A matter of health and trust


Despite ‘exorbitant’ tariffs, many COVID-19 patients are flocking to private hospitals as they get individualised attention and better facilities. It doesn’t help government hospitals that Delhi Ministers and healthcare workers too are opting for private facilities

On April 22, when 38-year-old Amit Gupta, a doctor working at Delhi government-run Satyawadi Raja Harish Chandra Hospital, tested positive for COVID-19, he was admitted at the same hospital. But not for long. “There was no space for new admissions and we had to clear a doctor’s duty room to admit him and another doctor,” said his wife Shristi Mittal, who is also a doctor at the same hospital. Dr. Gupta had to be shifted to Maharaja Agrasen Hospital, a private facility, within days and later to Medanta Hospital, another private hospital for “better care”. Dr. Gupta’s is not a lone instance.

People who are part of the government healthcare system, including many healthcare workers and Delhi government Ministers, prefer private hospitals to government ones. All three Delhi Ministers who tested positive — Satyendar Jain, Manish Sisodia, and Gopal Rai — too were admitted to Max Hospital in Saket, a private hospital, at some point in their treatment and finally discharged from there.

This trend did not evade the notice of Chief Minister Arvind Kejriwal, who in a video statement on April 11 had exhorted people to go to Delhi government hospitals. “Some people only go to private hospitals. In the past five years, your government has made government hospitals excellent. There is very good treatment at Delhi government hospitals. I request you to not run to private hospitals,” he had said.

Losing trust

But on April 30, Mr. Kejriwal’s wife Sunita, who had tested positive for COVID-19, was admitted to Max Hospital in Saket. “When people see that even politicians and bureaucrats are not opting for government hospitals, they lose trust. It sends a wrong message to the public. Politicians and bureaucrats should get admitted at government hospitals,” Girish Tyagi, Secretary of Delhi Medical Council, emphasised, adding that most people, including doctors and politicians, prefer private hospitals in most cases.

However, K. Srinath Reddy, President of Public Health Foundation of India, pointed out that though there are some good government hospitals, most have been neglected. “It is because of lack of funding and poor governance. Thus, private hospitals have an upper hand,” he said.

Delhi government spokesperson, though, did not respond to queries.

Personalised care

In April first week, a nurse at Lok Nayak Hospital, the largest Delhi government-run hospital, tested positive for the virus and was admitted to the same hospital. But within three days, the nurse moved to Saroj Hospital, a private one.

“I was admitted in the ICU of Lok Nayak Hospital. Going to the bathroom alone was difficult as I had to walk a lot. Then I developed breathlessness and I panicked and decided to opt for a private hospital for better care,” the nurse, who has been working with the hospital for over five years, said.

The nurse said there was better personal attention at private hospitals. “There is always someone to monitor you. There is more individualised care. In Lok Nayak Hospial, a doctor does a round and then the other doctor comes in the next shift. But the ICU of Saroj Hospital is small and doctors are there all the time. Also, the bathrooms at Lok Nayak Hospital were not as clean as Saroj’s,” the nurse said.

Vijay Gurjar, assistant professor at AIIMS, said people prefer private hospitals due to several factors. “Can any government hospital in Gurugram be compared with Medanta? Or any government hospital in Delhi be compared with Max or Ganga Ram? The services over there are way better,” Dr. Gurjar said. AIIMS and a handful of other government hospitals are exceptions, he observed.

Dr. Gurjar said the management, coordination between departments, and manpower are better in most private hospitals. “If a doctor is leaving a private hospital, then the HR steps in and a new person is hired even before the doctor leaves. Whereas in government, it will be vacant for a long time before someone is hired,” he said.

Costly affair

The nurse spent about ₹2.5 lakh at Saroj Hospital for a week’s stay. Dr. Gutpa’s family couldn’t afford the daily hospital bill and his wife said they were spending about ₹1.25- ₹1.5 lakh a day on treatment at the second private hospital, which was “more than our monthly salary”. The family had to start fundraisers online for treatment.

Later, after directions from the National Human Rights Commission, the Delhi government promised to take care of the treatment expenditure. Dr. Reddy said private hospitals among other things employ specialists, but it doesn’t necessarily mean the patient care will be better as a lot of unnecessary procedures might be done. “The solution is strengthening the public sector hospitals with better funding, better equipment and better payment to doctors and ensuring that there is a better governance of the system,” he said.

Hiding deficiencies

Dr. Gurjar said that administrative authorities are working just to hide the deficiencies in the system rather than finding solutions for the permanent shortage of machinery and human resources in government hospitals.

“Management is better at private hospitals. For instance, during COVID, in a government hospital, knowing a patient’s status will be difficult for the family. But in private hospitals, doctors are more approachable. Even nurses and nursing orderlies will be easily approachable and friendlier. At government hospitals, due to the high workload, this may not be possible. Treatment-wise, there is not much difference,” Dr. Tyagi said.

He said the government should increase the budget on health. “In government hospitals, the number of doctors is less, nurses are also less. Also, healthcare workers should be taken on a permanent basis so that they will get better remuneration and benefits. This will increase their dedication to work and they will work better. “Currently, it is the poor who suffer as they have no other option, but government hospitals,” he added.



This article was originally published on The Hindu

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