MORANG: Most doctors at Biratnagar’s regional-level Kosi Hospital leave their work stations after signing attendance and head off to their own private clinics. When patients arrive at the hospital’s gate, middlemen on the payroll of these doctors hustle them to the private clinics nearby.
A dozen small hospitals and up to 36 private clinics and pathology labs have mushroomed in the neighbourhood of the government hospital. Medical tests at Kosi Hospital cost around Rs 1,000 but the bills at private clinics are so inflated that most patients are forced to mortgage their possessions.
When we visited Kosi Hospital, we found nurses and health assistants in charge. The doctors are absent, and patients are eventually forced to seek treatment elsewhere.
“Everyone knows doctors employed at government hospitals do their real treatment at their private clinics outside,” says Uttam Dhungel of a public consumer group in Biratnagar. “But we can’t complain, there is no one listening to us.”
Senior physician Dipak Sigdel arrives at the Kosi Hospital at 10am and is off by 1pm to go over to Green Cross, a clinic in which he and NC Morang treasurer Nagesh Koirala have invested. Another physician Shital Prasad Yadav leaves before his afternoon shift is over for his own City Hospital, as do surgeon Narayan Basnet and gynaecologist Yogendra Mishra for Saptakosi Nursing Home. Sunil Chandra Adhikari, a surgeon, and orthopaedists Mukunda Dahal head to Kanchanbari. Other orthopaedists Nabin Subedi and Ramesh Basnet go to Green Cross, and paediatrician Bimal Agrawal works at Surakshya and Golden hospitals.
“They come in at 10am, take a walk around, visit some patients at the OPD, and leave as soon as they can,” a medical officer said on condition of anonymity. “Some even travel up to three hours to reach their own hospitals.”
When nurses complain there are patients waiting at Kosi Hospital, doctors want them referred to their private clinics. Doctors themselves frighten patients, telling them they won’t get proper treatment at Kosi. Although there is enough equipment in the surgery room, complicated cases are no longer treated here. Official records show up to 200 cases are referred outside every week.
“The Health Ministry allows doctors to run their own clinics as long as this doesn’t affect official duty,” says Tapeswor Lal Karna, Kosi’s medical superintendent who says he stopped going to private clinics after being appointed to his post.
The commercialisation has affected patients from surrounding districts who have to come in ambulances. Ambulance drivers who get a commission from the private hospitals take them straight to private hospitals. Guards are instructed to note down the names of all the drivers who arrive with patients. Depending upon how serious the case is, they are paid between Rs 500 and Rs 2,000. A private hospital owner said this is now standard operating procedure, if they don’t pay drivers, patients stop coming.
Rickshaw drivers, too, get kickbacks on patients they ferry from bus-stops or the Indian border to private clinics. In the last three months, police took action against rickshaw drivers, but Morang DSP Prabhu Prasad Dhakal says although patients complain they were cheated, it is hard to find proof.
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