PESHAWAR: The Khyber Pakhtunkhwa government is consistently releasing funds to the State Life Insurance Corporation, enabling the continuation of free health services under the Sehat Card Plus insurance programme, say health officials.

They told Dawn that the government was providing a sufficient amount of money to the insurer on a monthly basis to cover the current programme expenditure and outstanding payments.

The officials said the last caretaker government restricted the free health initiative to three emergency diseases in September last year due to the shortage of funds as the State Life Insurance Corporation, responsible for implementing the programme in the province, had refused to continue services until the clearance of Rs16 billion dues.

They said the SLIC provided treatment to the patients at hospitals empanelled for the insurance programme with the health facilities being paid at the end of every month.

Officials say around Rs3bn paid to SLIC every month for payment to hospitals

The officials, however, said non-payment to the SLIC had brought the programme to a standstill with only cancer, dialysis and emergency patients availing themselves of services.

They added that the situation cut the monthly expenditure from Rs2.5 billion to around Rs20 million.

The officials said after the PTI resumed power in the province, the insurance company got Rs5 billion to keep the Sehat Card Plus afloat.

They added that from March 12, the programme started providing all services under the insurance programme to the people entitled for it.

The health officials said the government had so far paid Rs11 billion for the programme but Rs5 billion more was spent on the treatment of patients since the resumption of services.

They said currently, the total liabilities totalled Rs10 billion.

The officials said the government had pledged to provide the SLIC with Rs6.5 billion in July - Rs500 million for May and Rs3 billion each for June and July.

They said on average, the government paid Rs3 billion every month to the SLIC for payments to hospitals.

The officials said the caretakers had proposed restricting the programme to 65pc population saying the rest of the people should get partial payment for treatment.

They, however, said the PTI government rejected the proposal and launched the programme from where it had been stopped.

The officials said the government restricted seven surgeries to its hospitals under the SCP to check “malpractices” by private health centres and enable those hospitals to claim the lion’s share from the programme funding.

They added that since the start of the health insurance programme in 2016, the private hospitals had been getting more money from the programme than the public sector ones.

The officials, however, said the move to bar private centres from carrying out caesarean delivery, tonsillectomy, cholecystectomy, appendectomy, cataract, angiography and septoplasty and submucosal resection was paying off as the income of public hospitals from the Sehat Card Plus had gone up.

They also said the SLIC was clearing the dues of hospitals leading to the resumption of patient care under the SCP.

The officials said for the current financial year, the government had allocated Rs37 billion funds for the programme against Rs28 billion earmarked in 2021-22 by the then PTI government.

They said the current government, in a bid to further cut down the expenditure, had planned to carry out an assessment of the private hospitals empanelled for its health insurance programme so that those not fulfilling the criteria should be stuck off the list.

The officials said the criteria for treatment under the SCP had been made stricter to ensure that patients get quality services at designated hospitals.

Published in Dawn, July 2nd, 2024