Cases of private hospitals holding patients or their bodies hostage due to unpaid bills are being reported from across India despite several high courts ruling that it is illegal.
On August 3, a
Covid victim’s daughter had to post a video on social media about a private hospital in Bangalore holding her father’s body for two days because of unpaid bills before the medical education minister intervened.
More than a week ago, in a private hospital in Ranchi, a 53-year-old
patient’s body was kept for more than two hours over partial payment of bills. In Mumbai, a hospital in Powai refused to release the body of a 62-year-old rickshaw driver over unpaid bills. In both cases, a local politician had to intervene for the release.
The problem is that neither central nor most state governments have put in place a mechanism to tackle this phenomenon though director general of the Association of Healthcare Providers of India (AHPI) Dr Giridhar Gyani was categorical in stating that no hospital has the right to hold a patient or body hostage over unpaid bills.
Dr
Devi Shetty of the Narayana Group of hospitals, says that such a practice is not legal. “More than legality, it is not right. In my group of hospitals, we have given very clear instructions that no matter how much money is unpaid, you cannot hold a body or a patient hostage,” he said.
However, Malini Aisola of the All India Drug Action Network (AIDAN), who has helped several families get detained patients/ bodies released from hospitals, says the official line that the patient is free to leave is bogus. “The truth is that employees have sanction from the top to hold patient/body as collateral and employ a variety of pressure tactics and even threats,” said Aisola.
Talha Rahman, an advocate for patients’ rights, said that in most such cases, hospitals deny that they have detained the patient because they know it is illegal. That is why patients must immediately dial 100 and register a complaint. “If I don’t pay my credit card bill or post-paid phone bill, the company can file a case against me, but cannot detain me. Hospital services are no different. Hospitals cannot cite an inefficient legal system as the problem in filing a case for recovering the money, as the disadvantage of the same system applies to the patient who might want to file a case against the hospital for overbilling or wrong treatment,” said Rahman.
The CEO of a Delhi hospital accused of holding a patient hostage asks how a hospital would pay salaries and keep going if patients made it a habit to leave without paying the bill. “As a policy, hospitals should start taking deposits before admission. If the cost goes beyond the initial estimate, a further deposit can be taken,” suggested Dr Gyani.
Aisola said estimates provided by hospitals were routinely misleading, opaque and exceeded, giving the family a shock. “The heart of the matter is unregulated rates where hospitals profiteer on every small thing. We need regulation to deter practices like detention of patients by linking it to penalties and instituting 24x7 grievance redressal mechanisms,” added Aisola.
Even insurance cover doesn’t seem to help, said patients’ relatives. “My mother was held hostage for almost 48 hours because the insurance company refused to pay the bill saying there was gross overcharging. My mother’s health insurance was a base cover for Rs 5 lakh with a top up for Rs 8 lakh. The final bill was for Rs 5.35 lakh and yet she suffered immense mental trauma,” said a patient’s son.
That such detentions are not legal has been made clear in several court rulings, first in June 2014, again in February 2018 by different benches of the Bombay high court, in April 2017 by the
Delhi High Court, and just last week by the
Kerala High Court. But still the practice goes unchecked.
That there is a better option is shown by states like
West Bengal and Tamil Nadu, where there are official mechanisms in place. The West Bengal Clinical Establishment Regulatory Commission has imposed fines on hospitals and stepped in suo motu to intervene in some cases. In Tamil Nadu, the Director of Medical Services has forced hospitals to repay excess billing or even cancelled licences to treat Covid patients. Whether this will happen in non-Covid times and for non-Covid patients too is the question.
(With inputs from health correspondents in states)