Most residents of Kathmandu seldom visit government hospitals, which would be the most economical choice. They have good reasons not to. The equipment at most government hospitals are outdated, their in-house facilities are inadequate, their responses often slow and indifferent, and their health services usually substandard. At Bir Hospital, for example, at one point when the x-ray machines were not working, an ailing patient has to be rushed off to another hospital for an x-ray, and come back for further treatment. The hassle and stress it inflicted on the patient, as well as their caretakers, is beyond imagination. [break]
As a result, private hospitals are proliferating in Kathmandu. Today, no less than 99 hospitals operate in this small city. But even though most middle and high income patients turn to these hospitals hoping for better services, the service they actually receive is questionable. Private hospitals often charge exorbitant rates for the services they provide. Patients complain of being made to go through unnecessary tests, each of which costs quite a bit. The charges for these services are often arbitrary, and differ widely from hospital to hospital. Moreover, there are also complaints that many of these health institutions do not have adequate equipment that a proper hospital must have. The private hospitals get away with these irregularities because there is very little monitoring to check their wrongdoing. To improve this dismal healthcare situation, the government should work towards standardizing the rates of health services, even for private hospitals, and monitor the availability of equipment before issuing permits.
Often, hospitals in Kathmandu are built without proper permits for construction, or without the mandatory environmental assessment. As a result, hospitals have cropped up in residential areas and in busy business complexes. Lack of environmental assessment means that hospital wastes are mixed with river water or are left unattended, which could be harmful to the people in surrounding areas. Again, lack of monitoring and clear policies is glaring. The government’s proposed policy of issuing no new permits to hospitals inside the Ring Road should be enacted as soon as possible. It would help balance the saturated healthcare market of Kathmandu and make health services more accessible to areas outside the Ring Road. And when permits are issued to hospitals, it must be only after a thorough environmental assessment as well as evaluation of hospital’s facilities and equipment.
The government also needs to focus on improving the services and updating the equipment of government hospitals because they are the only option for a large section of Nepalis. While those belonging to middle or higher classes have many options to address their health concerns, including going abroad, government health institutions offer the only succor for those in the lower rungs in the economic ladder. The two-tier healthcare system, where only those with fat incomes have access to quality healthcare facilities, is definitely not a mark of a progressive society that Nepali politicians purportedly want to establish. Until promises are matched with action, the huge gulf in health outcomes between the rich and the poor could be perpetuated for long time indeed.
Related story
Happy Birthday, Karl Marx. You Were Right!
