Editorial Viewpoint
Broadening the base
Finally realization is dawning. For decades the management of the B. D. Petit Parsee General Hospital (BDPPGH) insisted they would not deviate from their Parsis-only stance despite mounting losses. Now the august institution’s 97t h annual report for the financial year 2009-2010 states bluntly, “We find it extremely difficult to maintain the present level of charity care for free and subsidized patients and the state of progressively increasing operating deficit over the last decade or so is not sustainable… There is a need to take a hard look at the economics of running our Hospital objectively… by exploiting the unutilized assets of the Hospital for its sustenance.”
The losses, always in high figures, have for the year in question reached an “unprecedented…operating deficit” of Rs 9.36 crore (US $ 2,081,377), up Rs 1.27 crore from the previous year. This means an operating loss of over Rs 2.5 lakh (US $ 5,700) a day.
The loss is despite “all out efforts (made) to reduce the average stay of free patients from 42 to 35 days.” But overall “the average length of stay of free and subsidized patients has been almost three times the length…of paying patients.”
The community’s ageing demographic profile and the fact that the number of working members in a family is declining due to falling birth rates and a large percent of never-married Parsis, means the problem may accelerate exponentially. There was an approximate six percent increase in the number of “bed utilization days,” 56,164 as versus 52,766 the previous year. Of the 2,946 patients admitted in the year, only 26 were pediatric cases. Births in the hospital totaled 42 (up from 33 the year before) while deaths were 233, up from 198 the previous year. No doubt as Parsis move to the suburbs they are more likely to avail of maternity homes closer to their place of residence. Thus even the meager income (there are 200 or less births a year) the Hospital could have earned from the maternity wing goes elsewhere. For infirmities that require longer stay and costly medical examinations they would opt for the subsidized or free facilities of the Petit establishment.
Out of a total expenditure of Rs 16.25 crore, Rs 9.64 crore or close to 60 percent “was devoted to charity care.” Free medication supplied totaled over a crore. The hospital provides “free and subsidized diagnostic services to all the free and poor in-patients as well as OPD (outpatient department) patients.” For specialized investigation facilities such as CT scan, MRI, dialysis, cancer detection not available in the Hospital patients have to go elsewhere to institutions with which the hospital has tie-ups. The transport cost to and fro is borne by the patient. A trip across the road to the Breach Candy Hospital a few buildings away costs around Rs 800 by ambulance.
Apparently many of the free and subsidized patients do not subscribe to mediclaim insurance policies which would lessen the financial burden on the Hospital. One reason, aside from the cost of such policies, could be the inordinate delays in recovering claim payments. Despite submitting all the required bills, receipts and test reports, demands for additional documents and statements can delay payment over a year and in some cases deny it partially or altogether.
Though the Hospital which will enter its centenary year in 2011 has “qualitatively and quantitatively improved overall health care services” the institution’s services for inpatients and outpatients are restricted to Parsi Zoroastrians. There has been a consistent clamor that at least outpatient and diagnostic facilities be extended to all communities. The pathology laboratory and the x-ray department are on call 24 hours a day but are utilized for only a fraction of the time. By extending the facility to non-Parsis the Hospital would augment its income considerably without incurring any additional major expenditure. The managing committee and others have persistently declined to do so believing this would be “the thin edge of the wedge.” But with mounting costs they may be forced to widen their base as has happened in the case of other community founded and funded institutions.
All the former Parsis-only schools are now cosmopolitan. The Delhi Parsi Anjuman Dharamshala for example rents a fixed number of rooms to non-Parsis, thereby augmenting its income. The Parsi Gymkhana at Marine Lines admits a certain percent of non-Parsis as members. The Ripon Club has persistently turned down such suggestions. But now it is faced with an eviction suit filed by the landlord as the Club is unable to pay a higher rent due to its limited (around 600) and ageing membership. Most other clubs in Bombay are flush with funds and spend crores of rupees renovating, upgrading and expanding their facilities. The Ripon Club in contrast is in need of a coat of paint.
The community’s Parsis-only baugs booked largely for weddings and navjotes are generally utilized for only a third of the year. By permitting non-Parsis to also utilize the properties at a higher fee the trusts could generate incremental revenue of crores of rupees annually
One of the possibilities being examined by the establishment’s managing committee headed by noted solicitor Homa Petit to “exploit the unutilized assets” of the Hospital is reportedly a separate super-specialty, cosmopolitan hospital from whose income BDPPGH could be subsidized. This would preserve the Parsis-only status of the existing structures while catering to the general populace in the proposed new building. Any plans however would have to be approved by the Bombay Parsi Punchayet which owns the property. The Hospital’s management vests with the elected managing committee.
