When family members of veteran politician and trade unionist Alavi Moulana admitted him to a leading private hospital in Colombo for a simple medical procedure, which was to be followed by a few hours of hospital stay, they were told the cost would be around Rs 300,000. He was admitted on June 15, 2016 for [...]


‘Fleeced’ patients cry foul but hospitals have their way


When family members of veteran politician and trade unionist Alavi Moulana admitted him to a leading private hospital in Colombo for a simple medical procedure, which was to be followed by a few hours of hospital stay, they were told the cost would be around Rs 300,000. He was admitted on June 15, 2016 for the procedure to treat bladder stones. Sadly the long time Governor of the Western Province passed away less than 48 hours later, much of which he spent in the Intensive Care Unit (ICU) of the hospital. And to compound the tragedy, his family members were slapped with a bill of Rs 930,000 to be paid up before his body would be released.

In this case, the family settled the bill and got his body released but, this incident and many others alike raise serious questions about the exorbitant costs that thousands of people who seek treatment in private medical institutions have to pay, under a system, though regulated, does little to safeguard patients’ rights.

While the doctor’s and anesthetist’s fees and procedure costs combined added up to around Rs 80,000, the final bill with ICU care came to Rs 923,000 of which Rs 200,000 was stealthily included as “outside charges”. “We were perplexed by this massive amount that was charged, but we were too distraught to do anything about it. Nevertheless, I did tell the hospital authorities that they were cheating the public by charging unreasonable amounts and also not giving their customers a proper breakdown of the charges,” said the late Governor’s son, Naqueeb Moulana.

Mr. Moulana says that while his family managed to settle the bill and also had many offers of financial assistance, many others are not so fortunate. “The reason I wanted to speak out on this injustice is that, even though my father is no more, I hope it will serve as a warning to others who get hoodwinked, especially when seeking in-house treatment in private hospitals,” he said.

The situation has been far worse for others. The family of a patient who died at a private hospital after undergoing a bypass (Coronary Artery Bypass Graft (CABG) surgery last year is now embroiled in a legal battle with the hospital, as they struggle to settle a thumping bill of close to a million rupees .

The brother of the deceased patient who wished to remain anonymous due to the ongoing lawsuit, said that, the family was told the bypass and hospital stay would cost around Rs 900,000 which they had kept ready. However, due to complications following the surgery, the patient was in the ICU for nearly 17 days, before passing away. Consequently, the hospital bill had gone up rapidly and finally, they were asked to pay close to Rs. 1 million, in addition to the Rs 500,000 they had paid as an advance and halfway through, as ICU costs.

“We had Rs. 900,000 ready to pay for the surgery, but due to the prolonged hospital stay we had used up some of the money and finally could manage to pay Rs 500,000,” the deceased patient’s brother said. He alleges that, on three occasions he requested the hospital to transfer his brother to the General Hospital, which they refused to do, assuring him the payment could be settled amicably, and not to worry about the costs.

“However, such assurances were not honoured once his 61-year-old brother passed away, and the inability of his close relatives to pay up resulted in the hospital refusing to release the body for burial, even after police complaints were lodged seeking recourse. Finally, it was after a court case was filed seeking the release of the body, the hospital agreed to do so. Later the hospital counter sued the relatives of the deceased man, seeking to recover the rest of the costs. We are not in a financial position to settle such a massive hospital bill and have spent all the money we had. As a result, now I am embroiled in a court case with the hospital,” he said.

While the Private Medical Institutions (Registration) Act of 2006 provides for the registration, regulation, monitoring and inspection of Private Medical Institutions, there is no control over what such institutions charge from patients.

The Private Hospitals Regulatory Services Council (PHRSC) of the Health Ministry said that hospitals cannot refuse to release the body of a patient. A spokesman for PHRS said the body should be released and then the hospital may file action against the family members of the deceased for the non-payment of bills.

It is the Consumer Affairs Authority (CAA) that is entrusted with keeping a tab on charges, but implementation seems lax, with a gazette issued late last year making it mandatory to issue detailed bills to patients discharged after in-house treatment, being largely ignored.

The gazette issued in June last year was to become effective from November 1, 2015, but this has yet to happen.

Exasperating the situation is the introduction of the Value Added Tax (VAT) in May this year. Consumers complain the hospitals are charging more than the 15% VAT imposed by the State.

In addition, the hospitals have hiked hospital charges for outdoor patients who use their channeling services, drastically. One hospital has increased the hospital charge to Rs 750. Meanwhile the ordinary family doctor who regularly checks the blood pressure has increased his charges from Rs. 50 to Rs. 400.

The PHRSC said they have introduced a ceiling of Rs. 500 for hospital charges and Rs. 2,000 as doctor’s consultation fee. Patients who are charged more than the charges stipulated by the PHRS could lodge a complaint with the CAA.

CAA Director General K.D.D.D. Arandagoda said the CAA has had two rounds of discussions with the private hospital representatives, and they have asked for more time to adjust to the new requirement.

The CAA gazette directs all Private Healthcare Institutions to include details in the receipts/bills issued to all patients who seek indoor treatment at their institutions, such as details of all drugs and vitamins administered to the patient, including their Generic/ brand name, quantity used and the total cost for each and every drug and/or vitamin and details of all devices used for treatment, specifying the quantity and the cost for each and every such device used.

However, it does not place any ceiling on prices of drugs, diagnosis testing, doctors fee or room charges.

He said that, under the National Medicines Regulatory Authority Act, the CAA has no control over the pharmaceutical drugs administered in hospitals, but consumers can lodge a complaint with the Authority, if they are of the view they have been overcharged.

“This is an open economy and prices are determined by supply and demand. If a doctor is good, his demand will increase,” Mr. Arandagoda said.

Meanwhile, Private Hospital Association Secretary, Wijeya Ransi said private hospitals are regulated by the Regulatory Council and doctors’ charges and hospital charges can vary from hospital to hospital.” It is like in hotels which are graded where the rates differ. There are various types of hospitals, big and small, and with different types of equipment, and hence, it is difficult to standardise charges,” he said.

He said all private hospitals inform patients of the approximate cost, when a patient is admitted but, there are additional expenses depending on the need of the patients.

He also said there is no truth in the allegation that private hospitals keep patients longer than necessary, to charge more from patients. “It is the doctor who decides when the patient can go home. If patients have complaints they can go to the Regulatory Council,” he added.

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