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Cash crunch in hospitals post-demonetisation

Sentinel Digital DeskBy : Sentinel Digital Desk

  |  29 Nov 2016 12:00 AM GMT

By Devanik Saha and Swagata Yadavar

Aspate of deaths due to hospitals refusing to accept invalid currency notes has come to attention after Prime Minister rendra Modis announcement invalidating 86 per cent of Indias currency on November 8.

Unlike government-run hospitals, private hospitals have not been allowed to use defunct Rs 500 and Rs 1,000 notes, potentially affecting 58 per cent of Indians in rural areas who opt for private healthcare (68 per cent in urban areas), according to tiol Sample Survey Office (NSSO) data.

In Noida, an infant died after a hospital reportedly asked for an advance of Rs 10,000 and then refused to take old currency notes.

An 18-month old baby died in Visakhapatm as the parents didn’t have money to buy medicines, and a year-old infant in Mainpuri, Uttar Pradesh, died after reportedly being denied treatment by a local private doctor as his parents didn’t have money to pay for his treatment.

Despite multiple requests, Fince Minister Arun Jaitley said on November 17 that private hospitals would not accept old notes because that would encourage misuse of old currency.

Patients who had travelled away from their home states were particularly caught uware by the move and faced a serious shortage of cash.

IndiaSpend met 52-year-old Mahavir Malhar and his wife from Jharia, Jharkhand, staying on the footpath outside Mumbai’s Tata Memorial Hospital, a leading referral hospital for cancer patients tionwide. A labourer who earned Rs 200 every day before coming to Mumbai to address his wife’s ear cancer, Malhar had no usable cash.

“We do not have cash to buy meals or even tea,” said Malhar. Although treatment at Tata Memorial Hospital is free, and the hospital accepts old notes, staying in Mumbai is expensive for the couple. Since the note ban, their sons, also labourers, have not been able to send them money because of long lines at local banks.

“They are also daily wage earners and standing in a line for the whole day means loss of income,” said Malhar. The couple now depends on the free meals provided by the hospital and charitable trusts.

As noted, more than half of India’s population depends on private healthcare, despite the fact that private healthcare cost the poorest 20 per cent of Indians more than 15 times their average monthly expenditure, according to a 2014 NSSO survey.

Other markers of India’s dependence on private healthcare:

* Up to 86 per cent of the rural population (717 million people) and 82 per cent of the urban population (309 million people) are without health expenditure support.

* Indians spend eight times more in a private hospital than a government hospital, according to an alysis of tiol Health Accounts (NHA) 2013-14 data by The Hindu. The report estimated that households spent Rs 8,193 crore in government hospitals, an eighth of the Rs 62,628 crore spent in private hospitals.

* As much as 69 per cent of health expenditure in India is private (out-of-pocket) — the highest proportion in the world — according to NHA data. Out-of-pocket expenditure is the share of expenses that patients pay to the healthcare provider without third-party insurance or government-subsidised treatment.

* Of 930,000 doctors in the country, only 106,000 work for the government. This means there is one government doctor for every 11,528 people, according to the tiol Health Profile 2015 report.

* About 81 per cent sanctioned posts of specialist medical professiols in community health centres were lying vacant, according to a 2015 rural health statistics report.

Therefore, the government’s decision to not allow private hospitals to accept old notes will restrict access to healthcare for a significant section of Indians.

Lack of cash is making patients prioritise their cash needs, and health issues tend to be pushed back on family priority lists, reported private practitioners from urban centres.

There has also been an increase in the number of patients in government hospitals, where treatment is largely free or at nomil charges. “We have seen an increase in the number of patients in our primary healthcare centre since the currency ban,” said Amol Bhusare, medical officer at Pallam, a small town east of Mumbai. Bhusare said two of his patients who had gone to a private diagnostic centre for a CT Scan at nearby nded city were turned back for bringing old notes.

A few hospitals have pleaded that they be allowed to accept older currency. Mumbai’s Bhatia Hospital wrote to the Prime Minister the day after his initial note-ban announcement. “We are one of the oldest charitable hospitals in Mumbai and requested (that) at least charitable hospitals be allowed to accept older notes,” said Rajeev Boudhankar, CEO of Bhatia Hospital. He said no patient has been turned away. They are accepting payments through other means, including cheques, although three cheques have bounced. (IANS)

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