The Delhi government has notified 19 private hospitals where 80 per cent of ICU beds are to be reserved for Covid patients, 82 private hospitals with 60 per cent reservation and 101 private hospitals where 60 per cent ward beds are to be reserved for Covid treatment.

The 101 hospitals where 60 per cent beds will be reserved for Covid patients include leading names such as St Stephens Hospital, Max East/West Block, Batra Hospital, HAHC Hospital, BLK Hospital, Rajiv Gandhi Cancer Institute, Max SS Hospital, Patparganj; Fortis Escorts Heart Institute, Okhla, Indian Spinal Injury Centre, Vasant Kunj, Dharamshila Narayana Hospital, Shanti Mukand Hospital, Fortis SS Hospital, Vasant Kunj, Shree Agrasain International Hospital, Madhukar Rainbow Children Hospital, Primus Super Speciality Hospital, Delhi Heart and Lung Institute, among others.

This mobilisation gives an additional 5689 Covid ward beds to the Delhi government to handle the new wave of Covid cases.

It will mobilise 633 ICU beds from 82 hospitals where 60 per cent ICU beds are to be reserved for Covid patients.

Another 765 ICU beds will be mobilised from 19 private hospitals where 80 per cent of ICU beds are to be reserved for Covid treatment.

The Delhi government said in an order that the bed capacity dedicated for Covid needs to reach the November, 2020 levels.

At present, occupancy of Covid ICU beds has reached 100 per cent in almost all large private hospitals and more than 85 per cent in 57 out of 115 private hospitals. Similarly, the occupancy of Covid beds has reached 85 per cent in 32 out of 115 hospitals and 100 per cent in all large hospitals.

Designating 14 large private hospitals as fully-Covid will give the Delhi government 1135 ICU beds and 3202 ward beds.

So, in all 8891 Covid beds are being added and 2533 ICU beds are being added in the Delhi government order.

The Delhi government has notified 19 private hospitals where 80 per cent of ICU beds are to be reserved for Covid patients, 82 private hospitals with 60 per cent reservation and 101 private hospitals where 60 per cent ward beds are to be reserved for Covid treatment.

The Delhi government has notified 19 private hospitals where 80 per cent of ICU beds are to be reserved for Covid patients, 82 private hospitals with 60 per cent reservation and 101 private hospitals where 60 per cent ward beds are to be reserved for Covid treatment. The 101 hospitals where 60 per cent beds will be reserved for Covid patients include leading names such as St Stephens Hospital, Max East/West Block, Batra Hospital, HAHC Hospital, BLK Hospital, Rajiv Gandhi Cancer Institute, Max SS Hospital, Patparganj; Fortis Escorts Heart Institute, Okhla, Indian Spinal Injury Centre, Vasant Kunj, Dharamshila Narayana Hospital, Shanti Mukand Hospital, Fortis SS Hospital, Vasant Kunj, Shree Agrasain International Hospital, Madhukar Rainbow Children Hospital, Primus Super Speciality Hospital, Delhi Heart and Lung Institute, among others. This mobilisation gives an additional 5689 Covid ward beds to the Delhi government to handle the new wave of Covid cases. It will mobilise 633 ICU beds from 82 hospitals where 60 per cent ICU beds are to be reserved for Covid patients. Another 765 ICU beds will be mobilised from 19 private hospitals where 80 per cent of ICU beds are to be reserved for Covid treatment. The Delhi government said in an order that the bed capacity dedicated for Covid needs to reach the November, 2020 levels. At present, occupancy of Covid ICU beds has reached 100 per cent in almost all large private hospitals and more than 85 per cent in 57 out of 115 private hospitals. Similarly, the occupancy of Covid beds has reached 85 per cent in 32 out of 115 hospitals and 100 per cent in all large hospitals. Designating 14 large private hospitals as fully-Covid will give the Delhi government 1135 ICU beds and 3202 ward beds. So, in all 8891 Covid beds are being added and 2533 ICU beds are being added in the Delhi government order.

Delhi gets more than 11,000 beds in private hospitals to tackle fresh Covid wave

A division bench of the Delhi High Court on Friday deferred to September 28 hearing on a petition filed by the Delhi government challenging a single-judge bench order imposing an interim stay on the reservation of 80 per cent ICU beds in a group of top private hospitals in the national capital exclusively for COVID-19 patients.

