Woman deprived of angioplasty because of KEM's clerical error
60-yr-old had applied for surgery under Rajiv Gandhi Jeevandayee Arogya Yojana, but procedure couldn’t be done as unpaid vendors have stopped supplying equipment to hospital
A poor woman waiting to undergo a heart surgery under a government scheme had to return empty-handed from the KEM hospital last month, which told her it had no equipment to perform the operation. The vendors who supply the necessary equipment have stopped doing so, because they haven’t been paid.
Nearly 70% of people who were eligible for treatment under the RGJAY have been turned back from KEM Hospital in the last 1.5 months for lack of equipment such as stents, balloons and pacemakers. File pic for representation
The scheme under which Malandi Sheikh (60) had applied for an angioplasty is the Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY) — a programme that allows below poverty line (BPL) patients to avail of medical treatment up to Rs 2 lakh.
The Goregaon resident, after suffering from chest pains, had found out in an angiography in KEM Hospital that she needs to undergo an angioplasty to remove the blockage in her arteries. However, since the hospital doesn’t have the necessary stents, balloons, pacemakers and other implants, it had to ask her to go to other hospitals.
Sheikh continues to suffer from symptoms like intense chest pain, giddy spells and inability to carry out routine activities. “I had to run from pillar to post, asking doctors when my mother can undergo the angioplasty under RGJAY, but we were informed it has been temporarily discontinued,” said Abbas Sheikh, a driver.
“We can’t afford the Rs 1.5 lakh required for the angioplasty. After meeting the dean, we were assured that she would undergo treatment in the next few days. I hope it gets done, since she is suffering more as each day passes,” he added.
This has been going on at the Parel hospital since August; doctors at the hospital say that with no surgical equipment, above 70 per cent of cardiology procedures conducted under the health scheme had to be cancelled. Nearly 60-70 patients have been asked to go back, said doctors.
While a few lucky patients underwent treatment with funds from the hospital’s poor box charity funds, others were forced to go to Sion and Nair hospitals. “The health scheme covers patients for treatment up to R2 lakh and was launched in 2012 when the dean of the hospital was Dr Sanjay Oak. However, in the span of these two years, we have had two more deans who were in charge of the hospital for a shorter duration, due to which the paperwork related to the RGJAY scheme kept piling up,” said a senior doctor from the department.
According to the scheme, a patient has to submit documents that she is from the BPL category and, after the operation is done, the hospital sends the paperwork of the surgery to the insurance companies that are part of this programme. The company, after scrutinising the documents, releases payments to vendors who provided the equipment.
However, due to the workload, the staff in charge of preparing paperwork made many clerical errors, resulting in the insurance companies rejecting the claims. Thus, the operation was done; the patient had gone; but the insurance company didn’t pay the vendors, forcing them to halt their services.
A circular sent to civic hospitals in the first week of August finally made it the departments’ responsibility to ensure that every patient’s insurance claim is passed. “The cardiology department finally got the autonomy to complete the paperwork. Earlier, only a few employees handled the paperwork,” added the doctor.
After a meeting was held between hospital authorities, employees from the accounts department and doctors from the department on Monday, doctors say the surgeries under the scheme will resume in the near future.
Dr Milind Salve, deputy dean of the hospital, said, “The cardiology department is now in charge of the RGJAY scheme of their own patients, and they are handling the issue. I’m not aware of the current status.” Dr Shubhangi Parkar, dean of the hospital, remained unavailable for comment.