Very few poor and homeless people have been treated without charge at private hospitals under the mandatory 10 percent free beds that the health facilities have to allocate.

In the last seven months of enforcement of the provision, data from Bir Hospital show that only 26 patients have been sent to various private hospitals for free treatment. In Kathmandu, Bir Hospital recommends needy patients to private hospitals for free treatment.

Officials at Bir said very few private hospitals admit such patients. Also, in many cases, the patient party themselves fear exorbitant charges in private hospitals if admitted although many services are required to be provided free of cost to the recommended patients.

To qualify for free care, patients must produce recommendation from their respective Village Development Committee, Municipality, District Development Committee, District Adminis-tration Office or the District Public Health Office.

The letter exempts the patients from charges, including bed, consultancy fee, laboratory tests, diagnostic facilities and medical oxygen.

“Private hospitals are reluctant to take in these patients, many of whom come for treatment in advanced stages of ailment,” said Dr Bhupendra Basnet, the Bir Hospital director.

“They need special care, sometimes for many weeks. It could be due to the extra care they require that hospitals do not accept such patients.”

In some cases, Dr Basnet said, private hospitals do not accept critically ill patients fearing vandalism from patient parties if they fail to save their lives.

The government on December 16 last year enforced the 10 percent beds provision in government and private hospitals for the poor, underprivileged, senior citizens, single women and the disabled for free treatment. Private hospitals had initially complied with the directives after then health minister Gagan Thapa warned of scrapping their licence to operate.

The idea behind free beds is to make private hospitals accountable to the public while making health care accessible to people from all walks of life. Furthermore, if implemented strictly, it also helps to reduce the flow of patients in government hospitals.

In case of homeless patients, public and the police often tend to send them to government hospitals primarily to clear legal hassles and bonds in the event of the patient’s death. Bir Hospital alone handles at least two unattended cases either dead or severely injured each day.

Health Ministry officials said they have directed hospitals to submit monthly reports on free treatment. “Few hospitals report to us,” said Dr Bhola Ram Shrestha, chief of the Curative Service Division.

Hem Raj Sharma Dahal, general secretary of the Association of Private Health Institutions of Nepal, said patients reach hospitals without recommendation. “We cannot treat all the patients on free bed. Without recommendation, they should pay for our services,” said Dahal.

Free treatment fiasco

• In the last seven months of enforcement of the provision, data from Bir Hospital show that only 26 patients have been sent to the private hospitals in Kathmandu for free treatment
• To qualify for free care, patients must produce recommendation from their respective local authority
• A doctor says private hospitals do not accept critically ill patients fearing vandalism from patient parties if they fail to save their lives