May 03, 2007

Corruption Catalogue: Government Hospitals

Of those who interact with government hospitals, 26.5% (3 crore households) paid bribes – 19% in rural areas, 49% in urban; average bribe paid per household: Rs 663

Methodology
The study classifies Indian states into high, medium and low performance, based on the UNDP composite health indicator. Kerala, Karnataka, Tamil Nadu, Gujarat and Maharashtra, with low levels of corruption have better health indicators and fall in the first category. Andhra Pradesh, Haryana, Punjab, Assam, Himachal Pradesh and Orissa belong to the medium performance category, while West Bengal, Bihar, Uttar Pradesh, Madhya Pradesh and Rajasthan have the worst health indicators and belong to the last category.

Corruption in judiciary
Corruption in education system
Corruption in Public Distribution System

Key findings:

Total monetary value of petty corruption put at Rs 2,017 crore a year
59% of rural and 51% of urban households sought services of government hospitals. All India figure: 55% (11.3 crore) households
Of those who interact with government hospitals, 26.5% (3 crore households) paid bribes – 19% in rural areas, 49% in urban; average bribe paid per household: Rs 663
Irregularities like non-availability of medicines and unethical practices by doctors are much lower in southern parts of the country
43% of respondents felt quality of service in government hospitals was poor. In low performance states, 53% felt service was poor.
67% felt corruption was widespread in government hospitals.
45% said hospital staff frequently demanded bribes

Use of services
Location% of Households using Government hospitals
Urban 51
Rural 59
Overall 57
·In Himachal Pradesh and West Bengal, a significantly higher percentage of people was availing the services of government hospitals.
·In Bihar, considerably lower number of people were availing the services of government hospitals.

IS THERE HARASSMENT?
In low performance states, only 38% of the respondents received treatment or consultation compared to 66% in the high performance states.
Overall 23% said they did not receive any treatment or consultation during a visit to a government hospital

Reasons for repeated visits
Doctor not available in previous visit: 39%
Failed to get appointment: 21%
Admission to ward not available: 14%
Operation theatre was not free: 13%
Diagnostic lab failed to take sample: 12%

PERCEPTIONS ABOUT GOVERNMENT HOSITALS
Service

Perception about quality of services
Very Poor: 13%
Poor: 30%
Neither Poor/ Nor Good 26%
Good 28%
Very Good 3%

Prevalence of corruption
There is widespread corruption in hospitals
Strongly Disagree 6%
Disagree Somewhat 9%
Neither Agree Nor Disagree 18%
Agree Somewhat 38%
Strongly Agree 29%
In the high performance states, 62% felt that there was corruption in government hospitals, against 77% in the low performance states.

Common irregularities
Medicines unavailable 52%
Doctors suggest a visit to their private clinic 37%
Doctors refer to private diagnostic centers 31%
Over-prescription of medicines 24%
Bribes demanded by staff 20%
Diagnostic tests are done even when unnecessary 18%
Doctors are absent 13%

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