Indraprastha Apollo Hospital seeks SC relief to reduce EWS treatment obligation

New Delhi: After facing criticism from the Supreme Court for not providing free treatment to economically weaker section (EWS) patients, Indraprastha Apollo Hospitals in Delhi has now moved the apex court, seeking a major relaxation in its obligation.

In an intervention application filed before the apex court, the hospital has asked permission to reduce its EWS obligation to 10% of its In-Patient Department (IPD) and 25% of its Out-Patient Department (OPD). 

If accepted, this change would drastically reduce the number of beds reserved for poor patients, from around 200 to just 70, marking a significant shift in its obligation to serve the economically weaker sections.

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Currently, the hospital says that 33 per cent of IPD and 40 per cent of OPD services are already being provided to EWS patients, but they do not receive free medicines or medical supplies, only free treatment. Now, in an affidavit submitted on May 14, the hospital operator, Indraprastha Medical Corporation Limited (IMCL), has promised to provide complete free treatment, including medicines and consumables, if the court allows it to follow the reduced quota.

"The shift to 10% of the IPD and 25% of the OPD catering to EWS patients, along with providing completely free treatment, medicines and consumables, would be meaningful and actually beneficial to the economically weaker sections and poor patients," stated the affidavit. 

Medical Dialogues had previously reported that the Supreme Court slammed Indraprastha Apollo Hospital for allegedly violating the lease conditions, which required the hospital to provide free medical care to one-third of its indoor patients and 40% of its outdoor patients, without discrimination. The court emphasised that if poor patients are not given free treatment, it will hand over the hospital to the All India Institute of Medical Sciences (AIIMS).

The bench observed that the hospital, constructed by the Apollo Group in 15 acre land in posh area of Delhi which was given on symbolic lease of Rs 1, was to be run on 'no profit and no loss' formula but has instead turned into a pure commercial venture where poor people can hardly afford treatment.

On September 22, 2009, the high court had directed the hospital administration to provide one-third of the free beds, that is 200 beds with adequate space and necessary facilities to the indoor patients and also to make necessary arrangements for free facilities to 40 percent of the outdoor patients.

In response to the court's warning, IMCL sought a reduced EWS obligation so that it could follow the lease agreement and also make considerable profit from the treatment. 

According to a latest media report by the Indian Express, IMCL argued that while the Qureshi Committee in 2001 had recommended free care for 10% of indoor and 25% of outpatient cases in such hospitals, its lease agreement imposes a much higher burden. It claimed that maintaining 33% free IPD and 40% free OPD care had become unsustainable, especially after the loss of tax and customs exemptions.

"The Delhi government has received over Rs 87 crore till date as dividends from the hospital, and its original equity investment of Rs 23.83 crore has appreciated to about Rs 900 crore. At 26%, the Delhi government has the largest stake in the hospital, which was handed over 15 acres of land on lease at a token rent of Re 1 per month. Institutions like hospitals and schools, which get land from the government on concessional rates, are obligated as per terms of their lease to provide free services to those from the EWS," mentioned the affidavit. 

Further, the hospital said that while it had expressed willingness to purchase the land given on lease by the government, due to DDA policies, the land could not be allocated directly to a private company. The land was then allotted to Delhi government, which in turn was leased to IMCL.

In line with the court’s directive, the hospital has also submitted data on its current bed capacity and the number of OPD and IPD patients it has treated over the last five years. 

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