Two doctors at the Dept. of Ophthalmology, Government Medical College and Hospital (GMCH) in Nagpur were arrested by the police on January 29 on the allegation of taking Rs 3000/- from a patients relative for giving injection Avastin for retinal surgery. There were released on bail on January 31. A departmental inquiry is on, as reported by TOI, February 3, 2018. The explanation available was that doctors were helping the patients by buying the Avastin injection multidose vial and making them available to the patients at shared cost without profits.

As per the Government rules, the doctors practicing in Government hospitals cannot charge their patient for any service or medicine dispensed by them, more specifically, if the doctor is working in a government hospital, which is not charging any fees from its patients at all.  

Thus, if any doctor is charging any money from his/her patient separately, then such an act is an illegal act and is punishable under law.

Also, the doctors or any paramedical staff or any employee of Government Hospital cannot take any donation of money or used medicines, whether in cash or kind from any person in absence of any rule framed by such government hospital. 

“Right is right even if no one is doing it; wrong is wrong even if everyone is doing it”, so goes a famous saying.

However, if any doctor working in a government hospital is willing to help his/her patient then he should do the same as per the rules framed by the Government Hospital, Government Rules and more specifically as per law.

The Hon’ble High Court of Delhi in the matter titled as “Mohd. Ahmed (Minor) vs Union Of India & Ors.” on 17 April, 2014 has dealt with the issue of charitable activities of government hospital and has suggested that all government hospitals should have a separate charitable entity/account wherein donations can be received. It held that:

“81. This Court suggests that both the Central and State Governments should consider the following suggestions:

1. All government hospitals could have a separate CSR/ Charitable entity/account wherein donations can be received. The donations could be subject to an audit.
2. Each hospital could have a designated officer, to whom applications for assistance can be made by patients in need. The decision to whom financial assistance could be provided, be left to the Medical Superintendent/CEO of the Hospital along with Head of the Departments. Delhi could be adopted as the first model state.

    iii.        The Ministries of Corporate Affairs and Finance could consider providing extra credit (for instance increased credit) for donations in certain sectors, such as health.

1. The Government could adopt a holistic approach to facilitate donations, so that the tax regime supports the said efforts.
2. All donations in cash and kind must be accounted for, with complete transparency to ensure no misuse or misappropriation of donations.
3. Government hospitals could put up list on the State Department of Health website of the drugs, implants and devices they require for EWS/BPL patients. This way people would donate as per the need of each hospital. This could be revised on a monthly basis.

  vii.        The State Government may put up a list of drugs, implants and devices which are excluded from its budget for which donations would be welcome.

 viii.        Both the Central and State Governments could create a revolving fund to take care of recurring expenditure of patients suffering from chronic and rare diseases.”

Thus, a ‘patient welfare fund’ should be established by the government hospital/s, which the needy patients can access to procure medications or devices. The doctors, para medical staff and other employees of the government hospitals should restrain themselves from charging separately from the patients and/or accepting donations in any kind from any person.

What this also could mean that all unused medicines etc. which the patient’s family may choose to hand over to the hospital would be a part of this ‘fund’. But, all such donations to the fund should be made transparent.

Ignorance of the law is never a defense. Establishing patient welfare funds by the government hospitals, as suggested by the Delhi High Court Judgement (cited above) is the right way to help the needy patients.

Dr KK Aggarwal

 Padma Shri Awardee Vice President CMAAO Group Editor-in-chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA