Mamata’s flagship welfare schemes run into roadblocks in Bengal

The populism that has been the mainstay of the Mamata Banerjee-led Trinamool Congress government has become a headache with at least three welfare schemes facing roadblocks due to noncooperation from those crucial to their implementation.

The government is swamped with complaints of hospitals refusing to admit patients under the Swasthya Sathi scheme and banks refusing to sanction collateral-free loans to beneficiaries of the student credit card scheme.

These apart, the launch of doorstep ration delivery, as was promised by the TMC during the assembly election earlier this year, too is in a limbo as many ration dealers have refused to join the scheme calling it “absurd and non-implementable”.

Taking serious notes of the obstructions, the chief minister has reportedly directed officials to immediately clear the hurdles as the successful implementation of the schemes is politically crucial for her party, which rode to power in May for a third consecutive term deftly using welfarism as its main plank.

The Swasthya Sathi scheme, which provides basic health cover for secondary and tertiary care up to ₹5 lakh per annum per family, was extended to include the entire population of the state in December last year, barely a few months ahead of the election.

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Many political observers called the move a political masterstroke that eventually helped the TMC government to buck the anti-incumbency factor.

The original scheme, launched on December 30, 2016, was meant for economically deprived sections. According to the state health department’s figures, 2.3 crore families have been brought under the universal health insurance scheme. The health insurance card is issued in the name of the eldest female member of the family.

Since its rollout, the remodelled scheme has been finding problems in getting acceptance from many of the 2,330 empanelled private hospitals and nursing homes over treatment charges and other payment issues, prompting the state government to crack whip.

Banerjee recently cautioned hospitals of strict action, including cancellation of their licences in case they deny admission to any Swathya Sathi card holders. The state health department in an advisory to private hospitals and nursing homes last week also stated that in case a person is not carrying the insurance card the same must be searched with the Aadhar number of the beneficiary on the Swasthya Sathi web portal to facilitate the cashless admission.

Hospitals cite unrealistic treatment charges fixed by the state government and delay in clearing dues under the insurance scheme as bones of contention. A private hospital in Howrah last month even moved the Calcutta High Court against the state government for non-payment of outstanding dues accumulated for the cashless treatment of thousands of patients, mainly COVID-19 affected cases under the scheme.

The health department has fixed an upper ceiling of ₹5,000 for diagnosis and clinical investigation, which many hospitals find unfeasible. The Association of Hospitals of Eastern India has urged the department to reconsider the ceiling.

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“It has occasionally been observed that the private hospitals and nursing homes go for unspecified tests in the name of clinical investigation and diagnosis. This cannot be done. The hospitals and nursing homes can spend up to ₹5,000 for clinical investigation and diagnosis and after that the patient has to be brought under a specific package,” read a health department advisory.

The department also directed that a patient can be admitted for an unspecified package under the scheme only for accident and certain surgical cases. All other patients should be admitted under any of the 1,900 packages earmarked for the scheme based on the nature of ailment. Rates for the packages are predetermined by the government.

“Our contention is that it is unrealistic to assume that the cost of investigations in all emergency cases can be restricted to ₹5,000,” a private hospital official said, wishing anonymity fearing government’s wrath.

The state government spends around ₹250 crore per month to meet the health insurance claims, according to a state health department official.

Similar implementation hiccup is also witnessed in the West Bengal Student Credit Card Scheme, which provides loans up to ₹10 lakh at a nominal interest of 4 per cent to students studying in Class 10 or above for higher studies.

Expressing displeasure over students not getting credit cards, the chief minister last week reportedly asked officials to submit to her a list of pending applications. “I want a report. I want to know what is happening. I am told some banks are not cooperating even after chief secretary [H K Dwivedi] spoke to them,” a senior state government official quoted Banerjee as saying in an administrative review meeting last month.

The government launched the scheme in July fulfilling one of its main poll promises. But the scheme has failed to take off as expected due to reluctance of the banks to sanction loans to students without collateral despite the state being guarantor for every student seeking financial assistance.

To iron out the problem, the chief secretary in September met representatives of private banks. In the meeting the banks had assured the government they would streamline the disbursement process within a fortnight. But the problem remained.

The government’s plan to deliver ration at the doorstep of the beneficiaries from November 16 is also facing uncertainty as many dealers are reluctant to join the scheme. The All India Ration Dealers Federation even moved the Supreme Court against the scheme saying that no state in India, including West Bengal, has the necessary infrastructure to implement such an idea.

The general secretary of the federation Vishwambhar Basu said the ration dealers would need additional manpower and vehicles to deliver rations at the doorstep. The dealers said they are not in a position to bear the additional costs of the men and machine.

The government, however, agreed on principle to increase the dealer commission. “For the doorstep delivery the commission will be increased to ₹150 per quintal of ration from ₹75 per quintal,” said an official of the state food and civil supplies department.

The department is holding meetings with dealers to persuade them to join the scheme, the official added. There are 20,286 ration dealers in the state.