Two Uttarakhand clinics providing free treatment for kidney disease face the loss of their dialysis machines – leaving patients in the lurch.
NephroPlus, a kidney care chain, has said it will cancel dialysis services for two clinics in the state effective from March 23rd. This is unless past due payments totalling Rs 6.5 crore (US$947,152) are paid by the Uttarakhand state health department.
The clinics in question are located in Dehradun and Haldwani. Both provide treatment for kidney disease free of charge to patients living below the poverty line (BPL). The non-payment issue with NephroPlus, unless resolved, could leave needy patients in need of vital treatment unable to avail it.
“Living with kidney disease can prove expensive in India…of the Indians in need of treatment with dialysis, a mere thirty percent can avail it. Of these, just ten to twenty percent continue with treatment – often due to affordability issues”
As highlighted by Health Issues India on World Kidney Day this year, living with kidney disease can prove expensive in India. 22,000 cases of end-stage renal disease (ESRD) are diagnosed every year. ESRD leaves patients in need of renal replacement therapy (RRT), which involves the use of medical processes such as dialysis to perform the role of the kidneys in patients whose kidneys no longer function properly. However, of the Indians in need of treatment with dialysis, a mere thirty percent can avail it. Of these, just ten to twenty percent continue with treatment – often due to affordability issues.
NephroPlus, which operates 145 clinics in 86 cities across eighteen states as of last August, has said the amount owed by the state health department has been outstanding since last year. They say they have not received a response from officials despite efforts to contact them. As such, discontinuing free dialysis services at the affected clinics has become necessary as a last resort.
Dr Ravindra Thapliyal, Uttarkahand’s director general of health, informed the Times of India that “there were discrepancies in the bills submitted by the company. We have received the amended bills and have escalated their file to the higher officials for needful action.”
“Past controversial related to non-payment of dues by officials [has led] to private sector firms withdrawing their services – often at the expense of patients’ health”
The situation contains echoes of past controversies related to non-payment of dues by officials, leading to private sector firms withdrawing their services – often at the expense of patients’ health.
Perhaps most notably, oxygen shortages in August 2017 were linked to the deaths of scores of newborns at a government-run hospital in Gorakhpur, Uttar Pradesh. In that instance, non-payment of fees believed to total US$50,000 resulted in the company which provided medical oxygen to the hospital withdrawing its equipment, after it claimed to have sent nine reminders and a legal notice about nonpayment of dues. In the aftermath, a number of similar incidents involving hospitals struggling to pay for medical oxygen came to light.
Financial disputes between hospitals and suppliers often play a role in who gets care in India. This could entail that state-run facilities do not receive inadequate funding. Against a backdrop of broader inadequacies in how much the central government spends on health in India, and also how state health budgets often go to waste, the tragic implication is that such disputes may cost more economically vulnerable patients vital care in future.