West Bengal warns private hospitals of licence cancellation if they reject patients having government’s health insurance scheme

Chief Minister Mamata Banerjee.

The West Bengal government has warned private hospitals and nursing homes that refusal to accept the State’s Swasthya Sathi Scheme (the health insurance cover set up by the Trinamool Congress government) may lead to cancellation or non-renewal of the private establishment’s licence. Private hospitals for quite some time have shown a reluctance to admit patients with the Swasthya Sathi insurance scheme, which is one of Chief Minister Mamata Banerjee’s most trumpeted projects.

In a memo dated February 23, the Health & Family Welfare Department pointed out to private medical establishments that as per the West Bengal Clinical Establishments (RRT) Act and Rules, 2017, every registered clinical establishment is to take part in a State programme, as the Act clearly states that “the clinical establishment shall actively participate in the implementation of all National and State Health Programmes”. The memo directed all clinical establishments in the State with indoor capacity of 10 beds to empanel themselves in the Swasthya Sathi Scheme.

In a clear warning to the private hospitals that have not been accepting the government health insurance scheme, the memo said:

“Further, it is brought to the notice of all Hospitals and Nursing Homes that non empanelment under Swasthya Sathi Scheme or refusing/denying treatment to the Swasthya Sathi patients shall be treated as a violation of Clause (v) and (w) of Sub Section 3 of Section 7 of The West Bengal Clinical Establishments [Registration, Regulation and Transparency] Act, 2017, which may lead to cancellation/revocation or non-renewal of CE (Clinical Establishment) licence of that Hospital/Nursing home.

“This will take immediate effect and until further order”

Even though the Swasthya Sathi Scheme, which provides medical cover up to Rs 5 lakh per family per annum, is one of the most prestigious and popular projects of Mamata Banerjee, the State government has, nevertheless, repeatedly found itself at the receiving end of the opposition’s criticism for the ineffectualness of the scheme due to its rejection in private hospitals. According to a highly placed in a private hospital chain in Kolkata, “The main reason for private establishment to turn away patients availing themselves of the Swasthay Sathi is because of the very low rates that come with the scheme. Even the recently revised rates are unviable, especially when the capital expenditure and manpower expenses are very high.”