Free cardiac care for children under 15 years of age has been affected as the Shahid Gangalal National Heart Centre has run out of the government-provided budget within the first half of the fiscal year.

The hospital, which serves as the national referral centre for cardiac care, started charging parents of children with serious heart conditions after government officials informed them that no additional funding would be available to continue children’s free treatment.

“We get Rs120 million to perform valve replacements and other surgeries for 500 children,” Dr Rabi Malla, executive director at the hospital, told the Post. “Within six months of the ongoing fiscal year, we performed surgeries on 474 children, and we were told that there would be no more budget.”

Hospital officials say they would have to suspend free treatment for children under 15 years for the remainder of the year, if no additional funds are provided immediately.

“We will ask the Health Ministry whether we should continue surgeries of children under a free programme,” said Malla. “We still haven’t received Rs480 million owed from last fiscal year’s free social service programmes, and there has been no assurance from the government about reimbursing the treatment costs.”

Despite the financial crunch, the hospital has assured the public that no child has been denied treatment due to their inability to pay. For the parents of children unable to afford the services, the hospital has been covering the costs through its charity fund, according to them.

“We ask parents, who are able to pay for service to contribute, as the demand for free treatment is high and resources are limited,” a doctor at the hospital said, requesting anonymity as he is not authorised to speak to the media. “But poor and needy children will still receive treatment if those who can afford it, pay for their own costs.”

The government provides Rs120 million a year to the hospital for free cardiac surgeries for 500 children (Rs 250,000 per patient) under 15 years of age. However, the number of children seeking free treatment far exceeds 1,000. In 2023, the hospital provided free surgeries to 905 children.

Doctors say that in some complex cases, treatment costs can reach up to 1 million per child.

The free cardiac care scheme for children was introduced by the then health minister Gagan Kumar Thapa during his tenure in 2016-2017.

At the time of the programme’s launch, Rs120 million was enough to cover the cost. During the Covid pandemic, the hospital performed fewer surgeries, which allowed them to save funds and extend the scheme. But those savings have now been depleted.

“When we asked for reimbursement for services provided free in the past, we were told that no additional funds could be given beyond the ceiling,” another staffer at the hospital said, asking not to be named. “Without reimbursement, the hospital cannot do anything. We are forced to ask parents of ailing children to arrange money upfront before they can undergo surgery.”

Officials also complained that the government had not reimbursed millions of rupees of services provided under the health insurance programme.

Meanwhile, Minister for Health and Population Pradip Paudel said he is aware of the difficulties faced by parents of children with cardiac problems.

“The problem didn’t start after I became minister. When it was brought to my attention, I tried to arrange the funds but have not been able to do so yet,” said Paudel. “I am working to remove the cap so that all children with heart disease can get free treatment.”

Paudel also stated that he was informed that the hospital has been providing free treatment to poor and needy children through its charity fund.

Along with free treatment of children under 15 years of age, the government also provides free treatment to those suffering from rheumatic heart disease, for valvuloplasty (a procedure to open narrowed heart valves), free treatment for those above 75 years of age, and free service worth Rs100,000 to poor people.