The division bench of Chief Justice DN Patel and Justice Prateek Jalan listed the matter for further hearing on September 28.

<a href="https://www.wionews.com/india-news/admitted-to-hospital-for-covid-19-delhi-deputy-cm-manish-sisodia-also-diagnosed-with-dengue-330037">Also read:&nbsp;Admitted to hospital for COVID-19, Delhi Deputy CM Manish Sisodia also diagnosed with dengue</a>

The Delhi government, in a petition filed through additional standing counsel Sanjoy Ghose against the interim order dated September 22 passed by a single-judge bench, said that the bench has not appreciated the categoric submissions made on behalf of the appellant regarding the surge in the number of COVID-19 patients, and the dynamic efforts being undertaken by the appellant to tackle the ever-changing nature situation regarding healthcare and medical facilities in the NCT of Delhi, on account of the COVID-19 pandemic.

A single-judge bench had on Tuesday this week stayed the recent order passed by Chief Minister Arvind Kejriwal-led government instructing private hospitals in Delhi to reserve 80 per cent of ICU beds for COVID-19 patients, till the next date of hearing on a petition moved by the "Association of Healthcare Providers India".

<a href="https://www.wionews.com/india-news/india-reports-86052-new-cases-as-total-infections-near-6-million-mark-330100">Also read:&nbsp;India reports 86,052 new cases as total infections near 6 million-mark</a>

The petition filed before the single-judge through advocate Sanyam Khetarpal and Narita Yadav said that the order has been passed in an arbitrary, unfair and illegal manner without even realizing the difficulties that may be faced by the said private nursing homes and hospitals.

"Moreover, no consideration has been given to the fact that the non-COVID-19 patients may suffer fatal consequences owing to their prolonged or sudden illness and due to the non-availability of ICU/HDU beds they may not be able to endure the disease," said the petition filed by Association of Healthcare Providers India.

The plea had said that private hospitals routinely get patients with heart attacks, grievous injuries, acute pulmonary disorders, complex fractures, and even other conditions like cancer, transplant and cardiac patients which require urgent interventions and critical care.

"Reserving 80% beds in the ICU will deny urgent care to seriously ill patients, requiring vital surgical interventions and critical care. These beds, which may constitute 15 per cent to 20per cent of overall ICU bed capacity in some of the hospitals, are not usable for COVID-19 patients since very rarely does a COVID-19 patient of that age requires critical care," it had added.&nbsp;

A division bench of the Delhi High Court on Friday deferred to September 28 hearing on a petition filed by the Delhi government challenging a single-judge bench order imposing an interim stay on the reservation of 80 per cent ICU beds in a group of top private hospitals in the national capital exclusively for COVID-19 patients.

A division bench of the Delhi High Court on Friday deferred to September 28 hearing on a petition filed by the Delhi government challenging a single-judge bench order imposing an interim stay on the reservation of 80 per cent ICU beds in a group of top private hospitals in the national capital exclusively for COVID-19 patients. The division bench of Chief Justice DN Patel and Justice Prateek Jalan listed the matter for further hearing on September 28. Also read: Admitted to hospital for COVID-19, Delhi Deputy CM Manish Sisodia also diagnosed with dengue The Delhi government, in a petition filed through additional standing counsel Sanjoy Ghose against the interim order dated September 22 passed by a single-judge bench, said that the bench has not appreciated the categoric submissions made on behalf of the appellant regarding the surge in the number of COVID-19 patients, and the dynamic efforts being undertaken by the appellant to tackle the ever-changing nature situation regarding healthcare and medical facilities in the NCT of Delhi, on account of the COVID-19 pandemic. A single-judge bench had on Tuesday this week stayed the recent order passed by Chief Minister Arvind Kejriwal-led government instructing private hospitals in Delhi to reserve 80 per cent of ICU beds for COVID-19 patients, till the next date of hearing on a petition moved by the "Association of Healthcare Providers India". Also read: India reports 86,052 new cases as total infections near 6 million-mark The petition filed before the single-judge through advocate Sanyam Khetarpal and Narita Yadav said that the order has been passed in an arbitrary, unfair and illegal manner without even realizing the difficulties that may be faced by the said private nursing homes and hospitals. "Moreover, no consideration has been given to the fact that the non-COVID-19 patients may suffer fatal consequences owing to their prolonged or sudden illness and due to the non-availability of ICU/HDU beds they may not be able to endure the disease," said the petition filed by Association of Healthcare Providers India. The plea had said that private hospitals routinely get patients with heart attacks, grievous injuries, acute pulmonary disorders, complex fractures, and even other conditions like cancer, transplant and cardiac patients which require urgent interventions and critical care. "Reserving 80% beds in the ICU will deny urgent care to seriously ill patients, requiring vital surgical interventions and critical care. These beds, which may constitute 15 per cent to 20per cent of overall ICU bed capacity in some of the hospitals, are not usable for COVID-19 patients since very rarely does a COVID-19 patient of that age requires critical care," it had added.

HC defers Delhi govt's plea against interim stay on reservation of ICU beds in private hospitals

The private sector’s ability to provide an array of healthcare services to the common masses needs to be put under a microscope.

Many healthcare interventions, which are preventive and promotional in nature — communicable diseases, efforts to minimise pollution, improving food safety, protection from adverse health behaviour and childhood immunisation — need the help of the public sector. &nbsp;

Therefore, the core element of public health that manifests collectivity and benefits all, is essential for improving the health of the population and maintaining a healthy workforce. &nbsp;

However, the other variety of health services, which are exclusively curative in nature, can be provided by the market after charging a price.

Despite the fact that a large part of curative services is subject to a market transaction, state intervention must be considered mandatory for a majority of people, who cannot afford quality healthcare. &nbsp;

Evidence in India and other low and middle-income countries suggest that millions of people are pushed into poverty due to high out-of-pocket expenditure on accessing healthcare.&nbsp;

A recent study estimated that 55 million people had fallen below the poverty line due to exorbitant out-of-pocket health expenditure. The debilitating public health system caused by underfunding, mismanagement of staff, administrative and failure of governance, adds to the woes. &nbsp;

However, the recent rollout of Ayushman Bharat, providing financial protection to a targeted population and strengthening primary care for all citizens, covers the ground for universal health coverage. The all-encompassing approach, which does not exclude anyone from basic services, is certainly forward-looking.&nbsp;

In this scenario, the private sector plugs the gaps in the delivery of services, where they provide quality healthcare, with a price that is paid by the government.&nbsp;

The share of out-of-pocket expenditure is 63 per cent of the total health expenditure in India, which is largely used to purchase medicines, diagnostic services and related services in the private sector.&nbsp;

According to one estimate, the size of the private sector was 8 per cent after independence and in six-and-a-half decades, it has grown nine times, while the public sector has declined in absolute terms by a third of what it was, during the corresponding period. &nbsp;&nbsp;

The structure of the private sector is diverse and functions as single doctor clinics, tiny nursing homes and large corporate hospitals operating in Tier I and II cities. Add to it various health facilities run by faith-based organisations. It can also be said that private healthcare services are demanded by all income groups.&nbsp;

Though limited, there are precedents of partnership with the private sector in specific disease control programmes, without tenable strategies for a scale up.

Several models of public-private partnership (PPP) have been experimented - contract services, joint ventures, demand-side financing, telemedicine and mobile health units in several parts of the country, leading to diverse results.

The country has vast experience of buying healthcare from the private sector through government revenue in the Rashtriya Swasthya Bima Yojana (RSBY) and state- specific insurance programmes.&nbsp;

From experience, major uncertainties that drove trust deficit in the private sector were pricing, quality, transparency and accreditation of services. There are examples galore of over hospitalisation, redundant procedures and diagnostic tests inflating costs.&nbsp;

The private sector often raises prices of packages in many insurance schemes that do not deliver commensurate services. This issue assumes critical proportions. However, it is difficult to judge the merits of this argument in the absence of comprehensive costing data on different services by various types of health facilities. The unit cost of a service in a big corporate hospital is significantly different from similar service at a district-level hospital.&nbsp;

Land, building and vast administrative machinery propel costs in these hospitals. Do we really need the participation of big corporate hospitals in these schemes, where high-frequency-low cost episodes are more than the low frequency-high cost episodes? &nbsp;

We could negotiate to reserve some extremely critical procedures with a different payment mechanism in these hospitals.&nbsp;

Private hospitals have been given concessional land, customs exemption and liberal tax breaks with a commitment to reserve beds for poor patients, who would be entitled to free treatment.

