LAHORE: The obstetricians carried out nearly 80 per cent of the total C-section procedures covered by Sehat Card Programme in the private hospitals across Punjab, apparently making ‘huge financial gains’ at the expense of taxpayers, shows official data.

It is evident from official figures pertaining to the delivery procedures conducted from 2016 to January 2024 under the Sehat Sahulat Programme.

The data shows that the total amount claimed by the private hospitals only against the C-section and normal delivery procedures amounted to Rs16.36 billion.

This shows that a major chunk of the money paid by the government against the C-section procedures has gone to the private health facilities’ owners.

The State Life Insurance Corporation has been offering subsidies on several medical procedures under the programme.

The data further reveals that the public and private hospitals empanelled by the Punjab Health Initiative Management Company (PHIMC) have performed a total 668,238 C-section procedures during the period. The company was overseeing the healthcare cover provided to the patients under the largest health scheme in Punjab.

Of the total cases, 525,619 procedures were carried out in the private facilities, while 142,619 in the government hospitals all over the province.

This huge difference has shocked many independent observers in the medical community, who demand an independent probe into the matter.

Similarly, the number of normal deliveries in both public and private hospitals of Punjab was recorded at 210,124. Of these, 142,621 normal births were reported in the government sector hospitals of the province.

A senior medical teacher says that the reasons behind the huge difference between the percentages of C-Section procedures conducted in the public and private facilities needs to be thoroughly probed through a third party to bring facts to light. It should be made public as to why such a large number of women were apparently ‘forced to undergo’ the procedure, he asserts.

“We the health professionals are aware of many obstetricians indulge in such practices, as they are paid many times more for conducting a C-Section, compared to natural birth,” he says.

He adds that in medical profession, normal delivery is considered much safer than the surgical procedure. He says that the gynaecologists benefiting from the health scheme may have taken advantage of the patients’ lack of medical knowledge and misused it for huge financial gains.

The official figures in this regard support the medical experts’ view as the payments made to the private hospitals from 2016 to January 2024 against all the Cesarean procedures and normal deliveries totalled up to Rs16.36 billion.

Of the total amount, the major claim of Rs7.19 billion was recorded in 2023, Rs8.16 billion in 2022, Rs610 million in 2021, Rs168 million in 2020 while another amount was calculated for the rest of the years.

The data shows that the private hospitals carried out 197,376 Cesarean procedures, while the public hospitals performed only 97,390 only in 2023.

In 2022, private facilities performed 281,137 Cesarean procedures, while the government hospitals 31,372 and in 2021 the number was 28,366 in private hospitals and 87 only in the public sector healthcare facilities. Similarly, the private hospitals performed 8,174 Cesarean procedures, while the public ones carried out only six in 2020.

The data further shows, the private hospitals carried out 4,902 C-section procedures in 2019, 3,021 in 2018, 2,292 in 2017 and only 349 in 2016.

On the other hand, the government hospitals’ total number of C-section procedures from 2016 to 2019 was only eight, showing a visible upward trend in carrying out Cesarean procedures in the private health facilities after the launch of health card scheme.

An official says that the then caretaker Punjab government placed a complete ban on Cesarean procedures at the private hospitals in mid-2023, when it calculated that a major share of the total amount claimed by these facilities had reached an alarming proportion for the years 2022 and 2023.

He says that private hospitals had carried out a staring 478,513 C-section procedures during the two years.

Consequently, the amount of the claims against all the C-section procedures and normal deliveries carried out in the two years had gone up to approximately Rs15 billion, which was many times higher than the total sum claimed by the private hospitals during the previous six years, the official adds. This situation, he says, prompted the authorities to slap a ban and review the policy.

While placing a ban on such procedures at private hospitals, the official says, the government issued directions to the state-run facilities only to accommodate delivery cases under the health card.

However, the official says, the public hospitals also stopped entertaining the delivery cases under the health card when the doctors declared that their share from each case was insufficient and thus unacceptable to them.

However, the public hospitals kept accommodating expecting women without the health card cover, he adds.

PHFMC Chief Executive Officer Ali Razaq refused to comment on the issue.

Published in Dawn, March 6th, 2024