Sunday, August 2, 2009

Doctors accused of illegally profiting off cancer treatment

Doctors at a Hanoi hospital have been accused of cashing in by forcing cancer patients to use expensive equipment rather than the facilities their insurance policies allow them to use for free.

In 2000, K Hospital, or the National Cancer Institute, bought radiation equipment for US$1.4 million and has spent around $60,000 a year since then on its maintenance.

The public hospital now offers treatment for an average of 150 cancer patients per day and state insurance holders don't have to pay to use the equipment.

But as demand grew in 2006, the hospital cooperated with the Cancer Medical Equipment JSC to invest in more radiation equipment. All patients have to pay to use the joint venture's equipment, even holders of state insurance policies.

Recently, several patients reported that the hospital has claimed that the free equipment was broken, thus sending the sick to use the facilities they must pay for out of their own pocket.

The situation has drawn the ire of one of the doctors at the hospital, who wished to remain anonymous. He said he suspected it was a scheme in which medical workers were colluding to make commissions off the pay-only equipment.

"Why has the hospital equipment been broken down continuously when it has also been under maintenance for billions of dong a year?" he asked.

A patient from Nam Dinh Province undergoing treatment for breast cancer at the hospital, said she used to use the hospital's normal equipment for free. But she now complained of the high fees she had to pay for the joint venture's equipment.

Several other patients have made similar complaints.

Breakdowns

The hospital radiation equipment began to break down regularly once the Cancer Medical Equipment company's facilities were installed. The normal equipment broke down 127 times in 2007, according to hospital records.

A hospital technician said the machines had errors regularly and that repairs often took up to a week.

However, a breakdown in 2008 reportedly forced it out of operation for several months before resuming early this year.

In 2009, the device broke down several times, and the number of

Kbeing treated with it reduced from 150 patients to 80 patients a day. State insurance holders who have no choice other than to use the venture's equipment are now charged around VND13 million ($760) per treatment.

Kickbacks

Ministry of Health inspectors recently inspected the hospital after several complaints from patients.

The ministry said there was no evidence of doctors forcing patients to use the expensive equipment.

However, Thanh Nien reporters found doctors had received money from the Cancer Medical Equipment JSC and couldn't explain why.

According to the agreement between both sides, the hospital and the company split the fees from the equipment 30-70, respectively.

However, Thanh Nien obtained documents showing the company had in turn paid doctors 10 percent from its 70 percent as a kickback. The documents even noted the 10 percent as commission for assigning patients to use the Cancer Medical Equipment devices.

In April this year, the company collected more than VND774 million in fees from the devices and had to pay the hospital doctors VND77 million. The doctors' commission was VND82 million in total in May alone.

Le Duc Thang, director of the Cancer Medical Equipment JSC, said the company's accountant had mistakenly noted the money as "commission for assigning patients."

He said it was actually overtime pay for the doctors.

But the documents had noted payment for extra-hours in a section separate from the commission records.

Thang again blamed the accountant when asked by Thanh Nien to explain the two different payments.

The paper's investigation also found the commissions had been paid since 2006 when the equipment began operating. Many shareholders of the Cancer Medical Equipment JSC have also asked questions about this payment.

In a notice to its shareholders, the company said that after consulting with the hospital it had decided that the doctors fees would be reduced to VND50,000 per each patient treated with the device from September in 2007.

However, the fees then increased to 10 percent again in 2008.

Thanh also said payment for extra-hours had been transferred directly to doctors' bank accounts.

He also said the company was currently paying the doctors VND22,000 per patient for "overtime."

However, Thanh Nien found some doctors had collected up to VND15 million a month for overtime.

Dr. Dang The Can, K Hospital's vice director, said Wednesday the hospital was not aware of any payment for doctors' overtime, but said that [the overtime payment] was "a big amount."

He also admitted that some doctors had contributed their own funds to invest in the venture's equipment.
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