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Saturday, September 13, 2003

While we boast of having one of the world’s largest trained manpower pools in health care sector and a world-class pharmaceutical industry, there are many problems afflicting our health care system. Three critical issues standout. First, most people do not have access to health care of acceptable standards. Second, whatever is available is unaffordable to the bulk of our population. And third, there is absolute lack of accountability. Let us examine the issue of lack of accountability.

Many of us have either directly or indirectly experienced the trauma of a loved one being subjected to unwarranted pain and hardship either due to criminal negligence or gross incompetence of a physician. I keep getting numerous calls from suffering patients and their family members seeking justice and relief. Many a time even the wealthy and powerful sections of society have no recourse when faced with medical malpractice. I would like to cite two incidents to illustrate the crisis afflicting our health care system due to medical malpractice.

Dr Kunal Saha and his wife Dr Anuradha Saha (a child psychologist) were both trained in the US and were visiting their hometown Kolkata on vacation. Dr Anuradha developed a skin allergy for which she received treatment from two eminent doctors. She fell victim to brutal medical negligence/malpractice (administration of excessive steroids/ lack of supportive therapy) and died. A local court convicted the two doctors for rash and negligent treatment and sentenced them to just 3 months rigorous imprisonment and imposed a fine of Rs.3,000. Despite their conviction, the Indian Medical Council, the professional regulatory body exonerated both the doctors and refused to deregister them.

Closer to home, Srilatha a graduate in computer science from the US, wife of an officer of the Indian Foreign Service and daughter of a leading attorney in Hyderabad, died in a city hospital during delivery, due to the gross negligence of doctors supposedly attending on her. She was in perfect health and in fact walked into the labour room, where she fell victim to gross negligence and malpractice by the doctors. She died because of excessive dose of drugs, improperly administered epidural anaesthesia and bad management of complications. A few hours after she walked in, Srilatha’s dead body was handed over by the attending doctors, without even delivering the baby either by normal or caesarean section.

In any other mature democracy, in both the instances, the doctors would have received severe punishment and faced disciplinary proceedings from their professional regulatory agency. But alas, we are yet to develop systems of professional accountability in India.

It is not my intention to paint all doctors as members of a deadly tribe. I had the privilege of being trained as a medical professional and know only too well how demanding a profession it is. There are countless number of doctors who are doing yeoman service in every nook and corner of India, both in public and private sector. It is these great physicians who earn the undying gratitude of the community. But a minority of unscrupulous and negligent doctors are besmirching the profession.

The other day a gentleman who was trying to take legal action against the hospital and doctors whose negligence caused untold hardship to his wife was narrating how no other doctor was willing to testify against their professional colleagues! Trade union mentality doesn’t do justice to the noble medical profession. The society needs the services of high quality medical professionals; and physicians earn their livelihood from the society. They cannot afford to have an adversarial relationship. The profession and the society need to develop a culture of mutual respect and trust.

In many countries there is an internal regulatory mechanism for the medical profession. Even in India, the Medical Council of India (MCI) is supposed to be the custodian of the profession, but has grossly failed in its responsibilities. Certain members of the MCI are notorious only for taking bribes and giving licenses for setting up new medical colleges! The medical profession should introspect and evolve clear guidelines for ethical and professional conduct. The internal regulatory framework should ensure exemplary punishment for the erring doctor and justice for the victim. Only then will society regain a measure of trust and respect towards the medical community. That will benefit both the community and the profession.