April 03, 2009

Chiranjeevi Scheme: Gujarat Doctors want more money to deliver at work

Though lauded nationally, the Gujarat state government’s Chiranjeevi health scheme to reduce the maternal/infant mortality rate has the private doctors grumbling, wanting more remuneration.
Under the scheme, state-government recognised private doctors are paid a specific amount for every institutional delivery taking place in their hospitals, but private doctors claim the payment is inadequate. A normal delivery costs anywhere around Rs 3,000, and a complicated case is well over Rs 10,000.

But, under the Chiranjeevi scheme, they are paid an amount of Rs 1,545 per delivery.

Some of the doctors have now decided to pull themselves off from the scheme, while others are requesting for changes to justify the service provided by them.

A Godhra-based gynaecologist, Dr Shujaat Vali, who has decided to opt out of the scheme, said: “The Chiranjeevi doctors in the peripheral region do not accept complicated patients, but while they churn profit from normal deliveries, the complicated cases are sent to the city-based Chiranjeevi doctors. Over 50 per cent cases at my clinic are of a complicated nature.”

Dr Parul Kotdawala, president of the Society of Gynaecologists and Obstetricians of Gujarat (SOGOG), said: “With the increasing charges of medical services, the initially decided amount does not stand up to support the medical practitioners.”

At a recent review workshop of the scheme by IIM-Ahmedabad, obstetrics and gynaecologists from across the state, under SOGOG, listed out their grievances.

Dr Kotdawala said: “We are planning to survey all the doctors under the scheme to bring out the facts. The scheme is part of the social responsibility programme, and though the intention of the scheme is good, due to the low package, many doctors are compromising with the quality of service.”

Deputy Director of Health Dr Vikas Desai said: “This is a very preliminary level workshop to review the comfort level of the doctors in the scheme and costing of the doctors.”

IIM-A professor Dileep Mavalankar, who is undertaking the study, said: “The main intention of the scheme is not just to lower maternal and Infant Mortality Rate (IMR), but also to provide quality service. Doctors tend to cut corners by unethical means. We are trying to have regional level discussions with gynaecologists to find a solution to this.”

The doctors also pointed out other flaws in the scheme, like operations being conducted by junior doctors and nurses, use of low quality medicines, lack of post-delivery care, and of benefits being accrued by well-off patients through the use of fake BPL cards.

“People from high strata of society produce fake BPL cards and take advantage while the real and poor beneficiaries are left out,” said Dr R B Patel, the president of Godhra Obstetrics and Gynaecological Society (GOGS).
Link: Original Article

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