KATHMANDU, June 26: The government's move to require all government, community and private hospitals to provide free treatment, including 10 percent of hospital beds, to poor and vulnerable patients has met resistance from the Association of Private Health Institutions Nepal (APHIN). The measure is one of the government's 100 governance reform commitments.
Under the reform agenda, the Ministry of Health and Food Security has launched a Targeted Group Free Treatment Procedure along with an online treatment portal, available on the ministry's website. The portal allows anyone to check how many free beds are available at participating hospitals, a step the ministry says is aimed at improving transparency and accountability for both hospitals and patients.
The new system took effect immediately. It requires all hospitals to reserve 10 percent of their total beds for free treatment of poor and vulnerable patients. Hospitals must also provide 10 percent of their outpatient services free of charge to eligible patients. To receive the service, applicants must submit the required documents, including a recommendation letter from their local government.
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APHIN President Padam Bahadur Khadka argues that the policy is unfair because the government itself has failed to provide the 98 types of medicines it previously promised to distribute free of charge.
"If the government cannot provide the 98 medicines it pledged to supply free, how can private hospitals be expected to offer all services free of cost?" he said, adding that reserving 10 percent of all services without compensation would leave private hospitals operating at a loss.
Dr. Samir Kumar Adhikari, assistant spokesperson for the Ministry of Health and Food Security, said the requirement for hospitals to reserve 10 percent of beds for poor patients has been in place since 2014 and is not a new policy. The only new element, he said, is the online portal, which is designed to make the system transparent and hold hospitals accountable.
"The 10 percent free service requirement already existed. Only the portal is new," Adhikari said.
He said the ministry introduced the portal after receiving complaints that private hospitals were not providing the mandated free treatment. Hospitals, meanwhile, claimed that eligible patients were not coming to use the service. The portal is intended to verify both claims through public monitoring.
The government has also established burn units in federal and provincial hospitals across all seven provinces. Under its governance reform agenda, the ministry has approved 977 new health sector positions and directed hospitals to speed up the delivery of scanned medical reports.
Monitoring has been carried out at hospitals including Bir Hospital, Gangalal National Heart Center and Kanti Children's Hospital to improve service quality. According to Adhikari, the ministry has also kept air ambulances on standby in collaboration with the Nepal Army and helicopter operators in the Far West and eastern regions for emergency services. Other measures include promoting generic drug prescriptions, opening affordable hospital pharmacies, introducing digital ticketing systems and complaint management systems, with implementation underway in several hospitals.
Mahendra Shrestha, former additional secretary at the former Ministry of Health and Population, said the government's first three months have not produced meaningful results in the health sector. He argued that the reform agenda has failed to address broader public health needs.
According to Shrestha, federal and specialized hospitals continue to struggle with overcrowding, limited access to services and long waiting times for surgery. He said meaningful improvement would remain out of reach until basic hospitals are strengthened.
"Public health management and service delivery at primary level hospitals remain weak. Unless those hospitals improve, the patient burden on federal hospitals will not decline, making quality care difficult to deliver," he said.
