New Delhi, Dec 08: Patients need not check into the famous Rajiv Gandhi Cancer Institute (RGCI) any longer. Why? Because the hospital has stopped treating patients under the Central Government Health Scheme (CGHS) beneficiary scheme. Reason? Non-payment of pending bills by the CGHS, claim RGCI sources. Let's take a recent incident as a case study. Mrs Sharmila Devi (name changed to protect identity) was suffering from endometrium cancer and was being treated at the hospital since June this year. She has now been refused further treatment. "The authorities informed us on November 1 that because CGHS had not paid the pending hospital bill of Central Government beneficiaries that amounted to several crores, the credit facility was being stopped," says Sharmila's husband, CN Arora. An office bearer at RGCI informed him that even a notification sent to the CGHS more than a month back has yielded no result.

Arora also expresses his helplessness to spend over Rs 50,000 for every chemotherapy session at the hospital. "Six injections costing Rs 6,000 each are required for a session. The total sum comes to around Rs 36,000. Then, there is medicine expenditure as well," says he. Till now, Arora has been utilising his post-retirement funds. "But how long will they last? I have seen other patients at the institute who are getting treatement after procuring loans from banks, relatives or friends," puts in Arora who retired as a principal private secretary with the Ministry of Finance last year.


Strangely, most cases being refused treatment at RGCI fall in the pensioner category. "The present employees don't face a problem as they submit their bills in their respective offices which are reimbursed within a fortnight or so," informs Arora. By order of September 18, 1996, private hospitals in Delhi were recognised by the Ministry of Health for specialised, general purpose and diagnostic treatment of CGHS beneficiaries under CGHS Delhi. Along with packages, ceiling rates for the treatment had also been fixed. A package rate was defined as lump sum cost of in-patient treatment or diagnostic procedure for which a patient has been referred by the competent authority of CGHS. This includes all charges pertaining to a particular treatment/procedure including admission/accommodation charges, ICU/ICCU, monitoring, operation, anaesthesia, operation theatre, procedural or surgeon's fees, cost of disposable, surgical charges and cost of medicine used during hospitalisation, related routine investigations and physiotherapy.

However, the rate doesn't include diet, telephone charges, TV and cost of cosmetics, toiletry, tonics and medicines advertised in mass media. Cost of these, if offered on request of the patient, will be realised from the individual patient. The recognised hospital/diagnostic centre is not supposed to charge more than the package rate from beneficiary.

But hasn't Arora forwarded his complaint to CGHS authorities? "Of course. But you know how the government machinery works in this country," puts in Arora. Says Dr YP Bhatia, CEO of RGCI, "There has been a breach of contract from the CGHS end. It was after around eight months that we stopped treating these patients. However, a prior notice was sent to the Director, CGHS about stopping the treatment of the beneficiaries and a notice was put in advance informing patients about the same."

Under normal circumstances, the CGHS is supposed to make the payment to a private hospital within a month. Dr Bhatia adds the hospital could have continued with the treatment if the CGHS had informed them about making the payments within a specified time period. He puts in, "We still offer emergency treatment to patients, be it under the CGHS scheme or not." Repeated attempts to reach the CGHS top brass yielded no results.