"Only the rich would be able to come to AIIMS if the fees are hiked,'' says student & resident doctor
A memorandum sent by the health ministry has directed the AIIMS authority to not only review the tuition fees on students but also raise how much patients are being charged. Could this give rise to another JNU-like situation? We try to make sense.
Centre's proposal to review the tuition fees for the students of All India Institute for Medical Sciences has faced a massive backlash from the students and resident doctors of the institution. A memorandum from Union Health Ministry asked the Central Institute Body (CIB) of six AIIMS to 'review' tuition fees and fix uniform charges for various facilities for patients.
This means not only fees for MBBS students can increase manifold, but even patients availing medical services from the hospital could also have to pay more.
‘Where will the poor go’?
Citing Rule 47 of the General Financial Rules, 2017, what the memorandum says about the user charges could be particularly worrying for the patients.
"While fixing the rates of user charges, the ministries/departments must ensure that the user fees recover the current cost of providing services with a reasonable return on capital investment,'' it states.
This means a major hike in how much patients pay for getting their treatment.
The memorandum also says"any deviation from these principles shall be specifically recorded with reasons justifying the setting of user charges lower than the cost recovery norms".
The move comes even as a committee under Dr Anoop Saraya of AIIMS Delhi had made a proposal to remove user fee for Out Patient Department (OPD) visits and routine tests costing up to ₹500 in 2017. The proposal has been pending with the health ministry.
"AIIMS is one of the very few government hospitals where patients can expect quality healthcare at an affordable price. If the patient fees of this prime government facility are hiked, then where will the poor go to get treated?", said Dr Teg Rabab Singh, a resident doctor and student of AIIMS.
Money > merit?
According to reports, AIIMS provides the least expensive medical education in the country at Rs 6,000 per year. This could be raised up to Rs 50,000 to Rs 70,000 per year for an MBBS degree, as per officials in the human resources development (HRD) ministry. This would make medical training for the students particularly from impoverished backgrounds very difficult, if not impossible.
"If the tuition fees are increased to the tune Rs 50,000 to Rs 70,000 per year, then becoming a doctor would become a rich man's game. Students from the remotest corners and most marginalised communities come to study in AIIMS on the basis of their merit and hiking the fees could eliminate the importance of merit. This could be very detrimental to the medical community and patients alike,” said Dr Singh.
The AIIMS Resident Doctors Association (RDA) has also opposed the proposal saying that "quality education and healthcare are building blocks of society and we will not allow any person, organization or the government to compromise on them in any aspect".
In a statement, the RDA also said that we can achieve the dream of becoming a developed nation "only if the central and state governments make quality education affordable and healthcare accessible to all citizens.''
The counter-argument from the health ministry official is that it takes over Rs 1.8 crore to train an MBBS student (according to a department of hospital administration analysis) and that the tuition fees have not been revised for more than 50 years.
“We are asking these institutes to at least generate Rs 70-75 crore each year by charging for MBBS programmes and patients’ services,” a senior ministry official said. Currently, AIIMS Delhi generates only Rs 2-3 crore a year.
But Dr Singh of AIIMS refutes these claims: "It's a false statement when the authority says that it takes over Rs 1.8 crore to train a medical student. They are taking into account infrastructure like the ACs of auditoriums, or repair-work, benefits of which are used by everyone, and not only the students. So that is a gross miscalculation.”
The decision to call for an increase in AIIMS charges come on the heels of a students’ agitation against the sharp hike in hostel fees in Jawaharlal Nehru University, which garnered support from many other institutions in the country.
In recent past there have been several proposals to hike students' fees in various institutions. For example, About a couple of months back it was announced that the fee for M.Tech in government colleges will be hiked by 900%, taking it to Rs 2 lakh per year.