Pay clinics to kick off healthcare reforms in AP

Hyderabad | Updated: Nov 21 2005, 06:24am hrs
The Andhra Pradesh government is considering setting up pay clinics in all district hospitals. Health minister K Rosaiah had recently announced that the government was considering the proposal as part of health sector reforms, to establish pay clinics for the benefit of those who can afford to pay, thus eliminating the creamy layer from subsidised health services.

The proposal was placed during the all-party meeting to seek the opinion of the opposition parties. The government will not charge any fee from below poverty line families, he clarified.

According to the proposal, government doctors working in the district hospitals will attend the pay clinics after hospital hours. In fact, many doctors resort to private practice on the sly, though officially it is banned in the state.

However, former health minister N Janardhan Reddy (TDP), a medical practitioner himself, questioned the validity of the governments move since it opposed the earlier governments policy of levying user charges. The Congress government had abolished user charges in the hospitals immediately after assuming office. Mr Reddy further said that the move would lead to discrimination between the rich and the poor in hospitals, and it was very likely that the rich would get the attention of doctors.

Interestingly, the difference between user charges and pay clinics is that under the latter, services will be offered after the usual hospital hours on a prescribed fee determined by the government. A share of the fee will go to doctors. Thus, the doctor will be made to stick to the hospital and his services can be availed by one and all.

Under the user charges model, it was the discretion of the doctor to collect charges based on the patients capacity and the proceeds were to be utilised for maintenance of the hospital and for the benefit of poor patients. However, as medicos opposed collection of user charges by doctors, claiming that there was an element of discrimination and extortion, chief minister YS Rajasekhara Reddy (himself a doctor) had decided to abolish it and assured that the cost of hospital maintenance, including consumables, would be paid by the government.

This apart, the government proposes to divide the sector into three primary health, hospital services and medical education. Each of these will function independently.

Further, it has decided to allow government doctors private practice, which had been banned for about a decade. It also wanted to take the services of registered medical practitioners (RMPs), as they have been demanding legitimising of their practice. AP has over 60,000 RMPs providing basic medical services, especially in rural areas.