Pvt hospitals bill needs a relook

Unfortunately, a lot of controversy and mistrust between the medical fraternity and the state government has been generated by the introduction of the Karnataka Private Medical Establishments (Amendment) Bill – 2017.

We witnessed the unusual situation of thousands of doctors, healthcare workers and representatives of medical establishments taking to the streets to request the government to reconsider the provisions of the bill.

Though all of us would like the common man and our  patients to be treated well and get the benefits of modern healthcare, we believe that some of the provisions in the bill are unfair and draconian.

First and foremost is the introduction of price control. In the era of free market economy, this will destroy the private  healthcare  industry which controls over 70% of tertiary healthcare for sure. It is important to point out that this 70% includes a large no of neighbourhood small hospitals and mission hospitals which are in Tier 2 and 3 cities and not just large corporate hospitals in the metros.

If this Bill is enacted in the current form, we may have to go back to the olden  days of `control raj’ where for any serious ailment you had to go out of the state or country for treatment because no one would dare invest in the private hospital industry any more.

Unfortunately, the private sector had to fill in the vacuum created by very poor facilities in the public sector because of lack of funding (less than 2% of GDP for healthcare), poor infrastructure, inability to attract talent etc. We feel it is unfair to only target the private sector when healthcare should be a fundamental right and the government should also be equally, if not more responsible, to provide this.

The general impression that public healthcare is free is a myth because it is the tax payer who fund this and it is the public money that is utilised as against private investment in the private sector hospitals.

Hence, whatever rules are made, it should encompass both the sectors as was mentioned in the report of the Justice Vikramjit Sen committee, constituted by the government.

Some of the provisions of imprisonment and hefty fines seem draconian. There are already many regulatory bodies like the medical councils, consumer courts and the judiciary to protect the citizens and adding one more layer will only lead to more confusion.

Though it may be true that there are some rotten apples in the medical community like in other sections of the society, it is unjust to label the entire community as corrupt and dishonest.

Since all of us have the common interest  of providing the best of medical  care to our fellow citizens, we need to work together in coming out with reasonable, fair solutions to these problems. It would be very unfortunate if we get into the we (private) vs them (the government) in providing the fundamental right of healthcare for all.


Way forward

What is the way forward? Certainly, everyone would agree that emergency care needs to be offered in all cases and we need to prevent exploitation and price gouging by any healthcare provider.

The way forward would be to strengthen the public sector especially in rural and semi-urban areas in the fields of preventive, primary and secondary care. Any government spending on preventive, primary healthcare saves a lot more lives than funding tertiary and quaternary care.

Look at universal healthcare like the medicare in the USA and NHS in the UK with a reasonable reimbursement for the care delivered after holding dialogues with experts and representatives from both the public and private sector.

The government should don the role of an insurer rather than provider of healthcare especially in tertiary and quaternary care. Most of all, let us not destroy the faith the public have on doctors and healthcare facilities by insinuations that they are all rotten and need to be fixed.

(The writer is chairman of Manipal Hospitals, Bengaluru)

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