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EWS Beds in Delhi
In 2007, the Delhi High Court ordered all private hospitals in Delhi having the free treatment condition for economically weaker section patients in their lease deed to provide free treatment to 10% poor inpatients and 25% poor outpatients. This article analyses the monthly reports of “percentage bed occupancy” of the ews beds in 34 private hospitals from 2012–13 to 2015–16. The bed occupancy of 41% hospitals was below 10% and only two hospitals featured more than 30%. A number of loopholes need to be plugged by the custodian of the public properties, which is the state in this case, to ensure that the public partners who are the poor patients are welcomed and provided non-discriminatory health services without any fee.
The state, in pursuance of its social responsibilities bestowed on it by the Constitution,1 has been providing various concessions, including highly subsidised land at prime locations to the entrepreneurs and voluntary organisations to construct and operate hospitals in different parts of the country. This public–private partnership (PPP) to provide quality health services has existed since decades and the private partners have been claiming to extend the benefits to the economically weaker section (EWS) patients through charity. In 1973, the Land and Development Office (L&DO) of the Delhi administration2 allotted land to a trust for a 100-bed hospital in the posh Chanakyapuri area. The agreement called for providing free treatment to the EWS patients and it was inserted as a precondition and enforceable clause in lieu of the concessional land. The hospital management promised to reserve 70% of its beds completely free for the EWS category patients while the government approved reasonable rates were to be charged for the remaining 30% beds. Thereafter, the L&DO and the Delhi Development Authority (DDA) allotted concessional land to several trusts and non-governmental organisations (NGOs), and the clause of providing free treatment to the EWS patients were inserted in their lease deeds. The percentage of free treatment in the inpatient department (IPD) and outpatient department (OPD) categories, however, differed from hospital to hospital since there was no uniform policy. But none of the hospitals which signed such agreements met the requirement, and some of them even shut their doors for the poor and ran their hospitals as private business ventures.
However, as per their lease deeds, the landowning agencies (DDA and L&DO) were empowered to cancel the allotment and take over the hospital but these hospitals were part of a strong lobby that thwarted all attempts by the enforcement agencies to get them to implement the relevant clause. The Delhi administration even constituted a committee under Justice Qureshi3 to sort out the issue. After wide consultations, the committee recommended that, irrespective of their agreement, each hospital should provide 10% of its IPD and 25% of OPD facilities completely free to EWS patients. The hospitals refused to implement the recommendations. In 2002, the Social Jurist4 challenged 20 such private hospitals5 in the Delhi High Court through a public interest litigation (PIL) for not implementing the clause of free treatment for EWS patients in their lease deed and prayed that the high court order the Delhi government to implement the Qureshi Committee’s recommendations.
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