But the manipulation of this provision is acute. Their behaviour is guided solely by profit motives, which is heightened by the information asymmetry in clinical practice, where the provider is more knowledgeable than the client. &nbsp;&nbsp;

Regulatory frameworks in several forms –National Pharmaceutical Pricing Authority (NPPA), Drugs Control Authority and the Clinical Establishment Act, are hampered by inadequate capacities in the public sector.&nbsp;

Despite these limitations, the private sector has certain advantages - better management of diseases, efficient utilisation of skills, accessibility, active response to patients’ need, use of technology, good hospitality and superior administration, which need to be appreciated.&nbsp;

Forgetting the dichotomy between public and private sector for the moment, can we make effective collaboration between the two to uplift provision of services? &nbsp;&nbsp;

When the scope of collaboration has widened after the rollout of PMJAY, each other’s merits and pitfalls need to be discussed for meaningful collaboration.&nbsp;

The success is contingent upon how transparent and accountable the private sector is in delivering affordable care.

For any partnership to be successful, accountability, transparency, equality, mutual obligation and commitment to achieve common objectives is the need of the hour. Is the private sector ready for this? &nbsp;&nbsp; 
&nbsp;

(This article was originally published on The DNA. Read the <a href="https://www.dnaindia.com/analysis/column-time-to-make-the-twain-meet-2726456">original article)</a>

(Disclaimer: The opinions expressed above are the personal views of the author and do not reflect the views of ZMCL.)

The private sector’s ability to provide an array of healthcare services to the common masses needs to be put under a microscope. Many healthcare interventions, which are preventive and promotional in nature — communicable diseases, efforts to minimise pollution, improving food safety, protection from adverse health behaviour and childhood immunisation — need the help of the public sector.

The private sector’s ability to provide an array of healthcare services to the common masses needs to be put under a microscope. Many healthcare interventions, which are preventive and promotional in nature — communicable diseases, efforts to minimise pollution, improving food safety, protection from adverse health behaviour and childhood immunisation — need the help of the public sector. Therefore, the core element of public health that manifests collectivity and benefits all, is essential for improving the health of the population and maintaining a healthy workforce. However, the other variety of health services, which are exclusively curative in nature, can be provided by the market after charging a price. Despite the fact that a large part of curative services is subject to a market transaction, state intervention must be considered mandatory for a majority of people, who cannot afford quality healthcare. Evidence in India and other low and middle-income countries suggest that millions of people are pushed into poverty due to high out-of-pocket expenditure on accessing healthcare. A recent study estimated that 55 million people had fallen below the poverty line due to exorbitant out-of-pocket health expenditure. The debilitating public health system caused by underfunding, mismanagement of staff, administrative and failure of governance, adds to the woes. However, the recent rollout of Ayushman Bharat, providing financial protection to a targeted population and strengthening primary care for all citizens, covers the ground for universal health coverage. The all-encompassing approach, which does not exclude anyone from basic services, is certainly forward-looking. In this scenario, the private sector plugs the gaps in the delivery of services, where they provide quality healthcare, with a price that is paid by the government. The share of out-of-pocket expenditure is 63 per cent of the total health expenditure in India, which is largely used to purchase medicines, diagnostic services and related services in the private sector. According to one estimate, the size of the private sector was 8 per cent after independence and in six-and-a-half decades, it has grown nine times, while the public sector has declined in absolute terms by a third of what it was, during the corresponding period. The structure of the private sector is diverse and functions as single doctor clinics, tiny nursing homes and large corporate hospitals operating in Tier I and II cities. Add to it various health facilities run by faith-based organisations. It can also be said that private healthcare services are demanded by all income groups. Though limited, there are precedents of partnership with the private sector in specific disease control programmes, without tenable strategies for a scale up. Several models of public-private partnership (PPP) have been experimented - contract services, joint ventures, demand-side financing, telemedicine and mobile health units in several parts of the country, leading to diverse results. The country has vast experience of buying healthcare from the private sector through government revenue in the Rashtriya Swasthya Bima Yojana (RSBY) and state- specific insurance programmes. From experience, major uncertainties that drove trust deficit in the private sector were pricing, quality, transparency and accreditation of services. There are examples galore of over hospitalisation, redundant procedures and diagnostic tests inflating costs. The private sector often raises prices of packages in many insurance schemes that do not deliver commensurate services. This issue assumes critical proportions. However, it is difficult to judge the merits of this argument in the absence of comprehensive costing data on different services by various types of health facilities. The unit cost of a service in a big corporate hospital is significantly different from similar service at a district-level hospital. Land, building and vast administrative machinery propel costs in these hospitals. Do we really need the participation of big corporate hospitals in these schemes, where high-frequency-low cost episodes are more than the low frequency-high cost episodes? We could negotiate to reserve some extremely critical procedures with a different payment mechanism in these hospitals. Private hospitals have been given concessional land, customs exemption and liberal tax breaks with a commitment to reserve beds for poor patients, who would be entitled to free treatment. But the manipulation of this provision is acute. Their behaviour is guided solely by profit motives, which is heightened by the information asymmetry in clinical practice, where the provider is more knowledgeable than the client. Regulatory frameworks in several forms –National Pharmaceutical Pricing Authority (NPPA), Drugs Control Authority and the Clinical Establishment Act, are hampered by inadequate capacities in the public sector. Despite these limitations, the private sector has certain advantages - better management of diseases, efficient utilisation of skills, accessibility, active response to patients’ need, use of technology, good hospitality and superior administration, which need to be appreciated. Forgetting the dichotomy between public and private sector for the moment, can we make effective collaboration between the two to uplift provision of services? When the scope of collaboration has widened after the rollout of PMJAY, each other’s merits and pitfalls need to be discussed for meaningful collaboration. The success is contingent upon how transparent and accountable the private sector is in delivering affordable care. For any partnership to be successful, accountability, transparency, equality, mutual obligation and commitment to achieve common objectives is the need of the hour. Is the private sector ready for this? (This article was originally published on The DNA. Read the original article) (Disclaimer: The opinions expressed above are the personal views of the author and do not reflect the views of ZMCL.)

