Dialysis treatment at private hospitals in Gujarat is set to get affected from Monday for three days as the Gujarat Nephrology Association (GNA) has called for a protest till August 16 against the “imparity in dialysis rates” under the Pradhan Mantri Jan Arogya Yojana (PMJAY).
The GNA has said it has the “support” of the Indian Medical Association, which has also written to Chief Minister Bhupendra Patel over the issue.
In a press release on Saturday, the GNA said it has been “forced” to take the “drastic decision” as the state government has not responded to its representations made a month ago. The association has demanded the Gujarat government must follow the recommendations of the National Health Authority to increase the package cost of dialysis to Rs 2,500, including the EPO injection at a cost of Rs 700 as well as the transport allowance for patients of Rs 300. The association has also demanded the government must allow the reuse of the dialysis filter to reduce overall costs incurred by private hospitals, with immediate effect.
According to the GNA, most patients undergoing dialysis in Gujarat are beneficiaries of the PMJAY scheme, which includes medicines, injections, lab reports, central air conditioning, meals, transport allowance of Rs 300 as well as consultation with superspecialists free of cost. The association has claimed private hospitals in Gujarat are only allowed single use of the dialysis filter, thus increasing the costs incurred by the hospital.
“In Gujarat, every year, about 1.3 crore dialysis treatments are carried out, out of which about 1.02 crore (78 per cent) are done at private hospitals. The private hospitals are paid Rs. 2,000 per treatment for the last eight years by the government of Gujarat. Recently, the Gujarat government abruptly reduced the prices to Rs.1,650 per dialysis.
According to the state government guidelines, dialysis centers can only make a single use of the filter while other states are allowed to use the filter up to eight times (as per guidelines of the respective states). Due to the decrease of price in dialysis treatment, it is very difficult for private hospitals to sustain the dialysis treatment.”
The GNA also recently made a representation to Gujarat Health Minister Rushikesh Patel to raise the issue of ‘imparity of price’ in dialysis treatment. The GNA also added that the single use of a dialysis filter also increases biomedical waste tenfold. “Even the guidelines for dialysis issued by the Union Ministry of Health and Family Welfare recommend the dialysis filters should be reused,” the release said.
Dr Umesh Goghani, coordinator, of GNA, further highlighted, “The government used to pay Rs 2,000 per dialysis earlier, which was also insufficient to meet the costs incurred by the private hospitals in providing the treatment. However, we cannot fathom what occurred to the decision-makers to reduce the price to Rs 1,650, which makes it impractical to provide PMJAY services. We are left with no choice but to suspend the services under PMJAY since more than one crore people are visiting private hospitals to take benefit of the PMJAY scheme.”
The statement further added that Rushikesh Patel had previously assured the association that a “resolution would be reached soon”. However, there has been no action, the association has complained. “We have been waiting for over a month to see action in the case of our representations (about PMJAY payment imparity) but the government has not yet resolved the issue. We are left with no choice but to suspend private dialysis under PMJAY from August 14 to 16. We have the support of the Indian Medical Association (IMA), which has also written to the Chief Minister of Gujarat regarding the issue,” the statement read.
Dr. Jigar Shrimali, GNA co-ordinator, stressed, “In Rajasthan, Chhatisgarh, and other states, the dialysis charge at private hospitals is Rs 2,100. The National Health Authority has also issued guidelines pricing the dialysis treatment at Rs 2,200 (1,500 for dialysis+700 for EPO injection) and it also does not include the transport allowance. It also recommends the re-use of the filter. So, why has the Gujarat government deviated from these guidelines and recommendations?”
The statement further added the decision of the GNA to suspend the dialysis services in private hospitals will “force patients to seek treatment in government centers, where kidney specialists are not available”. “If private hospitals pull out of the PMJAY, all centres offering dialysis under PMJAY in Gujarat will be without the supervision of doctors. For such a complicated treatment like dialysis, the supervision of a nephrologist is a must… Why is the government attempting to make a life-saving treatment like dialysis free in private hospitals, when government centres were already offering the free treatment? The PMJAY has only slashed rates of kidney dialysis and not of surgeries like joint replacement and others, where the cost of treatment ranges from Rs 10,000 to 60,000,” read the GNA release.