Right to Health Bill: 20,000 doctors to protest as fear over 'exploitation' and reimbursement looms

> The Bill gives Rajasthan right to avail free OPD services, IPD services consultation, drugs, diagnostics, emergency transport, procedure, and

emergency care as provided by all public health

institutions accordantly to their level of health care as may be prescribed by rules made under this Act;

> Right to have adequate relevant information about the nature, cause of illness, proposed investigations and care, expected results of treatment, possible complications and expected costs

> As per the Bill, every resident will have the right to emergency treatment and care "without prepayment" at any "public health institution, health care establishment and designated health care centres".

> to have access to patient records, investigation reports and detailed itemized bills of treatment;

> The government must ensure that there is no any direct or indirect denial to anyone for any government-funded health care services.

> For logistical grievances, the state health authority will have 10 functions, including ensuring quality and cost-effective health and diagnostic services by the health sector and hearing all appeals against decisions of the district health authority related to logistical grievances.

> The main bill had the provision of "state health authority" but the amended version of the bill has the provision of two independent bodies which are – "state health authority for logistical grievances" and "state health authority for treatment protocol". In both committees, two members (each) will be nominated from Indian Medical Association (IMA), Rajasthan.

1. Doctors, who are seeking the complete withdrawal of the bill, said "it will give bureaucratic control on private hospitals". Dr Vijay Kapoor, secretary of the Private Hospitals and Nursing Home Society told PTI, "We are already giving free medical services to patients under government schemes and, in such a situation, there is absolutely no need for this bill."

2. Doctors are also concerned about how the government will reimburse the hospital for the cost incurred in stabilising and transferring the patient to another facility. They have sought clarification on how the government will reimburse them the amount.

The original bill did not have the provision for reimbursement but after the discussion in the select committee, the provision of reimbursement was added, PTI reported.

"After proper emergency care, stablisation and transfer of the patient if patient does not pay requisite charges, healthcare provider shall be entitled to receive requisite fee and charges or proper reimbursement from State Government in prescribed manner as the case may be," it read.

4. Doctors are also seeking a clarification on what an "emergency" is. "For a citizen, a mere headache can be an emergency and with this bill the citizen has a right to demand treatment for the headache at anytime from doctors," said Dr Aviral Mathur, Senior Resident MAMC & Lok Nayak Hospital, President FORDA.

5. Another doctor said the bill would put extra burden on private hospitals. In a letter to CM Gehlot on March 21, the IMA said the agitation is being held to "safe guard public health".

6. Doctor also fear "exploitation" by patients. "A private clinic runs from 9 am to 10 pm. If a patient has an emergency at 12 pm in the night (emergency like headache), then the patient can demand to get treated irrespective of the conditions at the clinic. So there are chances that doctors will get exploited because of the bill," Mathur said.

"Providing quality health free of cost to the citizens is the responsibility of the state and attempts at diluting this would be detrimental to public health. Creating burden on the already ailing private health sector will further jeopardise the system and will accelerate closure of the such institutions," the IMA said.

Vaibhav Jaiswal, a resident doctor at SDHM hospital, Jaipur, said, "In the end, this bill will bite the citizens back as the government will increase taxes to pay back the doctors and if the doctors keep on getting exploited, then they might just leave the profession leading to a collapse of the system."

Meanwhile, the health minister said that as per the Chiranjeevi scheme, the state government reimburses the amount to the hospitals within 21 days. Under the scheme, free treatment upto Rs 10 lakh (at present) is provided in empanelled hospitals.

In the state budget 2023-24, Rajasthan Chief Minister Ashok Gehlot announced to increase the limit under the scheme from Rs 10 lakh to Rs 25 lakh per year per family.

Countering it, doctors said that rather than putting a pressure on private hospitals, the government should improve facilities at government hospitals. Speaking with CNBCTV18, the doctors also warned to a system collapse keeping in view large scale protests.

The IMA said it will observe Monday, March 27 as a Black Day. Dr Rai, Chairman IMA Social Media Committee, called the Bill "draconian" and said over 20,000 doctors will join the protest. "We won't be able to work peaceful with this Bill," he said in a video damage. Some IMA officials had also met Governor of Rajasthan on Sunday with regard to the Bill.