Private Hospitals Refuse to Implement 10% Free Treatment Rule

Kathmandu. Although the Ministry of Health and Food Hygiene has passed a procedure mandating that at least 10 percent of the total approved beds in government and private hospitals across the country must be reserved for free treatment of the target group, private hospitals have stated that they cannot implement it.

The organization of private hospitals (OFIN) has made it clear that the private sector is not ready to provide 10 percent free beds, stating that this procedure was brought unilaterally.

According to the procedure, patients admitted to free beds must be provided with all health services available in the hospital completely free of charge, without any discrimination, similar to patients receiving treatment in paid beds. It is also mentioned that no fees can be charged for any service, including beds, doctor's consultations, surgeries, tests, and necessary medicines.

Private hospitals have stated that imposing impractical and vague service conditions in the name of 10 percent free treatment, which is discouraging them, puts the future of the private sector in crisis. Padambahadur Khadka, President of the Association of Private Institutions of Nepal (OFIN), the umbrella organization of private hospitals, said that this decision cannot be implemented.

Khadka said, 'While we have been providing quality and modern healthcare to 70 percent of the citizens through private health institutions by investing our lifelong capital without any support, aid, or grants from the state, imposing impractical and vague service conditions in the name of 10 percent free treatment, which is discouraging the private health sector instead of encouraging it, puts the future of the private sector in crisis.'

He stated that OFIN is ready to implement the agreement reached with the then Ministry of Health officials in 2073 BS, but the private sector is not ready to provide 10 percent free beds according to the interpretation of the procedure created using vague and ambiguous language.

OFIN had also submitted a memorandum to the Minister of Health and Food Hygiene, Nisha Mehta, regarding the issue of hospitals having to manage 10 percent of their beds for the treatment of poor patients and other problems of private hospitals.

After submitting the memorandum, Health Secretary Dr. Bikash Devkota had said that there was a weakness in not involving OFIN, the representative body of the private sector, in the preparation of the procedure, and this issue needs to be corrected. He responded that the ministry is ready to implement this decision for now and resolve future problems.

OFIN President Khadka said that they received an assurance from the ministry that a discussion program would be held immediately to form a clear and common understanding regarding the management of 10 percent beds. He complained that a procedure was being created and implemented for something not mentioned in the Public Health Act 2075 and the Public Health Regulations 2077.

Khadka said, 'An attempt is being made to implement something by creating a procedure that is not in the Public Health Act 2075 and the Public Health Regulations 2077. This is a matter of threatening to fulfill what is not in the act. This can also lead to judicial remedy. This is a matter of state necessity.'

Giving an example, he questioned how it would be possible for private hospitals to treat a cancer patient for an infinite period and with unlimited funds, when the government only provides one lakh rupees to a cancer patient.

According to the Target Group Free Treatment Portal prepared by the Ministry of Health, the total number of beds across the country is 25,061, but currently only 393 beds are in use. According to the updated data of the Ministry of Health, 2,627 more beds are unused.

Dr. Samir Kumar Adhikari, Joint Spokesperson of the Ministry of Health, said that the provision of providing at least 10 percent of the total approved beds for free is not new.

He said, 'The provision of 10 percent is not new. It has been a provision since the past. There was difficulty in implementation due to the lack of a procedure. The Free Treatment Portal has been brought into operation to make it transparent. The procedure has been introduced for implementation.'

• What is in the procedure?

The Target Group Free Treatment Portal (Operation and Management) Procedure, 2083 was issued by a ministerial decision on Jestha 25. The procedure clearly states that patients admitted to free beds must be provided with all health services available in the hospital completely free of charge, without any discrimination, similar to patients receiving treatment in paid beds.

The procedure also mentions that hospitals can provide at least 10 percent of out-patient services (OPD) for free as needed. To receive free treatment, patients must bring a poverty identity card issued by the Government of Nepal, a recommendation letter from the concerned local level stating they are poor or helpless, or in the case of unclaimed patients, a report or recommendation from the Nepal Police or local administration.

If false or misleading information is knowingly provided to the Target Group Free Treatment Portal regarding the ten percent free beds, or if the details are not updated, the hospital's operating license and renewal may be suspended or revoked, up to cancellation, in accordance with the prevailing laws.

According to the Ministry of Health, the 10 percent free bed service is available in all registered government hospitals, non-governmental, private, cooperative, or non-profit community hospitals.