Free treatment still elusive for many under new health scheme

Despite claims by the Health Department that the Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY) has been a success in the state and has received great response from the masses, the ground reality about the health scheme for the poor is not so rosy. Though people are enrolling themselves for the scheme, there are several barriers to providing them the promised free medical services.

While in the city alone there are 47 hospitals under the RGJAY, many of the 29 private hospitals among these have entered into only a partial agreement to implement the scheme, which means only select medical services are provided at these facilities. 

As a result, patients find themselves running from pillar to post to find the right hospital for a particular ailment.

There are problems at the government hospitals as well. Certain medical procedures are to be provided free under the scheme to patients below a particular income level, but officials of the state health department say they are still convincing some government hospitals to do so.

Agreement issues
Among the private hospitals that have entered into a partial agreement to implement the scheme is the Asian Heart Institute and Research Centre, where only angioplasty is performed under the scheme. Other cardiac procedures are not part of the MoU that has been signed.

At the BSES MG Hospital managed by the Brahma Kumari’s GHRC, the hospital management is still in talks with RGJAY officials regarding dialysis procedures, and so patients still need to pay for dialysis at the facility.

Patient experience
Abdul Rahim (name changed on request) has been undergoing dialysis at an Andheri hospital for about eight years now, but says he has had to skip one or two sessions every week because of his inability to bear the high expense. Now he is enrolled under the RGJAY, but there is still no relief in sight.

“I need about three sessions of dialysis every week, but for the past few years I have been skipping a session or two every week as my monthly income is meagre and I can hardly save enough to pay the bills for dialysis,” Eahim said. “Though I have put forward my grievance to the government, there has been no progress in the matter.”

Prakash Shah, whose relative requires dialysis, said the RGJAY had not changed things for him as the hospital concerned was delaying the scheme.

“After enrolling for the yojana, I expected that I would have to spend less, but the hospital management has been delaying the implementation,” Shah said. “I tried negotiating with the hospital management, but I am still forced to pay Rs 1,200 for each dialysis.”

8 districts covered
A total of 143 hospitals, from the government as well as the private sector, are part of Phase-I of the RGJAY in the state. The scheme has been introduced in eight districts for now, and the government plans to expand it to cover more of the state in the coming days.

The state government a few days ago claimed to have made great strides with the scheme since its introduction some months ago, and officials said 21 lakh of the 40 lakh RGJAY cards printed had already been issued to people.

Officials stated that the response to the scheme was lower in the city compared to other regions, and admitted that they were still at the “learning stage” and the scheme had a long way to go.

As several complaints about both government and private hospitals turning away patients enrolled under the scheme have reached them, RGJAY officers said they were currently concentrating on solving these grievances.

Dr K Venkatesham, CEO, RGJAY, said his officials were working improving services after the positive response to the scheme.

“Response from all stakeholders, especially hospitals, district administrations, municipal corporations and medical colleges, is tremendous,” Venkatesham said. “People in Mumbai have rightly responded to the yojana and now we are concentrating on the districts of Nanded and Gadchiroli. We are still working on it to improve the service levels.”

On the success rate of the RGJAY, he said that he was aware of problems like patients still having to pay for free services at certain hospitals and that grievance cells were being set up to iron out all issues.

“Phase-I, which covers only eight districts in the state, is a learning stage for us, and we know there are certain problems related to private hospitals when it comes to the implementation of the yojana,” Venkatesham said. “There are hospitals where the patients who undergo dialysis on a regular basis are forced to pay for each dialysis. There are other grievances faced by poor patients. We have set up grievance cells at every such hospital to solve these issues.” 

The toll free number that patiThe scheme Under the Rajiv Gandhi Jeevandayee Arogya Yojana, the state government bears medical expenditure up to Rs 1.5 lakh (Rs 2.5 lakh in case of kidney transplants) for families with an annual income of less than Rs 1 lakh.

The scheme covers expenses incurred on 972 medical procedures, like cardiac and cancer related surgeries, and therapies and procedures under 30 specialties with 121 follow-up packages.ents in need of dialysis can dial for information about their nearest dialysis centre

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