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The government and the Indian Medical Association (IMA), has drafted an act to advocate a central law specifically to address the issue of violence against doctors and to send out a strong message to the public. The government is already toying with the idea of a 10-year jail term, and a fine of Rs 5 lakh, for any person found guilty of physically or mentally abusing doctors, whether inside a clinic, or in close proximity of the clinic, or on home visits.
In a recent interview to the Hindustan Times, Harsh Vardhan, the Union health minister, condemned the violence at NRS hospital in Kolkata which had started a nationwide doctors’ strike in June. He said that a 10-member committee had been constituted, representing diverse stakeholders, who will look into the issue of violent outbreaks in hospitals. Also, the involved ministries agreed on the need for a central legislation with renewed discussions on a draft act submitted by the IMA in 2017. It has been shared with the states for their response.
The proposed Protection of Medical Service Persons and Medical Service Institutions Act, 2017, recommend a 10-year imprisonment term and a penalty of Rs 5 lakhs for physically attacking doctors and healthcare professionals. It wants to label such violence as an offence which is cognisable, non-bailable, non-compoundable, and just for trial by a court of the Judicial Magistrate of First Class. It also has provisions which will address damage to property, and make a lawbreaker pay double the price of the damaged property as compensation.
It is very important to provide a safe professional environment for doctors to work, and violence in no form can be overlooked, the suggestion of this draft are troubling. The provisions appear especially unforgiving given that medical negligence, even when resulting in death, carries a jail term of only two years, with or without a fine.
According to news reports, a recent Harvard University study has claimed that up to 5 million people in India suffer due to medical negligence annually. If this report is true, and the process currently in place for redressal directly put the burden of proof on the complainant, it becomes apparent that the system is far more geared to protect practitioners than patients. Patient families have to fight long and difficult battles in order to receive any compensation for medical mistake, many of which involve private hospitals and the privileged classes.
For the poor population, who are mainly dependent on public healthcare, navigating through the system is an even more difficult challenge. In cases of medical malpractice, their only option is to quietly accept their fate and the draft act of the IMA will end up institutionalising. An eye for eye is unacceptable, but one has to discard quick-fix, knee-jerk reactions to resolve the problem of violence against doctors. The present need of the hour is a systemic change. The terrible condition of primary healthcare, both in terms of infrastructure and personnel, requires urgent attention. Instead of providing security at public hospitals, addressing the problem of staff shortage, for example, could go a long way in pacifying public grievance. This is a difficult battle for the IMA to fight and as an alternative, it chooses to see it as a law and order issue.
The Indian Penal Code (IPC) has a lot of laws which deal with violence. An inflexible new law, specifically to protect doctors, as recommended by the IMA, will primarily discriminate against those who are already battling the structural violence unleashed on them by the State.
Media has accounted of the death of Mohammad Sayeed, the 75-year-old who died in Kolkata’s NRS Hospital, as quoted by the family members that there was a 40-minute delay in administering a lifesaving injection. Frustrated by this delay that no one was paying attention to their repeated requests, one of the relative pulled a doctor by his hand and asked him to attend to the ailing patient, for which they even had tendered an apology. The relatives allege that the doctors attacked them with hockey sticks and bamboo poles, when they asked for the body to be released and the police looked on without interfering. The family later lodged FIRs against three NRS doctors. Though, justice for doctors is being chased with great enthusiasm, the claims of medical negligence and assault by doctors has no grip.
The key question remains that what alternative do the poor of this country have in cases when doctors do not prioritise and attend to patient needs? It is time to think not only of doctors, but also of patients.