Aga Khan Hospital’s Rs2.4 billion patient welfare questioned in high court

An image of the Sindh High Court.

The counsel who sought direction for the Aga Khan University Hospital (AKUH) for providing free medical facilities to the poor has questioned the health facility’s claim of spending over Rs2.4 billion on patients from the patients’ welfare fund.

Filing an affidavit in the Sindh High Court (SHC), petitioner Dur Mohammad Shah questioned the hospital’s statement claiming of providing welfare to 708,000 patients at a cost of Rs2.4 billion.

Shah said it was impossible that the AKUH provided welfare to 488,000 patients in 2015 and 708,000 patients in 2017, as even the two major government hospitals did not treat as many patients in the past two years.

He said there was a difference between a charitable and a non-profit entity, as the Government of Pakistan did not treat the AKUH as a not-for-profit organisation, adding that there was no such outpatient welfare process at the hospital, as it had no facility to provide patients medical treatment free of charge.

The petitioner said if the AKUH was providing free treatment to the poor, then it must put up a relevant signboard outside their emergency. He said a physician charged a fee of at least Rs2,400, adding that the welfare process started with the charging of the hefty fee and after completing six different steps the patient would be able to get admitted in the hospital.

He asked the court to direct the AKUH to start free inpatient welfare process, where the physician did not charge a fee and would be available round the clock. Earlier, the hospital’s counsel said the AKUH was a charitable entity and not a nonprofit, adding that it was registered under the Companies Act.

He admitted that the Government of Pakistan granted the hospital 20 acres and 63 acres in two phases for the construction of a charitable and medical college, and that the federal and provincial governments also exempted the AKUH from property and income taxes.

He denied that the hospital was engaged in commercial activities and it had established Pakistan’s leading charitable and nonprofit hospital and medical college.

He said that only recovery of charges from patients did not change the basic character of the hospital as a charitable organisation because profits were not made for distribution among the members of the AKUH but reinvested in the hospital.

He added that the reason for charging the patients was to maintain world-class standards that had made it the country’s leading hospital network and to provide subsidies to poor patients or anyone in need of aid.

After taking the affidavit in rejoinder on record, the SHC’s division bench headed by Justice Mohammad Ali Mazhar adjourned the hearing for further arguments.

Shah had said in the petition that the AKUH was allotted land by the District East deputy commissioner in the 1980s for the construction of a charitable hospital and medical college, with the condition that no portion of the land “shall be used for commercial purpose”.

He said that under Section 10(4) of the Colonisation of Government Lands Act, the payment of land revenue annual assessment charges had to be made and recovered from the AKUH and it required a revised assessment on the expiration of the term after 10 years when the settlement of land was executed.

He added that no annual assessment of payment of land revenue on the expiry of 10 years had ever been made or recovered from the hospital by the government; besides, several blocks were being constructed without getting approval from the relevant government agencies.

The petitioner said the AKUH had said on its official website that patient welfare and Zakat programmes gave financial assistance to patients who were unable to pay the fees, but practically they were charging patients higher fees than those charged by other charitable hospitals.

He said the AKUH was built and operated for charitable purposes to serve the poor, but unfortunately it was providing medical facility at heavy costs, adding that the poor could not afford the specialised health care they desperately needed.

Shah said the hospital was providing medical facilities to higher-income groups and corporate employees, adding that it was extremely difficult for a common person to get medical treatment at such high costs.

The court was asked to direct the AKUH to provide medical facility to every poor citizen free of charge in accordance with the agreement for the grant of land to the hospital and produce the entire record of free medical care it had provided to the citizens.

He also sought action over the alleged misuse of land and the hospital’s failure to use the land for charitable purposes.

Published in Dawn on May 11, 2019 by Jamal Khurshid

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