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Probe after tragedies in Gorakhpur, Jharkhand reveals corrupt system of referrals in hospitals

After the tragic deaths of children at hospitals in Gorakhpur and Jharkhand, India's medical facilities came under question again as Cobrapost released the details of an investigation conducted by them detailing the malpractices committed by hospitals at the institutional level.

Christened "Operation White Coat", the investigation covered 20 major private multi-specialty hospitals in Delhi-NCR, Mumbai and Bangalore. These include well-known private health-care providers like Fortis, Columbia, MAX, Apollo, Nanavati, Hiranandani and Jaslok among others. Cobrapost interviewed marketing officials at these hospitals who admitted on camera that they were offering rewards to doctors and smaller hospitals in exchange for sending their patients to these larger hospitals for serious ailments.

Cobrapost summed up its findings in the following six points:

— To make more business out of patients’ miseries, all these hospitals offer handsome commissions to individual doctors, nursing homes and smaller hospitals, which cannot handle serious ailments, on all referrals.

— Each hospital has an elaborate process for such referrals and pay-offs thereof.

— Commissions to individual doctors are paid out to them as consultation fee.

— In addition to regular cuts, some of these hospitals give such doctors expensive gifts.

— All these hospitals have a well-oiled network of doctors and small nursing homes and hospitals, to help them generate a steady business out of patients’ needs for specialised treatment.

— Despite knowing that this is a malpractice under the MCI guidelines, they still indulge in it.

Chapter 6 of the Medical Council of India (MCI) Code of Ethics Regulations, 2002 specifically prohibits the giving of any gifts or commission for referrals.

The cuts given to the doctors and smaller hospitals is generally 10 percent. Cobrapost spoke to Senior Manager Ram Naresh Bhagat of Indraprastha Apollo Hospital in Delhi who said that one can get a 10 percent cut on referrals for almost all medical procedures, and the payments are usually made by cheque favouring only those with whom the hospital has entered into an agreement.

Representational image. AFP

Representational image. AFP

They also spoke to Deputy Manager Nishant Chauhan of Fortis Hospital, Noida who offered them a 10 percent cut. Chauhan also offered a fixed referral cut between Rs 10,000 to Rs 15,000 for every procedure package. Similarly the Senior Manager at Fortis Hiranandani Hospital, Mumbai offered 15 percent referral cut for surgical cases. Fortis had different referral cuts for different procedures.

Even the famous Jaslok Hospital in Mumbai engages in this practice. The marketing manager there told Cobrapost that a 10 percent cut on investigation bills is given to the professionals referring patients to it.

The practice is yet another blot on India's medical system which has come under fire after incidents at Gorakhpur and Jharkhand. In Gorakhpur, the latest jolt was the death of 42 children in 48 hours at the BRD Medical College and Hospital. This is the same hospital where nearly 60 children had died due to lack of oxygen supply between 7 and 11 August, in what was clearly a case of grave medical negligence. Though the exact reasons behind recent 42 deaths are not confirmed, The Indian Express quoted top officials at the hospital saying that seven children were suffering from Acute Encephalitis Syndrome (AES). The others, the official told the newspaper, died of other diseases.

On Sunday, it was reported that 52 infants had died over 30 days at Jamshedpur's Mahatma Gandhi Memorial Medical College hospital. The medical superintendent of the hospital told IndiaSpend that the number of deaths was not extraordinary as "more deaths were reported this month because more children were admitted."

It had earlier been pointed out that the empowered elites and the upwardly mobile middle class who were setting the public discourse in India, have been totally disinterested in lacklustre government services. They have instead put their faith in private service, leaving the government to take care of the masses who have little political agency except during electoral season. However, this investigation by Cobrapost shows that the medical problems are not limited to only the poor. Even at the most well-known hospitals across the country, there is a tendency to rip off patients looking for quality healthcare. There is thus a clear need for the government and the MCI to look into the malpractice and ensure that we don't have to go to hospitals worried for both our physical as well as financial health.

Updated Date: Sep 01, 2017 14:47 PM

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