|
AoH, Charity Commissioner suggest separate schemes to implement charity in trust hospitals
Shardul Nautiyal - Mumbai
In the wake of state government’s withdrawal of concessions
provided to 70 ’state-aided public trusts or charitable hospitals’
registered under the Bombay Public Trust Act, 1950, the Association of Hospitals
(AoH) and the Charity Commissioner are preparing separate schemes to implement
charity in these hospitals.
Refusing to divulge details of the scheme, Brig Joe Curian,
chief spokesperson of AoH, said, “The objective of the scheme is to come
to a consensus of how charity can be provided to the poor and weaker sections
of the society.” AoH comprises over 45 Mumbai-based hospitals. Meanwhile,
Sanjiv Punalekar (who had filed a PIL in the High Court for not receiving free
treatment for his father), Charity Commissioner and the Advocate General of
High Court Ravi Kadam are also jointly working out a scheme to implement free
and subsidised treatment for the poor, said Rajeev Pandey, counsel for the petitioner.
“Suggestions from the AoH are also invited for the formulation of the scheme.
Chief Justice Dalveer Bhandari have directed the AoH to give their suggestions
before May 5, 2005, on the day of final hearing,” he added.(see box 1).
The propriety of government functionaries or ministers making
an announcement of withdrawal of concessions, at this point of time is debatable
and questionable since the case is still pending in the court and is subjudice,
added Curian. AoH has also asked HC to clarify the ambiguity in Section 41 A
A (see box 2).
- Rs 2,000, be the penalty for violation of
the Bombay Public Trust Act, 1950 is inadequate and therefore should
be increased to Rs 10,000.
- A nodal officer or officer on Special Duty
(OSD) should be appointed to coordinate between charitable hospitals,
government hospitals and charity commissioner for the implementation
of charity in hospitals.
- Four to five private charitable hospitals
should be linked up to the civic hospitals for efficient referral of
poor patients.
- A register should be maintained in the hospitals
for general public to access information on the treatment given to the
poor patients and the cost incurred by the hospital and the patient.
- Lease deed for the land to hospitals should
be cancelled on violation of rules.
- Those who violate the provisions of the act
should be held liable for penal offence or criminal offence and the
income limit should be increased to bring more people into the ’economically
weak bracket’(i.e. Rs 25,000 per annum for indigent patients and for
patients of economically weaker sections to Rs 50,000.)
|
- Reserve and earmark 10 per cent of the operational
beds and 10 per cent of the capacity for treatment of the poor-free
of charge.
- Reserve and earmark 10 per cent of the operational
beds and 10 per cent of the capacity for economically weaker sections-
at concessional rates.’
a) Tax/ Octroi/custom duty exemption and Full Octroi Refund.
b) Concessional electricity/water.
c) Concessional land.
d) Waiver of property tax.
e) Income tax exemption.
f) Receiving donations easily.
g) Concessional/ Additional FSI.
h) Exempted from contributing two per cent of the gross annual income
of the trust.
i) Tax-free donation.
h) No two per cent income of the hospital to be given to charity commissioner.
|
Curian argues that charity commissioner’s office had certified
the implementation of the charity, duly registered by these hospitals. “It is
to be noted that the charity commissioner did not take penal action against
any hospital for non-compliance during and after the course of certifying the
hospitals, said Curian, adding, “Many of the concessions and benefits quoted
in the PIL are available under Income Tax Act. Such concessions are available
even to organisations that are not philanthropic, like religious bodies, sports
clubs, etc. For instance, Section 10 (23c) (vi a) provides exemption to hospitals
existing for philanthropic (not for profit) purposes.” The court had last year
suo moto taken up the cause of poor patients after an ex-mill worker, the father
of Sanjiv Punalekar was refused treatment in one of the charitable hospitals.
Punalekar filed a PIL on 15 December, 2004 with twin purposes: firstly, seeking
free treatment for his father and secondly in the form of a PIL against the
charitable hospitals in Mumbai.
Subsequent to taking up the case on the PIL, the court asked
the charity commissioner to probe into the laxity of charitable hospitals. Charity
commissioner S B Dhumal submitted an affidavit to chief justice Dalveer Bhandari
and Justice S A Bobade, which stated that the charitable hospitals did not properly
display or disseminate information regarding free or concessional treatment
to the public and charged regular rates irrespective of the patient’s income.
According to Punalekar, hospitals like Jaslok Hospital and Mandke Heart Hospital
have been granted land at a rate of one rupee. They are expected to reserve
30 per cent of beds for the poor and economically weaker sections, which these
hospitals are not implementing. Stating that the charity commissioner is not
clear about the meaning of certain provisions in the Act, Curian cited the example
of the petitioner Sanjiv Punalekar, who demanded free treatment even though
his father is not entitled to. According to the Act, his father did not fall
either under the category of ‘free’(annual income of Rs 3,600) or ‘concessional’(annual
income Rs 15,000).
AoH has further sought clarification on the extent of concession
to be offered to these hospitals. “The office of the charity commissioner is
unable to spell out these rates, which are to be in conformity with the rates
charged by the state government in medical centres maintained by it,” Curian
said. “The hospitals have a system of evaluating the financial background of
the concerned family and concessions are granted accordingly. These gradations
may extend from level A (minimum concession) to level K (maximum concession)
covering bed charges, investigations, surgeries, procedures and even certain
cases, medicines,” Curian informed.
AoH has also pointed out to the ambiguous definition of free
service. In one of the clarifications given by Attorney General of India, it
was stated that free service will not include medicines, consumables and such
items. “However, it is a known fact that many of the hospitals actually give
free medicines and totally free surgeries to financially poor, if and when such
patients are admitted,” Curian added.
According to J P Sharma, medical superindentent, Jaslok Hospital,
before making such a pronouncement of withdrawal of concessions, the government
should take into account the functioning and infrastructure of the hospitals.
“The community service rendered by voluntary health services in our hospital
for the past 20 years is a good example to cite. Jaslok Hospital offers 96 economy
subsidised beds and 51 free beds out of 376 beds. We offer treatment to the
patients according to two categories namely patients entitled for free treatment
and patients entitled for subsidised treatment,” added Sharma.
Endorsing government punitive action, Dr M E Yeolekar, dean,
Sion Hospital said, “The charitable hospitals should follow the rules strictly.
The charitable hospitals are accountable for their actions. There is a need
to create public awareness about the concessions given to the poor by charitable
hospitals.”
Interestingly, the Directorate of Health Services is also
working on a similar kind of scheme independently, according to sources.
shardul@expresshealthcaremgmt.com
|
