Events
& Issues
New Delhi, 19 June
2019
Jr Doctors’ Strike
SAFETY A CRITICAL ISSUE
By Dr. Oishee Mukherjee
The junior doctors’ strike
in West Bengal has drawn sharp focus on safety of doctors while discharging their
duties. The issue turns out critical yet again, as their colleagues across
States, be it in Maharashtra, UP, Kerala, Bihar etc joined the one-day
nationwide protest on Monday last called by the Indian Medical Association. On
the one hand, doctors expressed solidarity with their colleagues and on the
other patients were at the receiving end with many facilities at hospitals
closed down.
According to IMA
estimates, over 75 per cent of doctors in the country face at least some form
of violence. Its study revealed that doctors face maximum violence when
providing emergency services with as many as 48.8 per cent of such incidents
reported from intensive care units or after a patient had undergone surgery. And
the worst-hit are the junior doctors, who have maximum interface with patients.
The Kolkata High
Court thus reminding the striking doctors of the Hippocratic Oath to ensure
welfare of patients is not much of a help, as harassment, not to speak of
violence, appears to have become the norm in hospitals across the country. And
as is typical of a government, Mamata Banerjee’s administration is now to
report back on steps taken, if any, on the attack on junior doctors, at the NRS
Medical College and hospital, after the death of a patient.
Likewise, at best
Union Health Minister Harsh Vardhan says he has written to all States requesting
Chief Ministers ‘to bring specific laws to protect doctors.’ Plus, he assures
‘at central level, if we can do something, we’ll revisit the issue...Everybody
has to be sure about it that we are well-intentioned. The aim is to ensure that
such incidents are never repeated in this country.”
The problem, however,
is not simple to resolve, and wishing strike by the doctors and health workers
cannot be wished away. More so, as meagre facilities impact their work, as
there is poor allocation of funds by both the Centre and State Governments for
health. In fact, the country’s allocation in health sector is below 2 per cent
of GDP, which is much less than other comparable emerging economies. The
distressing fact is that there is no pressure and worse our political leaders
are quite oblivious to the sorry state of affairs in the country’s government
hospitals.
Every day these hospitals
are flooded with people and it is indeed difficult with the existing
infrastructure in most hospitals specially in States like Bengal, to tackle the
unending stream of patients. One is well aware of the fact that admission in
hospitals, not just in Bengal but in most States of Eastern India, is indeed hindered
due to severe scarcity of beds.
Apart from this, very
few hospitals have modern equipments, more OTs and necessary infrastructure to
treat very critical patients, who may need to be operated within a few hours. Like
Mamata many others have too voiced concern at treatment being stopped to needy
patients through strikes but have never said that the number of hospitals in
the State is inadequate. What they fail to address is why patients have to
travel long distances to come to Kolkata or other cosmopolitan cities to get
specialised treatment?
There is little
endeavour by the authorities, spanning across major political parties and
governments, to increase the number of hospitals and ensure there are at least
one or two big and specialised hospital in each district and two or three in
each sub-division with adequate doctors, specialist doctors and nurses.
Noted cardiac
surgeon, Dr Devi Shetty among others has repeatedly emphasised the need to
increase the number of hospitals as also number of seats in graduate and post
graduate courses in medical and dental sectors. The lack of health
infrastructure has been discussed and debated at length in the powers of
corridor but no concrete plan endorsed.
One obvious reason
may be due to the fact that those at helm of decision making -- whether
politicians or bureaucrats -- come from the upper echelons of society and are least
affected by the condition of government hospitals where the ordinary mass of
people go. They would end up either getting admitted hospitals like AIIMS in
Delhi and other cities or SSKM in Kolkata, where VIP wards are reserved for
them and specialists doing regular rounds. Plus, the luxury of fancy private
hospitals, now in business, is where they can get treated with no pinch to the
wallet as the treatment amount would be reimbursed!
Who cares about the agony
of the poor? Those who have to travel long distances to get to a specialised
hospital, end up in long queues for enrolling themselves, long wait for the doctor,
etc, would be on the edge and are bound to have a negative reaction, if something goes drastically wrong.
Thus, telling doctors
about their duty is quite easy but what about the State accepting its duty and
obligation to provide health care to all citizens, specially those belonging to
the lower strata of the population? It is a well known fact that in most
districts people are sent from health centres and government hospitals to
private nursing homes due to lack of infrastructure to treat patients. Is the
government unaware of the fact that health has emerged as an area of business,
where profits are assured unlike many other business areas?
Therefore, it can
very well be said that since the Government has not cared for the health of the
community, the burden cannot be transferred to the doctors. The best students
join the medical and dental profession and passing the buck on to them, denying
them the right to protest against violence and harassment of their fellow
brethren is clear unfair.
And while some may quote
a judgment way back in 1996, it rarely will help. The order stated: “Article 21
imposes an obligation on the State to safeguard the right to life of every
person. Preservation of human life is thus of paramount importance. The
government hospitals run by the State and the medical officers employed therein
are duty bound to extend medical assistance for preserving human life. Failure
on the part of a government hospital to provide timely medical treatment to a
person in need of such treatment results in violation of his right to life
guaranteed under Article 21”.
However, there is no
such judgment, which has gone deep into the problem of around hundred patients
flooding each department in government hospitals. There is no available data on
how many government hospitals are needed to cater to the needs of the
economically weaker sections and the middle income groups in the country. Time
it is done.
The IMA and doctors’ organisations
such as Alliance of Doctors for Ethical Healthcare (ADEH) have had to insist
that the Government frame a Central law to check violence against health care
workers in hospitals. In a letter to Union Home Minister, the IMA has urged “to
bring a Central legislation in the form of special law against violence on
doctors and health care establishments”.
While the legislation
is indeed welcome, both Central and State government should also work out a
plan of extending health care services in the district and sub-divisional towns
to ease the pressure on government doctors in metro cities. Earlier the better,
as doctors will get more time to attend to patients and treat them well. As the
adage goes a stitch in time will save nine. ---INFA
(Copyright, India
News & Feature Alliance)
|