Owners of private 'referral' hospitals are like scores of other businessmen who are guided by profit motive. They are happy with the fiscal benefits that have been coming in the form of reduced duties and taxes on the import of medical equipment and reagents.
The government, however, has been offering duty waivers to medical equipment and reagents so that these hospitals can offer their services to patients, particularly the poor and low-income ones, at an affordable cost. But, according to a report published in the Financial Express recently, the hospitals are not passing on the benefits accrued from duty waivers to their patients.
The hospitals that have at least 100 beds and advanced research facility can have registration from the health ministry as 'referral' hospitals. In the year 2005, the government offered duty-free facility to this particular type of hospitals for the import of advanced medical equipment and reagents.
However, the referral hospitals are required to fulfil certain conditions for enjoying the duty-free facility. A referral hospital must have at least two senior specialist doctors supervising each of the departments and ability to offer consultancy service to other hospitals. Moreover, the hospitals concerned are required to install the medical equipment within three months from the date of their duty-free import.
There exists a committee comprising representatives from the directorate of health and customs to ensure the timely installation of medical machinery and equipment imported duty-free.
But allegations have it that conditions attached to the duty-free imports are often overlooked while allowing many hospitals to import medical equipment and reagents. The committee concerned also does not take the trouble of seeing what is happening with the imported medical equipment.
It is more like a 'free-for-all' situation. The private sector health facilities have been taking the full advantage of it. But the poor patients in the name of whom the duty-free import facility is being offered are not getting any benefit. The cost of treatment at the 'referral' hospitals is still prohibitive for the poor and low income people.
One of the conditions is that the referral hospitals would keep 5.0 per cent of their beds reserved for poor patients and offer treatment free of cost. But suspicion is strong that these hospitals are ignoring the condition with total impunity. The committee concerned or the health directorate has, allegedly, never tried to ensure that the condition is fulfilled.
Rather stories about the authorities of these hospitals refusing to release patients or hand over bodies of patients to relatives for non-payment of dues are published at times. These hospitals are found not to be ready to consider sympathetically the conditions of cash-strapped patients or their relatives. However, many hospitals would dismiss the allegation forthwith claiming that they treat many poor patients free of cost and offer rebate to patients coming from low and middle income families.
The claims may or may not be true. But the fact remains that the patients with small means never dare seek treatment at the referral hospitals other than the state-owned ones. In most cases they go to the public sector general hospitals which with all their shortcomings and inadequacies would hardly refuse to treat patients.
The government waives regular duties, taxes, fees and charges in many areas to make many items, including essential ones, and services affordable to the poor and low income people. The duty-free import of medical equipment and reagents by the referral hospitals is one of those.
The cases of abuse of exemption and rebate of taxes, fees and charges are widespread. It is just not confined to the health sector. The benefit does hardly reach the target groups or the population.
Unscrupulous people operating both in the public and private sectors make the best use of the concessions offered by the government for their own benefit. All these have been happening for years after years. None bothers about it. In Hindi language, there is a saying: Chalta hai, chalne deo (what is happening, let it happen). So, what is happening with the tax and duty exemptions and rebates in the country should be allowed to happen without any interruption. This seems to be the approach of the authorities concerned!
The government has to sacrifice a substantial amount of revenue every year on account of tax exemptions and rebates and subsidies given to food, fuel and other services just to help the poor and low-income people. But most benefits of these fiscal measures, allegedly, are reaped by other classes of people, not poor and other target groups. There should be a detailed study on all the tax exemptions and subsidies to measure the extent of benefits the poor are deriving from those.
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