By Dr. Tilak S. Fernando Courtesy Ceylon Today

Private Hospitals have been focusing of late, mainly on their charging system especially with regard to Coronary Artery Bypass Graft Surgery (CABG). Many have written columns and articles in newspapers covering a whole gamut of incidents and experiences of people after visiting private hospitals in Sri Lanka.

The types of complaints vary from patient to patient, but a common feature appears to be the long delays, which the patients have to wait, after paying money for an appointment to channel a doctor or a consultant. The whole purpose and process of channelling becomes a travesty when Consultants fail to arrive on time, which is very common at any private practice in Sri Lanka. This frustrates long-waiting patients, and   another area of dissatisfaction is the charging system adopted by some of the private hospitals.

Basically, patients visit private hospitals to experience a hassle-free quality service despite the high charges.  Patients consider consultants and doctors as ‘Gods’ in human form! Therefore, it would be obligatory for them to arrive on time, but lo and behold, on average, they take their own cool time to arrive, even more than 40 minutes behind time in certain instances, and the worst being the specialist doctors, have no time even to spend a few minutes to go through the medical history of their patients. It is apparent that some of these specialists see more than 40 patients, within a matter of two hours! In such pathetic situations, it is natural for people to question whether the present day medicos in Sri Lanka are really interested in treating the sick or only hell bent to make money.

Heat Ailment and Surgery

The type of heart disease differs from patient to patient. According to WHO statistics, Sri Lanka is ranked as the 31st country in the world, with approximately two per cent of the total population as suffering from heart disease.

With regard to CABG, the writer was informed by one of his readers, by email, about a remorseful attitude adopted by a reputed private hospital in Colombo, well known for performing CABG. The reader had clearly explained about his lengthy   confrontation with the hospital, with regard to the discharging process of his father -in –law and the final payment after  a ‘by-pass’ surgery (CABG), on 15 February.

Unexplained CABG Charges

Usually all private hospitals in Sri Lanka charge the people who have undergone CABG based on a grading system. The grading is determined by the number of blockages; a patient has in his coronary arteries. It is very similar to the hotel tariffs, which are influenced by the hotel’s star grading! In this case Rs.690, 000.00 was quoted for the aforementioned patient’s CABG by the above mentioned hospital. However, at the point of the bill settlement, an extra amount of Rs. 51,000 had been added to the final bill, therefore,  the son-in-law of the patient had made persistent   enquiries regarding the excess.

According to complainant the final bill had been prepared in such a way to confuse anyone at a glance. When queried, the authorities had miserably failed to give a rational explanation, instead kept them waiting for 4 hours, insisting on the full bill payment, while the hospital staff were engaged in a ‘hide and seek’ game; and the irony being, both the Director of Finance and the Director Operations of that reputed hospital had blatantly refused to face clients to give a clear clarification on the jacked up bill.

When the drama had reached a boiling point, the hospital authorities had offered a discount of Rs.30, 000! But the son-in-law had rejected the offer and warned them of initiating legal action. Only after those words of warning the hospital has deducted the excess amount from the bill. What a palaver!

The email intimation about the above detailed   annoying experience at a reputed private infirmary in Colombo, well known for performing heart surgery, was shared here specially to caution the poor who spend all their savings to seek medical treatment in private hospitals. (The writer is in possession of the withheld name of the hospital).

Personal experience

According to the writer’s own experience on CABG, four years ago, which was very much similar to this incident, but had occurred at a different, again reputed private, hospital in Colombo. To his amazement, when he had scrutinised the daily interim bills, he detected the hospital had duplicated the charges for the same (3-4) drugs; and also the charges for physiotherapy; and also at that time, this particular hospital had a joint credit card promotion with a reputed Bank where discounts up to 25 per cent were offered (if paid by their credit card). Despite such a commitment, the hospital completely turned a blind eye with regard to their discount offer. After several contests and protests, while warded at the hospital, which continued over a period of three months, the bank which jointly promoted the credit card campaign   offered a certain percentage as discount as part of their obligation, but the management of the private hospital completely ignored the discount. How many people in this country would dare to challenge in this manner? This is akin to day light robbery!

A common complaint against private hospitals in Sri Lanka is that patients are subjected to numerous investigations and tests without their consent, and solely dictated to them by hospital authorities. This is seen, in the eyes of innocent patients, as a gimmick to jack up hospital bills. On the other hand, neither of these two hospitals gives a breakdown of their CABG package, except adding charges willy-nilly. In the UK, of course, a patient has the right to object to any specialist’s decision stating that it is my body & I feel it is unnecessary”. In Sri Lanka the hospitals seem to take undue advantage out of the timidity of the patients. It is high time that the Minister of Health looked into the CABG charging systems whereby every hospital becomes liable to give a clear breakdown on a CABG package and what it covers.

Doomed situations

Relatives of the patients, who are naïve to hospital bills, get shell-shocked when they get to know the total amount to be paid to settle the final bill, which normally exceeds the quoted amount, by the hospital, before the surgery. Generally, private hospitals demand payment upfront for any CABG operation, without any concern for the patient’s hardships whereas some patients settle such jacked up bills by mortgaging or selling their properties or pawning their valuable gold jewellery. How many of us have paid bills like in the two cases mentioned above?

Eye Hospital

Having said about private hospitals, the writer was shocked when he visited recently the National Eye Hospital in Colombo to hand over an optical coherence tomography (OCT) report to an eye surgeon, who was consulted privately. It was an utterly pathetic scene where the entire ground floor was chock-a-block with patients. For how many decades this eye clinic has been in operation, and have all the Ministers of Health, along the line, been blinded to such public suffering and torture?

Those patients had arrived from all parts of the country. A three-wheeler driver said, anyone visiting the eye hospital should be prepared to spend the whole day here …” The Minster of Health is boasting about the advancement in the health sector in Sri Lanka, concentrating on the reduction of drug charges, but he is strongly advised to pay a visit in a morning to the National Eye Hospital at Ward Place to see for himself and realise what a chaotic situation prevails there, and to what extent patients are pushed to the wall, metaphorically speaking!

Why cannot the Ministry of Health think of ways and means of regionalising this eye service to local and divisional hospitals, rather than patients having to travel from all four corners of the country to waste a full day in Colombo to get only shabby treatment of shoving, and jostling? In the UK for instance, Moorefield Eye Hospital in London is the main infirmary for eye care, and the National Health Service has systematically established an eye clinic in each regional hospital where patients could be treated locally. This is vital information for your personal attention, the Hon. Minister of Health, Sir !

tilakfernando@gmail.com