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Afternoon Pay Clinics, West Bengal
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Subject Area="Human Resources." Objective="Improved hospital services."
Details for Reform Option "Afternoon Pay Clinics, West Bengal"

Background: Medical Officers (MOs) of different specialisations are supposed to work between 8am and 4pm. However many were not staying at their posts for the full day - either leaving to practice privately or to go home. Many MOs would also not stay at their place of posting for the entire stipulated duration. Action: To give the MOs an incentive to stay at their post until 4pm, it was decided to set up pay clinics in the afternoon. The money charged to the patient would be split between the Government, doctors and the institution. Typically, out of an INR 50 charge, INR 10 would go to the Government, INR 2 would go to the institution and the rest would go to the MO. This service is aimed at patients who can afford it, though services are still free to those below the poverty line (BPL). Charges for the clinics are set by the Government. Results: There has been no evaluation of this scheme. However an initial rapid assessment suggested that only 5% of hospitals were actually holding afternoon pay clinics. An evaluation for further refinement of the scheme is planned in the near future.

Cost Minimal establishment costs like electricity, water, etc.
Place West Bengal medical college hospitals, district hospitals, sub-divisional hospitals and state general hospitals from November 2001.
Time Frame Approximately 3 months to issue a Government Order.

Funds generation: Not only does the scheme produce income for the MOs, it also generates funds to improve/maintain facilities at the institution.


Generating awareness: Many institutions have had difficulties in getting the message out to patients that the facility is available. Incentivising MOs: Many MOs have been reluctant to take part.


Willingness from MOs to take part in the scheme. Awareness generation of the scheme. Issue of Government Order.

Who needs to be consulted

Officials of the Department of Health & Family Welfare; MOs.




Chances of Replication

The scheme has been slow in taking off in West Bengal. This was due to a lack of proper dissemination of information to both beneficiaries and MOs and the fact that timings were not suitable for the beneficiaries.


Timely payment to service providers and Government order for participation of MOs are required for successful implementation of the scheme.


Submitted By

Clare Kitchen, Research Consultant, ECTA, New Delhi. November 2004.

Status Active
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