PESHAWAR: The Peshawar High Court on Tuesday directed the provincial health secretary and head of an insurance company to respond to a petition against private hospitals over the alleged denial of free treatment to people under the provincial government’s health insurance scheme, Sehat Sahulat Programme, and subjecting them to needless clinical examinations.

A bench consisting of Justice Mohammad Ibrahim Khan and Justice Ishtiaq Ibrahim issued the order after holding preliminary hearing into the petition filed by a resident of North Waziristan tribal district, Umer Ayaz, who requested it to declare that the hospitals’ act of not providing free services to patients under the SSP and seeking money for treating them ‘privately’is illegal.

He claimed that private hospitals first lured patients into admission in the name of the SSP and then refused to treat them under the insurance programme.

The petitioner requested the court to direct respondents, including the health department and the Khyber Pakhtunkhwa Health Care Commission, to initiate action against all private hospitals, which were cheating the public at large by not providing free treatment to patients despite being empanelled for the SSP.

Waziristan resident also claims private hospitals conduct tests needlessly

The petitioner’s counsel, Saifullah Muhib Kakakhel, said on Feb 9, the petitioner took his 74-year-old father to the cardiology outpatient department at a leading private hospital in the province for examination.

He claimed that the patient suddenly suffered a heart attack during examination, so he was admitted to the cardiac care unit under the SSP for observation.

Mr Kakakhel said that the petitioner’s father was kept there for five days and the doctors recommended his angiography and angioplasty.

He added that as the patient was admitted under the SSP, he thought that angiography and angioplasty would be conducted under the health insurance programme, but the hospital refused to do so and demanded a hefty sum of money.

The counsel said that his client requested the hospital’s administration to abide by the government’s policy, but it declined and discharged the patient on Feb 15 without providing the required treatment.

He added that the patient was then taken to a public sector health facility, where the required procedures were conducted free of charge under the SSP leading to permission for him to go home on Feb 17.

Mr Kakakhel contended that the private hospital in question and others mostly charged patients under the SSP even without offering the required treatment.

He claimed that the media had reported the misuse of the SSP by private hospitals insisting that they deducted the programme’s money in major cases without providing treatment to visitors.

The lawyer contended that some hospitals admitted patients for minor surgeries and kept them admitted for many days to grab the maximum money under the health insurance programme.

Published in Dawn, March 15th, 2023