With CMCHIS, govt hospitals in TN find maintenance difficult

The state health department is all praise for its Chief Minister's Comprehensive Health Insurance Scheme (CMCHIS) but things are not the same when it comes to finances being allocated to the hospitals specifically since the CMCHIS was implemented in Tamil Nadu. While state government hospitals find it difficult to raise the funds for the maintenance of the hospitals as they no longer receive funds for the maintenance of the hospitals, all the departments are under the pressure to source maximum funds under the CMCHIS scheme.

About 800 hospitals including at least 600 private hospitals from neighbouring states were empanelled under the CMCHIS scheme. Every year, government spends Rs.750 crore towards the premium for the insurance scheme. Though patients have benefitted from the scheme, government hospitals find it difficult to utilise the funds for the maintenance of the hospital.

Earlier, the funds were directly allocated for the particular purposes of buying equipment, maintenance of the basic amenities, buying new beds etc., before the CMCHIS came into existence. “Though the funds for the expansion of the services and the infrastructure is being allocated by the government, the regular maintenance is managed through the amount claimed under CMCHIS, but it is not sufficient,” said Dr Jeyachandran, director, Institute of Child Health.

The state health department is encouraging the advancement and expansion of the hospitals, the allocation of funds for due maintenance of the same is not being done. The government hospitals only receive funds for the essential services such as oxygen, water availability, advanced screening equipment and certain number of bed as a direct allocation.

“There are new blocks that will be reopened in the hospital soon. As the units expand and upgradation of the facilities is done, more funds are required for the upgradation of the same. The hospital undoubtedly raises some amount under the CMCHIS, however, the number of ward beds, seating availability, waiting area maintenance and others have to be done, which needs an extra allocation for complete upgradation of the new blocks,” said an official at the Rajiv Gandhi Government General Hospital on the condition of anonymity. “When CMCHIS was not into play, the funds for each ward was allocated by the hospital for a due period and thus, the maintenance was taken care of.”

While surgical and clinical departments boast of attracting the large amount of funds under the CMCHIS, the non-clinical departments are unable to claim equal amount of funds. Various departments such as general medicine, paediatrics, orthopaedics, general emergency, obstetrics and gynaecology receive good amount under the insurance scheme. However, the non-clinical departments such as radiology, bio-chemistry, microbiology and pathology are not able to match the amount. This not only adds to the pressure on these departments but has made the scenario competitive for the departments to raise a greater amount under the scheme.

“The amount is usually utilized by the particular department for upgradation of the services, but the non-clinical departments suffer in this case. The non-clinical departments have to be dependent on the direct allocations made by the hospital as the funds are usually low,” said Dr R Ravi, director, Barnard Institute of Radiology, Rajiv Gandhi Government General Hospital.

Various non-governmental organizations such as the Banyan, the Libra Foundation, Deepam society and others have joined hands with the government hospitals to provide basic equipment and medical facilities for the underprivileged patients.

“Though state health department projects are completely owned by the public health authorities, few NGOs are aiding the government hospitals for the due maintenance of particular wards. Libra and Banyan supplies basic non-clinical equipments for paediatrics and oncology department at ICH, which should ideally be done by the government hospital authorities” said Dr Mohan Kumar, paediatrician, ICH.

When contacted, state health department officials said that they discourage NGOs to support any particular project at the government hospital as all the activities are owned by the government authorities. State intervention is available in times of need- The government hospitals discuss the lack of funds for the maintenance of the hospitals in the review meetings and the issue has been raised to the CMCHIS project authorities.

“The state budget allocations have not been changed and the government hospitals receive funds for the maintenance project. CMCHIS serves to be an added benefit for most of the government hospitals, and only few hospitals might have lack of funds. If any particular government institution is facing crunch of funds and brings it up to the authorities, the State health department will intervene and allocate funds of the same,” said Dr T S Selvavinayagam, the officer in charge of CMCHIS.