Pune: A govt resolution issued on Jan 16 said the state would now charge for every single service, which were free or cost minimal over the last two years, provided at various govt hospitals in Maharashtra. A rate card was announced for the same.This effectively means right from Rs5 for an outdoor patient department case paper registration to Rs40,000 for a joint replacement surgery — patients would have to pay for various procedures at all state govt-run hospitals, including district, rural, sub-district and women’s hospitals.The govt rate card for the services has created confusion among hospital administrators and prompted questions from health activists, even though the implementation is yet to start at the ground level.As per the GR, in-patient department patients would pay Rs10 per day for admission. Blood tests would cost Rs15 each for haemoglobin, TLC, DLC, blood group and Rh testing, urine chemical tests, culture sensitivity, etc. The intravenous pyelogram meant to evaluate kidneys, bladder, etc, would cost Rs100 per X-ray scan. The head CT scan would cost Rs300, while spinal, neck and chest CT scan would be Rs400. Major and minor surgeries under anaesthesia would cost Rs60 to Rs160. The MRI scan was pegged at Rs1,600.The GR also mentioned that while the first delivery of a pregnant woman would be free, the second would cost Rs50 and the third and onwards would be Rs250 each time. An AC room in a govt nursing home would be Rs150 per day, while a non-AC room would cost Rs75 per day. The ICU charges were recommended at Rs100 per day and a single haemodialysis would cost Rs150.The GR also stated rates for various certificates. It would cost Rs1,500 to embalm bodies given to private institutions. The state would charge Rs5 per km for its ambulance services and Rs30 per hour as waiting charges for over eight hours of waiting.The highest charges under the GR are for joint replacement at Rs40,000.The GR further said no patient’s treatment must be delayed and names of doctors providing treatment to patients must be clearly displayed.The govt orders issued over time mention that certain sections of the society were entitled to free treatment and would continue to avail the same. It included govt employees and their dependents, medical officers and nursing staff of govt hospitals and dispensaries, students studying in medical, paramedical, occupational therapy and physiotherapy colleges, people detained under court orders, freedom fighters and their family members, people sent for medical treatment in medico-legal cases and prisoners under judicial inquiry, MLC cases referred by the police, patients from correctional facilities referred by the Leprosy Board, ashram schools and through women’s correctional facilities, destitute children from urban areas, MLAs, MPs, ministers, speakers, former members of the legislative assembly/legislative council and judges.However, civil surgeons were yet to start implementing the GR regulations.Dr Kailash Pawar, civil surgeon in Thane district, said, “We are confused. The govt had issued a GR in 2023 mentioning that all services — including those provided under PPP basis — would be completely free. I need further clarifications. The previous GR was also issued by the same govt, so there is some confusion.”Dr Kamlalkar Mudkhedkar, civil surgeon in Chatrapati Sambhajinagar, said, “We are yet to implement the rules of the GR, which I received just two days ago.”Meanwhile, health activist Sharad Shetty said, “The charges may seem nominal on the face of it. However, people who approach govt hospitals are either desperate and need treatment or belong to the lowest strata of the society. Often a day’s wages is more important to them than treatment. The govt charging money would be a huge deterrent to those availing such healthcare services. The irony is that the GR mentions free treatment for MPs, MLAs and judges who never come to govt hospitals for treatment. The decision must be analysed again. Health must be completely free for all in govt hospitals.”TOI made multiple calls to health minister Prakashrao Abitkar, but he was yet to answer till the time of going to press.
