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Reforming healthcare the wrong way

Vatsala Vedantam Dec 2 2017, 0:39 IST

The Vikramjit Sen Committee had clearly said that there cannot be two sets of rules for private hospitals and state hospitals.

Image for representational purpose only.

Image for representational purpose only.

The recent doctors' strike in Karnataka took me back to the year 1991 when a surgeon in Mumbai dropped a needle into my eye during a retro-bulbar procedure prior to surgery. It was a gruesome accident resulting in partial loss of vision. Angry and helpless, I started consulting lawyers. One of them wisely advised me not to fight this doctor. He was the President's surgeon and a member of the Medical Council of India. I understood.

Months later, after much introspection, I made my peace with him and returned to his care. Both of us felt much better after that. He was a brilliant surgeon and he, too, must have suffered agonies. Today, I can view that incident from a different perspective. Medical professionals are human beings subject to committing human errors. They, too, must suffer extreme trauma when such accidents occur. The fault lies in patients who endow them with superhuman strengths.

We forgive professionals in other fields for mistakes they commit. Yet, why are we so unforgiving of doctors? Is it because they deal with matters of life and death? We rarely realise that when doctors are faced with life-threatening risks while treating or operating on patients, it takes courage to take those risks. The medical profession takes a toll on its practitioners as well. True, there are careless and callous doctors just as there are substandard hospitals and "nursing homes." They are the bad apples that need to be discarded.

The Karnataka Private Medical Establishments Amendment (KPME) Bill has condemned them all with one stroke, provoking doctors to strike work and hospitals to turn away patients. The medical profession in Karnataka has come under the scanner for lapses and negligence. Private hospitals have become suspect for unnecessary tests and procedures. Medicines and medical bills are leaving families bankrupt. In this daunting scenario, the Karnataka government has decided to discipline private hospitals, nursing homes and doctors through legislation and punishment including, in an earlier version, a jail term, which has now reportedly been dropped after the doctors' protests. Perhaps, the government should examine its own backyard first.

If the state public healthcare system functioned as it should, why would patients turn to private doctors or hospitals even to treat diseases like cancer that would leave them financially ruined? A visit to the shocking Kidwai Memorial Hospital will provide the answer. So do the hundreds of pathetic primary healthcare centres that are meant for the poorest citizens. The proposed legislation should aim at reforming medicare in all its forms in the state, instead of chastising only private hospitals and doctors who have saved millions of lives €“ even if at a price.

The Karnataka government itself had earlier appointed the Vikramjit Sen Committee, which had clearly said that there cannot be two sets of rules for private hospitals and state hospitals. Where was the need for an amendment bill now to allow government hospitals to go scot free for misdemeanours, especially when there are no social security schemes in place? Poor patients who are in need of free medical treatment are neither protected with insurance or influence. It is no secret that the latter plays a big role in this country. As such, they are the victims of sleaze in state hospitals and dispensaries.

When so much needs to be done in this sector to save the most deprived sections of the population, why has the state government trained its guns at the private medical sector only? Yes, they may charge patients exorbitantly for special wards, food and other amenities. As long as the medical treatment is not diluted for poor patients, no government can take action against hospitals which charge more for extra privileges and amenities. In fact, several well-known hospitals in the country, including the CMC in Vellore, charge higher rates for better facilities to ensure that the poorest patient gets the same medical treatment for free. The Karnataka government could simply rule that private hospitals have a two-tier system where rich patients in private wards pay more to support free treatment for poor patients in the general wards. That would be a better option than punishing them and forcing them to close down. On the other hand, the government would do better to put an end to the nexus between hospitals, doctors and diagnostic centres.

It takes a fortune to establish a really good hospital with state-of-the-art technology. Global hospitals do provide the best of medical services -- at a price. Medical education is also a costly proposition and doctors need to earn back what they spent in the first place. Having said that, medicine is also a humane profession and both hospitals and doctors need to practice it with humanity. This cannot be enforced through legislation. It has to be instilled through education.

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