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Experience of User Charges in HP

Experience of User Charges in HP. Gautam Chakraborty Health Economist GTZ Basic Health Project HP. Creation of Societies ( Phase I). Hospital Welfare Societies At District Hospital, Zonal Hospital, Medical College Hospital Governing Board - for taking policy decisions (Chairman: DC)

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Experience of User Charges in HP

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  1. Experience of User Charges in HP Gautam Chakraborty Health Economist GTZ Basic Health Project HP

  2. Creation of Societies (Phase I) • Hospital Welfare Societies • At District Hospital, Zonal Hospital, Medical College Hospital • Governing Board - for taking policy decisions (Chairman: DC) • Executive Council - for managing day-to-day affairs (Chairman: CMO) • Members include local representatives, VyaparMandals, NGOs, etc.

  3. Creation of Societies (Phase I) • Charges levied on Non-health and health services • Non-health: renting out of space, fee for medical certificates, etc. • Health: lab tests, X-ray, ultrasonography, private ward • Charges at 1974 rates (5-10% of current NSRC)

  4. Creation of Societies (Phase I) • Adoption of wards • Donation of equipment • Revenue used on building repair, equipment purchase (Nurse Trolleys, intercom, printer for ultrasonography)

  5. Creation of Societies (Experiences) • No Seed Money given • Budget support for maintenance, METP withdrawn • OPD parchee fee withdrawn • withdrawl of PWD and HPSEB support • funds utilized on provider care, not patient care

  6. Creation of Societies (Experiences) • Public outcry, supported by Opposition • Confusion on exemption policy • Confusion on recruitment of temporary staff • Confusion on Financial and Administrative powers

  7. Creation of Societies (Phase II) • Media campaign on Society Mechanism • Societies renamed Rogi Kalyan Samities • Full powers to GB on equipment purchase, repairs, hiring of technicians/assistants • Charges first on non-health services, followed by diagnostics at a later stage

  8. Creation of Societies (Phase II) • Societies asked to invest on services giving direct and visible benefit to patients (OPD waiting space, wards, toilets, etc.) • Charges increased to 50-70% of NSRC • Societies started at SDH, Civil Hospitals • Charges on voluntary basis, exemptions discretion of concerned MO • Medicines from hospital pharmacy free

  9. Issues to be addressed • Purchase procedures and powers to be defined and clearly laid down • Definition of administrative sanction (for new constructions by PWD) • Clarifications on ownership of assets (linked to loan liability) • Objective exemption policy • Focus on patient satisfaction, not providers

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