Karunya scheme: Govt freezes order to transfer 20% insurance amount from hospitals after row

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Thiruvananthapuram: An official order to set apart 20 per cent of the insurance amount reimbursed to government hospitals under the Karunya Arogya Suraksha Padhathi (KASP) for the State Health Agency (SHA) - which oversees the project - has led to a controversy. The order also suggested incentives for hospital staff amounting to 15 per cent of the insurance amount. After objections were raised against these proposals, the authorities issued another order freezing the earlier one.

While the first order was issued on January 10, the order to keep it on hold came the next day. The latest order says that no decision should be taken on January 10’s directive until yet another order is released.

Presently, the SHA owes government hospitals around Rs 500 crore as reimbursement under KASP, which is a health care scheme for poor and vulnerable families.

If the order of January 10 had been implemented and 20 per cent of the insurance amount transferred to SHA, funds of government hospitals would have dipped drastically. As a result, functioning of hospital development committees, which utilize the insurance amount to meet day-to-day expenses, would have been severely hit. The proposal in the order to pay different incentives to staff, including doctors, also invited widespread protests.

The order was issued without consulting organisations of health workers, it is pointed out. Meanwhile, it is alleged that SHA took decisions even without holding discussions with the Health Department, but blindly implemented suggestions from some consultancy agencies.

When a patient who is covered under KASP applies for insurance, the amount is paid to the respective hospital development committee by the state government after treatment. As this amount is utilized for hospital development work and meeting various expenses, a 20-per cent reduction would affect such activities badly.

According to the controversial order, the insurance amount should be spent for the following purposes (in percentage):

Staff incentive: 15%

Temporary appointments: 20%

Medicines, tests: 40%

Hospital development: 20%

Administrative expenses: 5%

Incidentally, the incentive scheme was introduced some years ago also, but was withdrawn following protests. The order of January 10 sought to reintroduce the scheme without proper consultations. The order said that a committee led by the hospital superintendent had full authority to distribute the incentives. “Various incentives have been mentioned in the order without considering the actual workload of different health workers in government hospitals. This will only lead to disputes,” said a medical professional.

Incentives proposed for staff in medical college hospitals are (in percentage):

Head of the Department: 2%

Professor: 4%

Associate Professor: 8%

Assistant Professor: 12%

Senior registrar, senior resident: 14%

Junior registrar, junior resident: 8%

Nursing staff, paramedical technician: 30%

Karunya nodal officer: 2%

PRO: 2%

Clerk, computer operator: 3%

Class 4 employees: 15%

The rates of incentives in other government hospitals are (in percentage):

Surgeon, main physician, doctor treating the patient: 30%

Assistant surgeon aiding in surgery, other doctors: 10%

Anaesthetist, doctors from other departments aiding treatment: 20%

Staff nurse: 10%

Lab technician: 2%

PRO: 1%

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