Need to collaborate efforts of private and public sector to meet healthcare objectives

In view of Nipah virus scare in Kerala, some nursing homes and private hospitals in Meerut have cancelled the leaves of their nurses, who wanted to go to their home state Kerala, reported news agency ANI.

The report quoting Dr. JV Chikara, former president of Indian Medical Association, Meerut, stated, "Nurses agreed to take this precautionary measure."

Meanwhile, the Bihar Government has also issued an advisory regarding the occurrence of the virus, the report said.

The Bihar advisory said that the disease is spread by bats and pigs. Also, people infected with the disease can spread the virus.

The initials symptoms are that of fever, headache and muscle pain in most cases. And a person affected by the virus can slip into comma within 24-48 hours.

Hence the advisory directed that people must stay away from bats and pigs to not contract the disease.

Puducherry also issued an advisory on Saturday, mentioning preventive steps to be taken in high-risk areas to check the spread of the contagious disease.

So far, the virus has claimed 12 lives in Kerala.

(With ANI inputs)

Dr. JV Chikara, former president of Indian Medical Association, Meerut, said, "Nurses agreed to take this precautionary measure."

In view of Nipah virus scare in Kerala, some nursing homes and private hospitals in Meerut have cancelled the leaves of their nurses, who wanted to go to their home state Kerala, reported news agency ANI. The report quoting Dr. JV Chikara, former president of Indian Medical Association, Meerut, stated, "Nurses agreed to take this precautionary measure." Meanwhile, the Bihar Government has also issued an advisory regarding the occurrence of the virus, the report said. The Bihar advisory said that the disease is spread by bats and pigs. Also, people infected with the disease can spread the virus. The initials symptoms are that of fever, headache and muscle pain in most cases. And a person affected by the virus can slip into comma within 24-48 hours. Hence the advisory directed that people must stay away from bats and pigs to not contract the disease. Puducherry also issued an advisory on Saturday, mentioning preventive steps to be taken in high-risk areas to check the spread of the contagious disease. So far, the virus has claimed 12 lives in Kerala. (With ANI inputs)

Nurses' leaves cancelled in Meerut hospitals due to Nipah virus scare

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