Hopefully politics should not come in the way of safeguarding one of the community’s best loved and most beneficial institutions.
The losses, always in high figures, have for the year in question reached an “unprecedented…operating deficit” of Rs 9.36 crore (US $ 2,081,377), up Rs 1.27 crore from the previous year. This means an operating loss of over Rs 2.5 lakh (US $ 5,700) a day.
The loss is despite “all out efforts (made) to reduce the average stay of free patients from 42 to 35 days.” But overall “the average length of stay of free and subsidized patients has been almost three times the length…of paying patients.”
The community’s ageing demographic profile and the fact that the number of working members in a family is declining due to falling birth rates and a large percent of never-married Parsis, means the problem may accelerate exponentially. There was an approximate six percent increase in the number of “bed utilization days,” 56,164 as versus 52,766 the previous year. Of the 2,946 patients admitted in the year, only 26 were pediatric cases. Births in the hospital totaled 42 (up from 33 the year before) while deaths were 233, up from 198 the previous year. No doubt as Parsis move to the suburbs they are more likely to avail of maternity homes closer to their place of residence. Thus even the meager income (there are 200 or less births a year) the Hospital could have earned from the maternity wing goes elsewhere. For infirmities that require longer stay and costly medical examinations they would opt for the subsidized or free facilities of the Petit establishment.
Out of a total expenditure of Rs 16.25 crore, Rs 9.64 crore or close to 60 percent “was devoted to charity care.” Free medication supplied totaled over a crore. The hospital provides “free and subsidized diagnostic services to all the free and poor in-patients as well as OPD (outpatient department) patients.” For specialized investigation facilities such as CT scan, MRI, dialysis, cancer detection not available in the Hospital patients have to go elsewhere to institutions with which the hospital has tie-ups. The transport cost to and fro is borne by the patient. A trip across the road to the Breach Candy Hospital a few buildings away costs around Rs 800 by ambulance.
Apparently many of the free and subsidized patients do not subscribe to mediclaim insurance policies which would lessen the financial burden on the Hospital. One reason, aside from the cost of such policies, could be the inordinate delays in recovering claim payments. Despite submitting all the required bills, receipts and test reports, demands for additional documents and statements can delay payment over a year and in some cases deny it partially or altogether.
Though the Hospital which will enter its centenary year in 2011 has “qualitatively and quantitatively improved overall health care services” the institution’s services for inpatients and outpatients are restricted to Parsi Zoroastrians. There has been a consistent clamor that at least outpatient and diagnostic facilities be extended to all communities. The pathology laboratory and the x-ray department are on call 24 hours a day but are utilized for only a fraction of the time. By extending the facility to non-Parsis the Hospital would augment its income considerably without incurring any additional major expenditure. The managing committee and others have persistently declined to do so believing this would be “the thin edge of the wedge.” But with mounting costs they may be forced to widen their base as has happened in the case of other community founded and funded institutions.
All the former Parsis-only schools are now cosmopolitan. The Delhi Parsi Anjuman Dharamshala for example rents a fixed number of rooms to non-Parsis, thereby augmenting its income. The Parsi Gymkhana at Marine Lines admits a certain percent of non-Parsis as members. The Ripon Club has persistently turned down such suggestions. But now it is faced with an eviction suit filed by the landlord as the Club is unable to pay a higher rent due to its limited (around 600) and ageing membership. Most other clubs in Bombay are flush with funds and spend crores of rupees renovating, upgrading and expanding their facilities. The Ripon Club in contrast is in need of a coat of paint.
The community’s Parsis-only baugs booked largely for weddings and navjotes are generally utilized for only a third of the year. By permitting non-Parsis to also utilize the properties at a higher fee the trusts could generate incremental revenue of crores of rupees annually
One of the possibilities being examined by the establishment’s managing committee headed by noted solicitor Homa Petit to “exploit the unutilized assets” of the Hospital is reportedly a separate super-specialty, cosmopolitan hospital from whose income BDPPGH could be subsidized. This would preserve the Parsis-only status of the existing structures while catering to the general populace in the proposed new building. Any plans however would have to be approved by the Bombay Parsi Punchayet which owns the property. The Hospital’s management vests with the elected managing committee.
Hopefully politics should not come in the way of safeguarding one of the community’s best loved and most beneficial institutions.
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From the archive