All empanelled hospitals should be free to admit patients because it is only then that the objectives of the AB-PMJAY scheme will be achieved

To make a country of 130 billion people a happy and healthy nation is a mammoth task that requires access to a robust healthcare system, education, employment and industrial infrastructure. The other element which is very vital in today’s scenario is the state of our environment and the stability of natural resources like water, air and soil.

 A few of the NDA Government’s pro-poor initiatives like the Pradhan Mantri Jan Arogya Yojana (PMJAY), better known as Ayushman Bharat (AB), the Ujjwala Yojana for providing LPG connections and the Swachh Bharat Mission (SBM) under which individual toilets were built, made a lasting pro-Government impression on the minds of poor families in both urban and rural areas before the 2019 general elections. The result was that the NDA Government returned to power at the Centre with a thumping majority.

While speaking on the first anniversary of the AB-PMJAY on  October 1, the Prime Minister flagged it as an employment generation tool for the next five years as it is expected to create around 11 lakh jobs for the youth. The Government’s endeavour is to make AB-PMJAY the best healthcare scheme in the world with the registration of 46 lakh people. Out of this number, around 50,000 people have availed of the benefits of the scheme outside their home districts.

There are two facets to the scheme. The first is to bring more than 10 crore poor and vulnerable families within its ambit by providing a cover of `5 lakh per family per year for secondary and tertiary hospitalisation. Second, the Government is going to upgrade 1.5 lakh primary health centers by 2022 so that the needy can get comprehensive and quality healthcare.

Though, the Government’s endeavours to provide affordable healthcare to the needy are laudable, the success of any welfare programme depends largely on the role played by the bureaucracy and in this case, the honesty of private hospitals and benefit seekers.

In the past, many such welfare schemes were ruined by graft and the best example of this is the deep-rooted corruption that unfolded in almost all States in the National Health Mission. A huge amount of money was looted by the medical fraternity and the bureaucracy all over the country.

Another case in point is the complete collapse of the health and sanitary infrastructure in Uttarakhand due to the arrogance and lackadaisical attitude of Government officers and public representatives. The problem there is of systemic failure. First bureaucratic guidelines run counter to the objectives of the scheme and bury the patient in mounds of red tape. Second, is the insensitivity and lack of integrity among the doctors, senior Government officers and Ministers sitting in the State capital.

For instance, recently, a tuberculosis patient from Uttarkashi district became critical and started vomiting blood. He was rushed to a hospital in Vikas Nagar but it did not have the infrastructure to handle the case. He was then taken to the Doon Hospital, which is part of the Government Doon Medical College. Unfortunately, he could not be admitted there as the Emergency as well as Intensive Care Unit (ICU) were both overflowing with dengue patients.

He was then rushed to the Indresh Hospital and Medical College, which is a private hospital but was turned away due to the  crowd of dengue patients at the facility. At this juncture, his hapless family informed me and I contacted the Agriculture Minister of Uttarakhand Subodh Uniyal, who arranged the man’s admission to the Doon Hospital’s emergency section late in the night. As he continued vomiting blood, the hospital staff told his family that he needed intensive care as he was critical.

 He was taken to Max Hospital where some preliminary treatment was done.

But when the family was told about the cost of the treatment, they approached me for advice. I contacted Vijay Dhasmana, Vice Chancellor of Jolly Grant Medical College, and apprised him of the situation. Consequently, the patient was admitted to a special room in the Jolly Grant Hospital, despite it being full of dengue patients also.

Shockingly, the AB-PMJAY card was not accepted by any of the private hospitals in Dehradun, including the Jolly Grant Medical College. The hospital staff told me that as per the Uttarakhand Government’s guidelines (this is a BJP-ruled State), they are not authorised to accept the card unless the patient was referred by a Government hospital.

My question is, why the red tapism in emergency cases? All empanelled hospitals should be free to admit patients because it is only  then that the objectives of the AB-PMJAY scheme will be achieved.

The Government could better use the medical bureaucracy to monitor the effectiveness of the scheme.

Also, this incident happened because the health and sanitary infrastructure of the State has collapsed resulting in a dengue epidemic. The hospitals are full of dengue patients and many people have died. This has happened due to the negligence of all agencies concerned and the chief culprit is the Dehradun Municipal Corporation.

Its sanitation employees don’t collect garbage on a regular basis, the staff remains on strike on one pretext or the other and senior officers do not  bother.

Hopefully, the Central and State authorities concerned will take note of this and revamp the healthcare system so that the beneficiaries of AB-PMJAY do not have to rush from pillar to post to get treatment. There is also a crucial need  to control the burgeoning population of the country as no amount of welfare schemes and facilities will be sufficient unless the numbers are effectively controlled.

 (The writer is a retired civil  servant)