ESI hospitals fare well in COVID treatment, but the insured bear brunt

At a time when government-run hospitals in Tamil Nadu face a shortage of beds and ventilators to treat COVID-19 patients and private hospitals earn the wrath of people due to their exorbitant treatment costs, ESI hospitals in the state are silently faring well in providing better treatment than other hospitals.

The Employee State Insurance (ESI) Scheme, introduced in 1948, is one of the major social security schemes existing in the country. Many hospitals were established under the scheme to serve employees working in industrial clusters across the country

The scheme provides medical services through a network of nearly 1,500 dispensaries, 3,000 clinics, over 300 diagnostic centres, about 150 hospitals and more than 40 hospital annexes with over 30,000 beds. As many as 850 local offices of the ESI Corporation handle the disbursement of cash benefits.

In Tamil Nadu, the scheme was implemented in 1955. As of today, there are 10 ESI hospitals in the state. Of these, two are run by the ESI Corporation and eight by the state government with ESI’s funding.

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Once, these hospitals were popular among the public due to quality treatment provided at a low cost. Even if ESI hospitals lack facilities to perform major surgeries, they shift patients to private hospitals, but the ESI Corporation bears the costs.

But, after the arrival of corporate hospitals in the state, ESI hospitals started losing their sheen. They began to function like other government hospitals. Between 2017 and 2018, the state witnessed corruption charges over the procurement of medicines for ESI hospitals.

However, amid the COVID-19 crisis, the hospitals have regained attraction. For example, the ESI hospital in Coimbatore, one of the oldest institutions to established in the state under the scheme, receives patients from Coimbatore, Tiruppur and Nilgiris.

A model hospital

“Though Coimbatore is considered as the medical hub of the state due to the presence of a large number of corporate hospitals, the city would have gone through a difficult phase, if there was no ESI hospital,” said Kandhavelan, the founder of Aathma Trust, which recently organised an event to honour health workers at the ESI hospital.

The hospital management has even started a crèche for children of women who are undergoing treatment for COVID-19.

Speaking to The Federal Dr A Nirmala, dean of the hospital, said staff had been working as a team since the hospital was converted into a COVID-care centre and the teamwork has borne the fruit.

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“For each and every activity like preparing rosters for daily duties, arranging PPE kits for doctors, diet, accommodation, etc, we have separate teams and have not faced any difficulties,” she said. “We held a week-long session for all health workers about the disease. So they had a better understanding of dealing with the patients,” said Nirmala.

When the management came to know that patients who lacked immunity would get affected severely by the disease, it began concentrating on diet that could increase immunity in patients. “Earlier, we did not use steroids and medicines like aspirin. But now we have changed our protocol and started using those medicines” she said.

As on June 25, the hospital had discharged 375 patients and saw only one death. This shows ESI can offer good treatment on par with private hospitals if proper measures are taken. The ESI, in fact, had accumulated over ₹85,000 crore, which remains unutilised.

For benefit of workers

However, the money was neither collected from the public, nor it was generated by the government. It was fully contributed by employees and employers. So the money should be used only for their welfare, said Dr GR Ravindranath, general secretary, Doctors Association for Social Equality.

“ESI Corporation runs nine medical colleges and a dental college. The core objective of the corporation is to provide medical benefits to workers in the form of insurance. It’s an insurance corporation run by the government. It’s not the duty of the corporation to run medical colleges for the public as the money was collected from them,” he said.

Ravindranath said most ESI hospital lacked super-speciality treatments and the government should develop the hospitals with its funds and not with workers’ money.

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As some ESI hospitals have been dedicated only for COVID-19 treatment, other treatments that had been offered by these institutions have been stalled.

“Amid the pandemic, workers who had not been affected by COVID-19, but have other ailments like cancer or renal failure could not get treatment or undergo dialysis,” said Ravindranath. “But these hospitals have largely been benefitting the public. This is an injustice meted out to workers” said.

Sureshkumar, joint secretary of the Salem unit of the Centre of Indian Trade Unions (CITU), said the reduction in contribution would make conditions worse.

“Earlier the ESI’s contribution was 6.5 per cent. Employees and employers used to contribute 1.75 and 4.75 per cent respectively. But now it has been reduced to 4 per cent. So the corpus fund will reduce and make conditions worse,” he said.

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For instance, the ESI Corporation has enlisted several private hospitals to which patients are referred to. However, the corporation is yet to settle the outstanding amount to these institutions. So, the private hospitals are not admitting the patients, if they are shifted from ESI hospitals, said Sureshkumar.

The ESI hospital in Coimbatore is faring well as it is functioning with the ESI medical college. However, other ESI hospitals like in Salem offer a poor service. The hospital has not even hired an ambulance driver for nearly a year now, said Sureshkumar.

“The Corporation has also tweaked rules for enrolment of new beneficiaries. Earlier, workers from a notified industrial area with 3,000 labourers were eligible. But, now, the strength has been increased to 20,000,” he added.