MADURAI: The Madurai Bench of Madras High Court recently directed the state government to formulate procedures for de-empanelling private hospitals that fail to implement the government health insurance scheme and also to conduct surprise inspections.
A Bench of Justices R Mahadevan and J Sathya Narayana Prasad passed the order while hearing a Public Interest Litigation (PIL) filed by Karthick, a cardiothoracic surgeon, who sought guidelines to ensure that every patient gets medical treatment under the government's insurance scheme.
The court observed that medical schemes initiated by the government are vital for ensuring access to quality healthcare for the people. However, the implementation of these schemes has been a challenge due to private hospitals that attempt to exploit the system for their personal gain, the judges said. Though there exist various guidelines, the goals for framing such schemes have not been achieved due to the absence of a proper monitoring framework and awareness among the public about the scheme, they opined, adding that the inadequacies in the implementation and monitoring of the scheme have led to a decrease in the quality of healthcare available to citizens.
The judges then directed the State Empowered Committee headed by the Chief Secretary, to conduct periodical review meetings to examine complaints and irregularities relating to the implementation of the scheme and deaths of patients covered under such schemes, surprise inspections of empanelled hospitals for sustained compliance and take action if any wilful violation or non-compliance is found. Among other directions, the Bench also wanted the government to make scheme-related online portals and websites user-friendly, and introduce a toll-free number.
The petitioner claimed that the government introduced various insurance schemes to provide world-class health care to the people, especially to the poor, through government and empanelled private hospitals, but a large number of people are not aware of the same and around 65% of the state's eligible population are denied admission under these schemes.