn off the vehicle’s engine while they wait.
Read this article to learn about the various health services provided at a PHC.
Reasons for the fee hike
Providing a medical laboratory facility at a PHC level is highly beneficial for the community. The equipments required for the laboratory was supplied by the NHM (National Health Mission). The laboratory technician’s wages has to be met from the hospital fund itself. That means the OPD fee, and the nominal charges levied for the laboratory investigations.
Compared to the private laboratories, we charge only a fraction of the amount for every investigations. For example, one has to pay just 15 rupees for the fasting blood glucose test from our lab. The same test will cost more than 30 rupees in a private lab or hospital.
In Kerala, a manual labourer will charge you 500 rupees for a half day’s work. How can we expect a lab-technician to work for just 350 rupees a day? If the fee collected from the OPD from every new patient is just 1 rupee. The maximum amount that can be collected from the OPD alone per day will be below 150 only.During the initial months the collection from the laboratory will be meagre. For the last one month, our average lab fee collection was just 200 rupees.
That sums up to a total of just 350 rupees per day. There has to be a minimum collection of 500 rupees per day in order to pay the minimal wages to the lab technician. One has to keep in mind that the hospital fund is utilised for meeting a number of other expenditures too. For example, buying office supplies, buying essential drugs, for hospital maintenance work etc.
I have been receiving many calls from political leaders enquiring about the hike in the OPD fee. Any decision to change the fee can be made only during the meeting of the “hospital management committee” (HMC). The members of the HMC who were present while making the big decision are also restless now. They are under the pressure of the “revolting public” to bring an end to the “capitalist” change!
Funny thing is that the elections to the local self-governing departments (LSGD) came in the midst of this big decision. All the members of the HMC will now be replaced with the new ones. An HMC meeting needs to be conducted once in 3 months only. The next meeting for our PHC needs to be conducted only in January 2016.
It has been 45 days since the change was made. I am not sure for how long the 5 rupees fees can be charged. Perhaps the new members of the HMC will summon an emergency meeting to take a reverse decision. But, till then we will continue to ignore the protesters and provide the services we have been providing for years.
Have you ever been to a government hospital? How much fee do they take at the PHC near your house? Do you think that charging 5 rupees for OP consultation is intolerable?
Image Credit – Harsha
