Patiala, Feb. 21 -- Despite the Punjab government's stated aim of reducing out-of-pocket expenditure for healthcare, a large number of patients visiting sub-divisional hospitals and district hospitals are not receiving in-house radio-diagnostic services, such as ultrasound and CT scans. The findings have emerged in the government's own patient feedback survey at these hospitals, accessed by Hindustan Times. The survey was discussed at the two-day Civil Surgeon Conference held on February 16-17, which was attended by Punjab health minister Dr Balbir Singh. The survey received responses from 18,244 patients across 23 district hospitals and 9,958 patients at 36 sub-divisional hospitals (SDHs). According to the data, 37% patients at district hospitals did not receive in-house ultrasound services, while the figure rose sharply to 52% at sub-divisional hospitals. The situation is equally concerning for CT scans, which were inaccessible to 17% and 47% patients at these facilities, respectively. It is pertinent to note that the Punjab government provides ultrasound and CT scan tests at subsidised rates either through in-house facilities or at empanelled private radio-diagnostic centres. The gap was most stark at the Rupnagar district hospital, where 79% patients could not get an ultrasound done, followed by nearly 52% similar patients at the Patiala district hospital. In the absence of the facilities, patients are compelled to approach private radio-diagnostic centres, often at higher costs. Health officials and patients alleged that a nexus between private diagnostic centres and government doctors was rampant at several district and sub-divisional hospitals. Health officials told HT that the shortage of radiologists and long pendency of cases force the patients - especially those from economically weaker sections - to seek services from private diagnostic centres. Confirming the issue, a senior health official, requesting anonymity, said, "We have already warned the civil surgeons and senior medical officers over this. They have been directed to ensure ultrasounds are conducted through empanelled private centres if in-house services are not available. Kumar Rahul, principal secretary, health and family welfare, did not respond to repeated calls and messages. The patient feedback survey also highlights a shortage of medicines at these hospitals. Punjab government data accessed by HT shows that only 67% patients received medicines at district hospitals and 69% at sub-divisional hospitals. In most cases, medicines account for the largest share of out-of-pocket expenditure. Their unavailability at government hospitals is furtherpushing patients into financial distress....