Charitable hospitals in Pune oppose mandatory government health schemes

Hindustan Times

15-07-2025

The Association of Hospitals (AOH), Pune, has challenged a recent Maharashtra government decision mandating all charitable hospitals to implement state-run health schemes. On Monday, the association filed a writ petition in the Bombay High Court, citing financial and operational difficulties with the move. The controversy stems from a Government Resolution (GR) issued by the Department of Law and Judiciary on April 21, 2025. (REPRESENTATIVE PIC)
The controversy stems from a Government Resolution (GR) issued by the Department of Law and Judiciary on April 21, 2025. The GR eliminates the earlier voluntary nature of joining health schemes, making it compulsory for charitable hospitals to participate in Central and State-run initiatives like the Pradhan Mantri Jan Arogya Yojana (PM-JAY), Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY), and Rashtriya Bal Swasthya Karyakram (RBSK), among others.
Subsequently, on June 4, 2025, the Joint Charity Commissioner's office in Pune issued directives requiring charitable hospitals to begin implementation and submit compliance reports by June 12. The AOH, which represents several leading hospitals in the region, strongly opposes the mandate.
Member hospitals of the AOH include Ruby Hall Clinic, Jehangir Hospital, Vishwaraj Hospital, KEM Hospital, Sancheti Hospital, Inlaks and Budhrani Hospital, Poona Hospital, and NM Wadia Hospital. In the petition, AOH argues that while they support providing care to the underprivileged, the package rates under the schemes are too low to cover the operational costs of running tertiary care hospitals.
Dr HK Sale, executive director of Noble Hospital and chairman of the Association of Hospitals, Pune, said, 'If the hospitals start all the schemes, they will be flooded with patients who want to get treated under the scheme, and there will be no space for other patients. For investigations, the hospitals have high-end, latest machinery and devices, which are cost-exorbitant. There are senior and expert doctors and trained staff which needs to be paid at par with the market rates. How will it be possible for the hospitals to survive?'
According to data shared by officials, there are 58 charitable hospitals in Pune, 74 in Mumbai, and 468 in other parts of Maharashtra. All charitable hospitals are already obligated under the Indigent Patients Fund (IPF) scheme, mandated by a 2006 Bombay High Court order, to allocate 2% of their gross billing for free or subsidised treatment. This includes reserving 10% of beds for indigent patients (treated entirely free) and another 10% for economically weaker sections at a 50% discount.
The AOH claims the charitable hospitals are already fulfilling their duty by providing free and subsidised treatment to the needy under the IPF scheme. However, the government has issued the GR to ensure that no needy patient is deprived of medical aid due to the unavailability of IPF. Many times, the charitable hospitals have reportedly denied or refused treatment to the needy patients, stating unavailability of IPF and in such cases, the patients can be given the option or benefit of other government health schemes, said the officials.
Adv Manjusha Kulkarni, from Ruby Hall Clinic, who is secretary and legal advisor of AOH, said, 'The petition was filed by the association, which includes all trust hospitals, against the government decision. This will affect the hospitals badly and they won't be able to sustain and compete with the global healthcare facilities that offer advanced technology in healthcare. We will not be able to develop or sustain it, and every hospital needs to maintain its standards.'
As per AOH, around 78% healthcare services are provided by private hospitals, and they are not considered by the government prior to making any decisions. Currently, everyone is using Robots for surgery, and it is expensive and patients can't be provided surgical management under the rates offered by the schemes.
Furthermore, diagnostic facilities like CT Scan machines cost around ₹8 to 10 crore, and scan machines are worth up to ₹50 crore. Comprehensive Maintenance Contract (CMC) for medical equipment costs around ₹50 lakh to ₹2 crore, due to which the scan tests cost around ₹15 to 18k. This test cannot be provided for nominal charges, unlike small nursing homes that have CT machines worth ₹40 to 50 lakh.
Dr Priti Lokhande, coordinator for MJPJAY and PM-JAY scheme, who is coordinating with the Charitable hospitals for the empanelment, said, 'There has been a Lukewarm response even after the GR and directions from charity Commissionerate hospitals. We have received requests from only two charitable hospitals in the Pune district who have shown interest to get empaneled. However, the charitable hospitals remain firm on their stand and are not ready to get empaneled,' she said.
Ashish Purnale, district coordinator for RBSK, said only nine hospitals are currently empanelled under the scheme, of which six are private. 'There are over 104 procedures covered under RBSK, but uptake remains low,' he said.
Dr. Vinod Sawantwadkar, CEO of Jehangir Hospital, emphasised that government facilities should first upgrade their infrastructure. 'We are already contributing through IPF and health camps. The issue is limited bed capacity and staff. Government hospitals need better facilities; private hospitals cannot bear the entire burden,' he said.
He also pointed out that maintaining high standards of care is non-negotiable. 'We offer world-class treatment through specialised doctors and cutting-edge technology. Quality cannot be compromised for affordability alone.'
The AOH's legal challenge seeks to revoke the GR and restore the voluntary nature of empanelment, emphasising that charitable hospitals should not be forced into schemes that threaten their viability.