Sehat Sahulat Card: Referrals put patients on long waiting lists
Officials say there is a need to send more patients to private health facilities
PHOTO: EXPRESS
PESHAWAR:
People living outside the Peshawar district say they face difficulties in availing the healthcare facilities through Sehat Sahulat Card due to the referral system that has put excess burden on public health facilities.
Sehat Sahulat Card, a government sponsored health insurance, has made it difficult for people to access free of cost health services rather giving relief to underprivileged citizens.
Khyber-Pakhtunkhwa (K-P) government launched Sehat Sahulat Card project enabling poor patients seek free medical services not only at public but designated private health facilities at the same time. Things however have become difficult for patients from district other than Peshawar.
According to officials from the health department, patients availing health insurance are mostly referred to public sector health facilities. Therefore, they explained, a patient living in Mardan needing neurosurgery is referred to Lady Reading Hospital (LRH), Peshawar. However, LRH is already overburdened by Peshawar’s own patients, they said. There is a need to send people to private sector hospitals too, so as to share the burden of public sector health facilities, they said.
“You are referred to a hospital and you need to have a copy of the referral otherwise you cannot be entertained,” a health department official informed adding “we have noticed that most of the patients are referred to public sector hospitals but with influx of patients, the referred patients, some even critically ill, have to wait for months.”
In some instances times is of essence, the official said while requesting anonymity since he was not entitled to speak to media. “If a patient with cardiac problem is referred to LRH and there is already a huge list of patients waiting for their turn, where will the patient go?” he said.
The official said that doctors and physicians referring patients to particular hospitals must realise the existing burden on the public health facilities. “Keeping in view the influx of patients, those having been entitled to refer patients, should keep record and share the burden so that people with chronic diseases receive medical assistance as soon as possible whether in public or private health facilities.”
Officials also informed that some private health facilities misused the scheme. Some private sector health facilities, in a bid to make more profit, carry out unnecessary procedures. Therefore, the provincial health authorities came up with the idea of referral system.
Earlier, Sehat Sahulat Card patients had the freedom to choose the health facility of their choice, so the ratio people seeking medical assistance through the social security health insurance for public and private sector hospitals in the past was 12% and 88% respectively. However, after the system of referring the patients to particular doctor or health facility was introduced, the ratio has come to 52% public and 48% private sector hospitals.
When asked, Sehat Sahulat Card Project Director Dr Riaz Tanoli said the initiative was launched to give relief to underprivileged people instead of adding to patients’ problems. Dr Tanoli said adding things were now being monitored.
“We have made it clear that patients should not wait more than 15 days for any procedure in public sector hospitals,” Tanoli told The Express Tribune adding, “if we realise hospital where patient is referred to is overburdened, patients should be referred to designated private health facilities.”
He also informed that one of the reasons for referral system was that public health facilities carried out all procedures for Rs300,000 where as private hospitals charged Rs500,000 for tertiary healthcare services and Rs240,000 to Rs300,000 for secondary healthcare services. “We also wanted to minimise patients’ out-of-pocket expenses,” he informed.
Published in The Express Tribune, April 3rd, 2018.
People living outside the Peshawar district say they face difficulties in availing the healthcare facilities through Sehat Sahulat Card due to the referral system that has put excess burden on public health facilities.
Sehat Sahulat Card, a government sponsored health insurance, has made it difficult for people to access free of cost health services rather giving relief to underprivileged citizens.
Khyber-Pakhtunkhwa (K-P) government launched Sehat Sahulat Card project enabling poor patients seek free medical services not only at public but designated private health facilities at the same time. Things however have become difficult for patients from district other than Peshawar.
According to officials from the health department, patients availing health insurance are mostly referred to public sector health facilities. Therefore, they explained, a patient living in Mardan needing neurosurgery is referred to Lady Reading Hospital (LRH), Peshawar. However, LRH is already overburdened by Peshawar’s own patients, they said. There is a need to send people to private sector hospitals too, so as to share the burden of public sector health facilities, they said.
“You are referred to a hospital and you need to have a copy of the referral otherwise you cannot be entertained,” a health department official informed adding “we have noticed that most of the patients are referred to public sector hospitals but with influx of patients, the referred patients, some even critically ill, have to wait for months.”
In some instances times is of essence, the official said while requesting anonymity since he was not entitled to speak to media. “If a patient with cardiac problem is referred to LRH and there is already a huge list of patients waiting for their turn, where will the patient go?” he said.
The official said that doctors and physicians referring patients to particular hospitals must realise the existing burden on the public health facilities. “Keeping in view the influx of patients, those having been entitled to refer patients, should keep record and share the burden so that people with chronic diseases receive medical assistance as soon as possible whether in public or private health facilities.”
Officials also informed that some private health facilities misused the scheme. Some private sector health facilities, in a bid to make more profit, carry out unnecessary procedures. Therefore, the provincial health authorities came up with the idea of referral system.
Earlier, Sehat Sahulat Card patients had the freedom to choose the health facility of their choice, so the ratio people seeking medical assistance through the social security health insurance for public and private sector hospitals in the past was 12% and 88% respectively. However, after the system of referring the patients to particular doctor or health facility was introduced, the ratio has come to 52% public and 48% private sector hospitals.
When asked, Sehat Sahulat Card Project Director Dr Riaz Tanoli said the initiative was launched to give relief to underprivileged people instead of adding to patients’ problems. Dr Tanoli said adding things were now being monitored.
“We have made it clear that patients should not wait more than 15 days for any procedure in public sector hospitals,” Tanoli told The Express Tribune adding, “if we realise hospital where patient is referred to is overburdened, patients should be referred to designated private health facilities.”
He also informed that one of the reasons for referral system was that public health facilities carried out all procedures for Rs300,000 where as private hospitals charged Rs500,000 for tertiary healthcare services and Rs240,000 to Rs300,000 for secondary healthcare services. “We also wanted to minimise patients’ out-of-pocket expenses,” he informed.
Published in The Express Tribune, April 3rd, 2018.