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Unhealthy exclusion

Delhi government’s decision to increase reservation for the locals in GTB Hospital, to be implemented from September 15, has evoked strong reactions. Outstation patients might get elbowed out unless more beds are created

A 57-year-old man from Bijnor (Uttar Pradesh) who has a urinary bladder tumour; a 32-year-old man from Kanakpur village (Bikaspur, UP) who has to get his gastrointestinal endoscopy done; a 46-year-old woman from Saharanpur (UP) who was recently diagnosed with throat cancer; a 5-year-old who belongs to Amroha and is suffering from encephalitis, a 40-year-old woman from Beri (Haryana) who has a heart disease; a 25-year-old girl from Chandausi (Sambhal, UP) who has been ill for three months but her ailment is undiagnosed — are a few among hundreds of outstation patients who come to GTB Hospital for treatment.

“Despite being ill, we come this far hoping to find the right treatment. We also get free medicines here and the doctors are better equipped and proficient,” says Bhushan, who has come from Barabanki for his mother’s treatment and is waiting in the queue at the hospital pharmacy.

“Since most big hospitals with specialised healthcare services — including better facilities and qualified doctors — are concentrated in major cities, patients from small towns and villages often go to such metro cities in search of a cure,” says Rakesh Gautam, a public health worker. Delhi being the capital and easily accessible, many patients from states like UP, Bihar and Haryana come here for proper and affordable healthcare services.


Guru Tegh Bahadur (GTB) Hospital in Shahdara, East Delhi, too has a large number of outstation patients. It is the largest state-run hospital in east Delhi with 1,500 beds. About a month ago, the government had declared its intent for separating the OPD counters for locals and outstation patients at GTB Hospital.

Recently, the Delhi government decided that reservation for the residents of Delhi in GTB Hospital will be increased to 80% from 40%. A day before this announcement was made, the Delhi State Cancer Institute (DSCI), which is the only cancer hospital run by the state government, was also given 80% reservation for the locals.

According to officials, outstation patients are adding to the burden of Delhi hospitals because of which the locals are not able to avail the facilities. This is why the proposal to give preference to the Delhiites was approved in a meeting attended by Chief Minister Arvind Kejriwal and Health Minister Satyendra Jain. It was decided that out of the 17 registration counters in GTB Hospital, 13 would be for the locals and the remaining four for those from outside Delhi.

“The pilot project comes into effect from September 15. Residents of Delhi would get preference at the registration counters, in-patient department (IPD), tests and medicine counter service,” the Delhi government said in a statement. Free medicines and big tests would only be available to locals with valid voter cards. However, simple tests — like blood test and X-ray, consultation and emergency services will continue to remain free for outstation patients as well.

For the locals, 80% beds in the IPD will be reserved and the remaining 20% would be for other patients. The registration cards will be colour coded to differentiate between the patients. The identification of the residents will be on the basis of valid voter ID cards.

“This process might become cumbersome and increase corrupt practices like that of touts and fake registration cards. Currently, there are touts at the medicine counter who will evade the hours-long queue and get medicines in minutes, if you pay them Rs 200-300,” says a security guard who does not wish to be named.

Many public health experts have slammed the move, considering it discriminatory. “Cancer care in India is still available mostly in big cities and DSCI being the only state run cancel hospital in the capital, should not have reservation of this kind. As doctors, we cannot differentiate between patients on the basis of where they come from,” says a doctor practicing in another government hospital.

Some believe that it is unconstitutional and regressive. “Delhi is a multi-cultural city. We all are Indians but this is like robbing Delhi of its national character. Healthcare is a facility that should be available to all and not be restricted on the basis of a person’s regional identity. Why can’t they think of other alternatives to ease the burden?” questions Prashant, a resident of North Delhi.

A Delhi University teacher who is a resident of Krishna Nagar, criticising the scheme, says, “There is, indeed, an influx of patients in Delhi but this is not the way to handle the situation. Health is such a sensitive issue. If they do not have access to affordable and good facilities in their towns and villages, where else can they go? This will make them more helpless. Delhi is the capital, not just any other state, and I think that comes with a responsibility.”

Kishore whose wife is suffering from cancer and is being treated in DSCI, says, “Delhi has always been our first option, whenever we have to go for any facility that is not available in our hometown. Where else do we go? Is it our mistake that we are from a different region? If after coming this far, we do not get beds, what will we do?”

“My daughter is sick and there we do not have such hospitals. For her treatment, I will go wherever the most affordable and best medical treatment is available. Those who can afford to go abroad, they go there for better treatment. Why can’t we go to another state in our own country?” questions Dinesh who has come for his daughter’s treatment to GTB Hospital from Auraiya.

Condemning the government’s move, Amit Parmar who is from Lucknow but is presently staying in south Delhi, says, “Depriving the needy of any kind of healthcare facility is like violation of basic human rights. Under the garb of providing welfare to the people of Delhi, this is a cheap populist move for electoral gains. But healthcare should not be politicised.”

Dr Vivek Chouksey, ex-president of the Federation of Residents Doctors Association has also opposed the move and said that it should be repealed. He said that there should be no discrimination in medical treatment and no matter what part of the world they come from, they should be given what they need.
CM Kejriwal also made another announcement — he took to twitter to announce that an additional 6.5 acres of land will be given for the expansion of this hospital. The doctors are hopeful that this will make space for everyone and they will not have to turn away outstation patients.

There are certain doctors and locals who support the move, hailing it as a good measure. “Why should we suffer because they don’t have adequate infrastructure in their states? Being a Delhiite, I support the move as it will make beds available for the locals now. Otherwise, they had to wait for months for their treatment,” says Gunisha, a resident of Laxmi Nagar.

Vishnu Kohli, a resident of Gurugram, says, “There are still other hospitals where they can go.

Healthcare is a state subject. The states from where these patients are coming should focus on their shortcomings and improve their system, so that they can get treatment in their own city, without spending money in travelling to other states.”

If this pilot project succeeds, it is being said that it will gradually be implemented on other state run hospitals. Last year, the Delhi government reserved 50% beds in GB Pant Hospital — the largest super speciality hospital being run by it — which was opposed by doctors in many government hospitals. This year in February, there were reports of a 19-year-old boy committing suicide because he could not get admitted in GB Pant Hospital.

Mansi Joshi, a Delhiite who is undergoing treatment at GTB Hospital, says, “The patients here have to struggle with delays and hassles at times, so this might help them. But what effect will this have on the outstation patients can only be known after the scheme is implemented. Let us hope no patient who is in dire need of help is turned away because of this. Be it a local or a person from another state.”