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Killer clinics and welfare governments!

Prof. S. Balasubramanian
Wednesday, November 1, 2017, 08:00 Hrs  [IST]

Almost every fortnight we get one or other bad news about our Indian hospitals. It ranges from bribing a ward boy to carrying dead body of a relative from hospital on the shoulder or bicycle to deaths of dozens of patients due to medical negligence. If you are a regular reader of daily news papers you will be astonished to read them at regular intervals and if you are with melting heart and empathy for the fellow human beings too, you will experience anger and helplessness to frustration at the end. What is happening in this beautiful country of saints and mahatmas? What our welfare governments are doing? Are they alive or dead?

Stone heart
Corruption which engulfed the entire nation starting from the bureaucracy to politician has not spared even our doctors and hospital managements who are supposed to be above board because of their dealing with suffering patients. How can a doctor who treat a patient with intolerable pain and agony due to disease get the heart to cheat him, we cannot imagine. Has his heart become a rock?

News headings
Have you got the chance to read or remember the following news headings appeared recently in leading news papers of India? ‘Govt yet to bar pharmaceutical companies from bribing doctors’;  ‘Indians spend on stents is equal to 40% of Union health budget’;  ‘The cuts that complicate efforts to cap stent price;  'It would be catastrophic to follow high cost health care model of US’  ‘Not only stents other high cost devices too bleed patients dry’; ‘Imported catheters sold at 500% markup, finds probe, Hospitals making most gain, reveals Maha FDA’; ‘Med. Negligence: Biggies in health sector de-empanelled, Pvt hospitals accused of inflating bills’; ‘Why you pay 2 to 5 times the whole sale price: Medical devices: How patients are exploited everyday’; ‘Hospitals reuse disposables, pocket profits’; ‘Misuse of high end antibiotics is rampant in hospitals says doctors’; ‘One Indian women dies every 5 minutes during pregnancy and child birth – WHO’;  ‘Kickbacks among doctors wide spread since 1950s says senior doctor’; ‘Physician heal thyself: How graft affected NRHM in UP, the CBI has filed 82 cases so far’; ‘Free pizzas can influence doctors' prescriptions: Study’;  ‘Refusing to give free treatment - Rs.600 crore fine for 5 Delhi hospitals’;  ‘SC issues notice to Vellore College for Rotavac data kept secret; Rs 15,000 Vs Rs 800: Why hospitals make you buy costly drugs, get medicines cheap and sell at a premium’; ‘Thousands of Pvt healthcare units evade IT net, says CAG’; [Times of India and The Hindu]. The list is very long; due to space constraint let me stop with this. Are our so called welfare govts not aware of this? What they are doing?

Medical council and medical education
What about the origins - Medical education and Medical council of India? Let us once again go through the news flashes. ‘British Medical Journal questions ‘tainted’ Desai appointment; has became Prez of world Med Assn’. [Desai who was the president of MCI was jailed in a corruption case. He was nominated not only to MCI but also to Dental council of India by the Gujarat Govt, even though there are thousands of eligible dentists in the state. Desai episode and other malpractices of MCI leads ultimately to its dissolution and formation of a committee to head it] Even after that ‘MCI says corporate can run medical colleges’; ‘Doctors flay bill [by Niti Aayog] to restructure regulation of medical education, jobs’. ‘It is merely championing accelerated privatization and commercialization of medical education, they say’.

This acceleration is in spite of the fact that there is huge shortage of specialist medical teachers in the country. But, corporate are ready to start medical colleges. Who will lose a chance to mint money? They can throw any amount to lure and hire senior teachers and thereby deprive government hospitals of senior faculties. The big salary is nothing but a bait to catch even bigger fish in the form of sale of MBBS/MD/MS seats for them. The following news clips prove the situation. ‘New AIIMS struggle with nonexistent staff’. ‘The vacancies in faculty posts in AIIMS ranging from 56% in Bhubaneswar to 82% in Bhopal. The health minister told Parliament that these vacancies have not been filled due to lack of high caliber professionals’.  Where the situation has leaded to, you know? Read the next news: ‘Karnataka govt to go for bidding for specialist doctors’; ‘There are 1035 specialists post remain vacant in Karnataka hospitals, doctors can quote the pay package they expect to serve in Govt hospitals’ [TOI 4.7.17]. So you are forced to go to the looting private hospitals to get crucial treatments! Can you understand the gravity of mindless privatization? Not only that as a result of huge vacancies in Govt hospitals, “Burnout high among Indian doctors” ‘It is worrying because doctors suffering from burnout may lack empathy towards their patients or have impaired judgment’ [TOI 7.1.17].

What to do?
All these problems are due to privatization of medical education and healthcare.  Indian Govt is not willing to raise the budget allocation for health care sector, even after hundreds of well meaning people demanded it. On the other hand it goes in opposite direction by reducing funds for health care, TOI reports on 21.3.17: “Parliament panel slams govt on health funding. Shortfall of over Rs 7,000 crore in this year’s allocation for National Health Mission” It said against the projected demand of Rs 34,316 crore for 2017-18 under the NHM, the allocation in the 2017-18 budget is only Rs 26,691 crore leaving a shortfall of Rs 7,625 crore!

As the successive governments are not allocating sufficient funds for healthcare, people are compelled to spend from their pocket for their health care needs. This amount is nil or negligible in Cuba, only 5% in Denmark, 18% in the UK, 44% in China and 52% in US, whereas Indians are forced to spend more than 70% of their healthcare costs.

Selfish bureaucrats
In these circumstances what our Central government run by bureaucracy is doing you know? It spends Rs 4,895 per year per Central govt employee covered under Central Govt Health Scheme [CGHS], while the average public spending for the health of all Indians is about a fifth of that amount [less than Rs 1000]. There is clearly some scandalous selective prioritizing writes Dr. Kiran in TOI [13.11.16]. How can we expect justice from such a government?

Unless and until general public – first the so called educated people – raise their voice, protest and force their MLAs and MPs to act nothing is going to change. Dear fellow Indians are you listening? When will you wake up?

(Author is ex-president, Indian Pharmacy Graduates Association, Madurai, Tamil Nadu)

 

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