Around 75 percent of doctors across India have faced some form of violence, according to a study by the Indian Medical Association
The attack and injury of several junior doctors of NRS Hospital in Kolkata, West Bengal by family members of a 75-year-old deceased patient, accusing doctors for alleged negligence in treatment, has brought to fore the dangers faced by doctors in India.
The attack has now snowballed into a state-wide doctors’ agitation. Doctors have hit roads, hundreds of government doctors have put-in their papers, out-patient divisions (OPDs) of private hospitals were shut down and there was disruption of healthcare services in the state. The agitating doctors in West Bengal have received solidarity from medical fraternity across the country.
Chief Minister Mamata Banerjee, who is also in-charge of the state’s health ministry, was said to be slow while reacting and let the agitation escalate.
The issue also took a communal turn. The Bharatiya Janata Party (BJP), the main opposition party in West Bengal, blamed the state government for not acting against the attackers as they belonged to a particular community, that they allege Banerjee has been appeasing for years.
Banerjee finally blinked and issued a statement four days later, appealing junior doctors to withdraw their agitation and resume their services as people were not receiving treatment.
"Cancer patients, kidney patients, accident victims, even children coming from distant places are suffering for not getting treatment," Banerjee said.
She added that five people had been arrested and their bail applications had been rejected by the court.
"An enquiry has be started to look into the issues from all sides. The government has taken all necessary action, whatever required," she said.
Reasons for attack on doctors
Assaults on doctors by patient's family members and relatives is not isolated to West Bengal. There are numerous such cases of attacks on duty doctors and vandalism of hospitals across the country.
Around 75 percent of doctors across the country have faced some form of violence, according to a study by Indian Medical Association (IMA).
More than half of those attacks were on doctors providing emergency services.
Many states have enacted the Prevention of Violence Against Medicare Persons and Institutions Acts, to punish people who attack doctors and damage hospital property. However, the enforcement has been a problem. The conviction rate is extremely low.
Doctors and their professional bodies have been appealing the government for a Central law, with tougher penal action to make it deterrent for attackers.
The meagre spending on healthcare by the government is also putting tremendous burden on government hospitals.
Neeraj Nagpal, Convener, Medicos Legal Action Group (MLAG), a qualified doctors’ trust that takes legal action on issues which adversely affect the medical profession in India, in his paper 'Incidents of violence against doctors in India: Can these be prevented?' argues that violence against doctors in India is due to the poor conditions in which patients are treated in government hospitals.
"There is overcrowding, long waiting time to meet doctors, absence of a congenial environment, multiple visits to get investigations done as well as consult doctors, sharing a bed by two and sometimes three patients and poor hygiene and sanitation. There is frustration with systemic problems of government hospitals, from dysfunctional equipment to shortage of staff," he said.
Nagpal states that only 1.06 lakh doctors are employed by the government in India, of the 9.38 lakh doctors registered to provide healthcare to a population over 120 crore. Of these, only 27,355 are posted at primary health centres (PHCs), which serve the rural population.
"With poor infrastructure and no increase in the number of posts for government doctors over the past many decades, despite an increasing population, the public healthcare system is on the verge of collapse. Violence against the health service provider is only a symptom of this crippling underlying malady," Nagpal said.
With under investment in public healthcare and government transforming itself from provider to payer, there is an over-reliance on private establishments to provide healthcare. This has also led to commercialisation of healthcare and a general feeling of suspicion among people.
There is also lack of awareness on grievance redressal mechanism if a patient or their family members have a case of medical negligence against a doctor or a hospital. Even if patient goes through grievance redressal mechanism, there is little guarantee that they would get justice.
All this has resulted in trust deficit between public and doctors. Section of doctors blame it on media for widening trust deficit by sensationalising few cases of lapses.But there is no way out. All stakeholders, including the government, doctors, hospitals administrators, civil society and media should come together to find a solution for this menace. Doctors running for cover for their lives is bad for the state of healthcare.The Great Diwali Discount!
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