The Fortis tragedy should compel us to ask if we really need five-star hospitals

Outside view of Fortis Hospital in Gurgaon | Image from Fortis website

A weak and overcrowded public health system has led to the burgeoning private healthcare business across the country. But many of these hospitals are poorly regulated and expensive.

The Fortis hospital in Gurugram recently handed the family of a dead seven-year-old dengue patient an exorbitant bill for almost Rs 16 lakh after a fortnight of care. The bill allegedly included the costs for about 1,600 surgical gloves. Health minister J.P. Nadda has sought details of the case for the government to investigate.

Does the Fortis tragedy show that private healthcare is unaffordable even for the middle class?

The incident that has taken place was incredibly tragic. I don’t think we needed this to demonstrate that private healthcare in India is largely unaffordable.

Of course, as a private facility, they need to cover their costs, like pay the professional staff, infrastructure costs etc. The important question is if there is any way in which these costs can be capped.

Most people will agree that private care will cost a certain amount. The middle class is willing to pay this amount. Even the parents of this child were willing to pay. However, the price is so monstrous that the need for regulation has become tantamount. It is shocking that 1,600 surgical gloves have been charged for!

Let us also remember that the Fortis ecosystem is one extreme end of the private sector. There are various levels of charges and some very affordable private places. This raises the question: Do we need five-star hospitals?

Here are other sharp perspectives on the issue of whether even the middle-class cannot afford privatised healthcare:

Amir Ullah Khan: is a professor of economics

K K Aggarwal: national president IMA and Heart Care Foundation of India

Mira Shiva: public health activist

A third set of questions arises when claims surface about “useless tests” being performed as a way of “raising additional funds”. Now, the tests required on a patient are a matter for professional opinion. It is the duty of the doctors to provide best possible treatment; it is also their duty to ensure that nothing unnecessary is done. It has to come from within the physicians’ community.

There is a great need in the high-end system for self-regulation. The middle class will pay for a certain standard. Extra costs are equivalent to exploitation. Misusing the desperation of a patient is not ethical.

Conversations about private hospitals like Fortis can only be in the context of the middle classes that have a certain paying capacity. Lower fee-charging private hospitals can help reduce the burden on the public sector hospitals. At the basic level, primary care in India needs to be provided by a well-resourced and well-equipped publicly-funded system, for free.

Keshav Desiraju is the former health secretary