ESI hospitals fail to deliver medicare

By Mahesh Vijapurkar

MUMBAI, AUG. 25. In the early 50s, freedom fighters including Pandit Jawaharlal Nehru, J. B. Kripalani and several others signed a deed along with the Mill Owners' Association and set up a trust to found the Mahatma Gandhi hospital in the working class area of Mumbai, run by the Employees State Insurance Corporation. Now, the hospital is virtually non-functional, owing to the decline in standards and paucity of funds.

Several eyes are on this facility, which has impressive buildings, but the MOA is unwilling to part with it. A leading provider of cancer treatment would like it to expand its operations. The Government is inclined towards such a step. If this is indicative of a positive approach to maximise the use of facilities available, it also speaks volumes for the ESI's failure to keep up its mandate.

There are other indicators of a slide in the system, meant to serve 19 lakh employees and their dependents. The dispensaries are decrepit and the massive network of independent medical practitioners who receive Rs. 5,000 monthly are disinclined, sources say, to do their work. Some were paid even after their death.

Not all are MBBS degree holders among the 1,300 doctors. Many are Ayurvedic practioners are allowed to prescribe allopathic drugs. Many druggists have opted out with a low margin allowed at 13.5 per cent on drugs supplied by the ESI. No wonder, the ESI hospitals have less than 50 per cent occupancy.

Hospitals have caved-roofs and go without superintendents. There are only ``in-charge'' officials. The Staff absenteeism is high. Members of the scheme often prefer public hospitals, which have better standards.

Dispensaries are functioning in the rented premises, which have not been properly maintained for years. Doctors would not like to proclaim through their signage that they are on the ESI panel as they ``fear that they would be inundated'' when actually, most employees, despite paying up their share to the ESI, prefer treatment elsewhere.

Many of the workers who pay 6 per cent of their pay -- the total contribution is upwards of Rs. 300 crore annually, have made the scheme optional to such an extent that even the trade unions are not serious about it.

The success of such schemes, officials in charge of the system concede, lies in the ability to deliver Medicare. There is further decline with every passing day. ``Even the scarce allocations do not reach us in time,`` sources in the ESI lament.

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