CHITWAN: Ambulance drivers bringing patients to Kathmandu phone hospitals to negotiate commissions, an undercover investigation has revealed. Doctors ask for information about how serious the case is and personal information about the patient. If they can afford to be hospitalised for longer periods and are serious cases, drivers are paid as much as Rs 10,000 commission, while most patients fetch drivers up to Rs 5,000.
Private hospitals have employees and agents in place to rent out ICU beds. Their job is to stay in contact with ambulance drivers and coax them to bring patients to their employers’ hospitals.
Yeti Hospital and City Centre Hospital in Kalanki, Star Hospital and Shivajyoti Hospital in Balkhu pay drivers Rs 5,000 per patient. Norvic International Hospital and Blue Cross Hospital, both in Thapathali, give drivers up to Rs 4,000 as soon as patients are brought in. Green City Hospital, Basundhara, pays Rs 3,000, Alka Hospital, Jawalakhel, pays Rs 1,000, and Diyaz Hospital and International Child Friendly Hospital pay drivers Rs 500 each.
The more serious a patient, the bolder ambulance drivers are in negotiating their fees. When hospitals determine patients will need ICU care, they try to sweet-talk the drivers into bringing them in right away.
When hospitals get fewer patients, they increase rates to tempt drivers. But the extra charge is dumped on newly admitted patients, forced to pay large deposit sums that include the commissions.
At Chitwan College of Medical Sciences, drivers are handed a slip upon arrival, which they submit at the reception and receive Rs 400 in cash. The NPI Narayani Community Hospital in Chitwan pays annual commission to drivers, who are happy with this procedure because they don’t have to run around each time they turn up at the hospitals.
Drivers who are faithful to parent hospitals even get bonus gifts. A ‘new scheme’ at Life Care Hospital in Sundhara plans to give away motorcycles to drivers if they bring in 10 patients in 90 days.
Hospitals that were found to have prize schemes have not been pulled up by the Nepal Medical Council. “Because this is related to management and not doctors’ conduct, the Ministry of Health has to look into it,” says NMC Chairman Damodar Gajurel.
According to Buland Thapa, director of Bir Hospital, private hospitals charge as much they like because the government has not fixed official rates for regular checkups and hospital admission. In the absence of regulation and monitoring, private hospitals continue to take advantage of patients.
Health Minister Khag Raj Adhikari says, “I have heard there is a huge commission racket in private hospitals, but so far there is no proof. Everyone found guilty of wrongdoing will be punished without pardon.”
(Centre for Investigative Journalism)
A secretly recorded conversation between the udercover journalist and a staff at Life Care Hospital.
Devaki Shrestha: Hello?
Pramod Acharya: Namaste. I am a driver. I’m new, so I don’t know how the system works. I was told by the receptionist to call you.
DS: There’ll be no problems. You come right ahead. I will call and tell them.
PA: How much will you give?
DS: When will you arrive?
PA: We’re about to leave.
DS: Meaning 5 to 6 hours?
PA: Yes. How much will I get?
DS: Make them deposit as soon as you reach and you’ll receive your payment immediately.
PA: How much will I get?
DS: Rs 10,000.
PA: What if I come every time?
DS: I’m at home and can’t talk. I’ll call you tomorrow.