New Delhi: “You are requested to sympathetically review the enclosed application and refund the money spent on the treatment.”
That is an excerpt from a letter sent on March 1, from the office of health minister J.P. Nadda, to Naresh Trehan, chairman of Medanta Hospital. The letter was on the letter head of Om Prakash Sharma, additional private secretary to Nadda.
In 20 days, Medanta hospital processed a refund of Rs 15.6 lakh to Gopendra Singh Parmar, whose son Shourya Pratap died of dengue while admitted to Medanta Hospital in Gurgaon, last November.
When Gopendra met Medanta administrators this month, they told him they would refund his money, but on one condition – he would have to withdraw the police complaint he had filed against the hospital’s treatment, and give them his word in writing. Gopendra had alleged that doctors were negligent and that he had been overcharged.
Gopendra signed a Medanta document agreeing to withdraw his complaint. In exchange, he was given a cheque for Rs 15.6 lakh.
The health ministry’s letter tries to justify its out-of-turn request by saying, “The person is from a very poor family and keeping in mind the untimely death of their son and the trauma…”
This is not standard practice for a Union Ministry whose role is to, in fact, put in place public policy that will impact the public at large and not intercede on one-off cases of aggrieved families.
The letter shows the health ministry taking an arbitrary and out-of-turn action to financially help a single patient who was in distress. The health ministry acted on this as a BJP MP from Rajasthan, Manoj Rajoria, contacted the ministry asking for their attention on the matter.
While Rajoria was looking out for Gopendra, one of his constituents, the health ministry’s actions raise questions about why the ministry is instead not enacting wider reform on the issue of quality and pricing in private medical care, which has dogged the news for months. It also raises questions about Medanta – if they did not neglect or overcharge the patient, why are they refunding money and buying their impunity? Also importantly, will the health ministry and Medanta do this for other individual patients in distress or is this a special case?
“If we had pursued a legal case, we would have been living on the street.”
“I got a first hand opportunity to see how corrupt the system is. See my situation, where I have written to everyone in this country, from the prime minister and below, for help. We saw how justice works in this country,” says Gopendra.
Gopendra and his family live in Dholpur, Rajasthan. In addition to the set back of Rs 15.6 lakh from his son’s medical expenses, he hasn’t been able to work himself – following up on his son’s case with various authorities has had him travelling to and from Delhi instead.
“If we [had] pursued a legal case, we would have been living on the street,” he says.
He and his family are not well off. He worked as a life insurance agent, and he and his wife get by on the commission he makes. He had not taken a medical insurance policy for his son Shourya. “I saw how much difficulty people had in actually getting any medical claims back. I decided not to deal in health insurance and only life insurance,” he reasons.
He repeatedly thanks his parliamentarian Manoj Rajoria, for stepping in to rescue his family from their distress. “I never asked for a compensation and I don’t feel happy about taking this compensation over the death of my first son. But the medical expenses and the months of not working after that has really affected us,” he says. “A longer legal fight would have meant more expenses. Our son is gone but this compensation will at least prevent us from further ruin.”
Why is Medanta buying people’s silence and the health ministry taking arbitrary action?
Naresh Trehan, chairman of Medanta, picked up The Wire’s phone calls, but repeatedly hung up without speaking. Medanta’s corporate communications staff did the same.
The health ministry also did not reply to The Wire’s emails on this matter.
Although Gopendra’s son died in November, till date he has not been able to file an FIR with the police. With difficulty, he only managed to file a police complaint. But even so, a “withdrawal” of a criminal complaint following settlements is a concerning practise.
“It is not legal for people to be asking for complaints or FIRs to be withdrawn. Once a criminal complaint is lodged, it is a matter which is against the state. The police has to register an FIR here, the state has to investigate, prosecute and close. The complainant themselves cannot close or be made to close [the case], only the court can close a case” says Jai Dehadrai, a lawyer based in Delhi.
Dehadrai is also representing another bereaved parent – Jayant Singh – whose seven year-old daughter died last year at Fortis hospital and left the parents with a similar bill of Rs 16 lakh. Jayant has filed a writ petition in the Supreme Court this month, which has called for larger institutional reforms.
“If the police accept a withdrawal of cases or if it turns out that the government has been involved in negotiating withdrawals, it would be a clear case of corruption and obstruction of justice,” says Dehadrai.
“It is an unconditionally good thing that late Shourya’s family was refunded the bill amount. However, we need an enduring solution to the problem of exploitation by private hospitals so other patients don’t have to depend on anybody’s largesse,” says Malini Aisola who has been working on patient-issues with the All India Drug Action Network.
Instead of arbitrary actions, the government should take action to implement ceiling rates on healthcare, says Aisola. This is already mandated under the rules of the Clinical Establishment Act.