LRH suspends services under Sehat Card over unpaid dues

PESHAWAR: The Lady Reading Hospital (LRH) has stopped providing services to patients under the Sehat Card Plus Programme, saying the State Life Insurance Corporation of Pakistan has failed to clear their dues, making it difficult for the hospital to spend its own resources on free healthcare of patients.

LRH has become the second public sector hospital that has stopped offering free healthcare to patients under the sehat card package.

Before it, the Peshawar Institute of Cardiology (PIC) stopped services to patients under the sehat card programme, saying the insurance company had failed to clear their previous payments amounting to Rs2 billion approximately.

The caretaker provincial government, headed by an elderly chief minister Mohammad Azam Khan has been suffering from financial difficulties and failed to provide funds to hospitals for stipends of their employees.

The caretaker government citing lack of resources has already stopped work on all under-construction projects in the province that were initiated by the previous Pakistan Tehreek-e-Insaf government.

The PTI government had initiated two flagship projects, i.e. Sehat Card Plus Programme, known as sehat card, and granting financial and administrative autonomy to 10 tertiary care hospitals of the province under the Medical Teaching Institution Reforms Act 2015.

The government had launched free health services in the province in 2016 and extended it to 100 percent population of the province in 2019-2020. It helped thousands of patients to seek free treatment.

The caretaker government is clueless about the two important public friendly projects of the previous government.

It could not manage to maintain the two major projects that were implemented after a long struggle and resistance from certain powerful elements of vested interests.

The LRH administration on Wednesday issued a notification to officially inform patients about suspension of services under sehat card.

“In pursuance of the decisions taken in the 42nd meeting of the Board of Governors of LRH-MTI, held on 03-10-2023, this is to notify that all the admissions and services under the Sehat Sahulat Card programme will be stopped with immediate effect till further orders. However, emergency services will be continued as routine,” Medical Director of LRH has stated in the notification, its copy is available with The News.

The LRH spokesman, Mohammad Asim Khan, told The News that they had managed to provide services to patients under the sehat card programme, but it was not possible for the hospital to continue as the State Life Insurance Corporation of Pakistan failed to clear their dues.

“The insurance company needs to clear our Rs2 billion arrears that we had already spent on patients under the sehat card programme. LRH has always been the first priority of the patients as we used to admit 800-1000 patients daily under the sehat card scheme,” the hospital spokesman said.

He didn’t agree with certain complaints from patients and officials of the insurance company, saying the LRH administration has never cooperative with the sehat card patients compared to the Hayatabad Medical Complex (HMC) in Peshawar.

“All sehat card patients in LRH were made to procure contrast used in angiography from a market. Even under the sehat card package, each patient requiring angiography would have to spend Rs10,000 for buying a contrast and other items,” an official of the insurance company told The News.

Pleading anonymity, he said the same issue had once surfaced in the HMC, but medical director of the hospital, Prof Dr Shehzad Akbar Khan immediately took its note and stopped doctors’ share but purchased 1000 vials of contrasts for the patients undergoing angiographies.

“In the LRH, we could not see that support from the hospital administration. Imagine, they made it mandatory for each sehat card patient to bring 10 white pages along for the documentation purposes,” said an official of the insurance company.

The LRH spokesperson didn’t agree with these claims, saying they used to refund the patients in case they purchased some drugs from the open market.

According to the insurance company, the government is required to clear Rs30 billion dues of the company.

“The government made some commitments when we suspended the sehat card package but it never fulfilled its promises. We are planning to suspend the sehat card services in the next couple of days if the government didn’t make the payment,” an official of the insurance company said.

To overcome the ever-growing cost of sehat card payments, the government and the insurance company had made certain changes that reduced expenses.

Patients will only seek free angiography services in the public sector hospitals as some of the private hospitals reportedly exploited the sehat card package.

Also in the public sector hospital, if the patient does not require a stent, the patient will have to pay for the angiography.

Besides angiographies, the government has also excluded some of the procedures under sehat card including caesarian delivery, tonsillectomy, cholecystectomy, cataract, septoplasty and SMR in the private sector hospitals. The government believed that the private sector hospitals were allegedly misusing the sehat card facility to make money and therefore they stopped surgical procedures there.

Caretaker Advisor to Chief Minister on Health Prof Dr Riaz Anwar told The News that they had brought down the pending arrears of the insurance company from Rs39 billion to Rs15 billion. The insurance company, however, claimed the government still needed to clear Rs30 billion dues to the company.