Tryst with Health
Approximately 3 million years of healthy life are lost in India each year due to medical errors, as per the landmark report by an Indian doctor from Harvard School of Public Health!
Cases relating to medical negligence are piling up in courts! It is understood that a major chunk of 3.5 lakh pending cases in Consumer Forums across country relate to this segment!
Here are some more eye-openers:
In the path-breaking case of Indian Medical Association V/s V.P. Shantha, (AIR 1996 SC 550) the Supreme Court had upheld that a doctor can be held liable under Consumer Protection Act 1986 for deficiency of service. There have also been some landmark cases like that of US-based doctor Kunal Saha, whose wife had died in 1998 due to negligence of some doctors in Kolkata. After fighting for 12 long years, the National Commission ordered compensation of Rs 1.73 crores in 2011, which was further enhanced to around Rs 6 crores by the Supreme Court during 2013!
The Medical Council of India (MCI) was set up to regulate medical profession. MCI and State Medical Councils are empowered to take disciplinary action when prescribed Code of Ethics is not observed by the doctors. They are even empowered to debar doctors from practising medicine. Had they acted on their mandate, Courts would have been spared of thousands of cases being filed due to unethical medical practices! And consumers would have been spared of the trauma of unending fight to safeguard their right to health!
Despite huge network of hospitals, dispensaries and sub-centres set up by the Government in each and every State, 80% patients still prefer to go to private sector! This may be due to absenteeism of doctors and paramedic staff, coupled with poor upkeep, lack of medicines, non-functioning of testing facilities etc.
Lack of confidence in Govt health facilities drives people, particularly in rural areas and urban slums to quacks. It is estimated that Delhi alone has around 40,000 quacks! Balwant Rai Arora, a quack, allegedly gave 50,000 fake MBBS degrees by his fake institute located in Uttam Nagar, Delhi, since 1995.
The urban middle class often takes recourse to private hospitals, which are being set up by big business houses on commercial lines. The doctor-patient relationship, which used to be of utmost faith, is dwindling. Medicine has become a business and patients are treated as clients or customers – or better still – cows, waiting to be milked!
Trade in Human Organs, though illegal, is flourishing. The victims of poverty have either willingly sold kidneys or have been duped to give up their kidneys unknowingly for little sums of money. This is not possible without involvement of Doctors.
Unholy Nexus between Doctors and Pharmaceutical Companies is leaving huge holes in the common man’s pockets. Drug companies in USA have to reveal on their website how much they spend on doctors. Why not in India? Are we not ready to address such inconvenient but crucial issues?
Prenatal sex determination tests, though illegal in India, are flourishing. The magnitude of the problem can be visualized by the declining trend of child sex-ratio (0-6 year old). Even in Delhi, the capital city of India, it is seeing constant decline, from 915 females per 1000 males as per 1991 Census, to 868 in 2001 and 866 in 2011!
Doctors are not allowed to advertise. But they are advertising not only their hospital/ clinic but also soaps and toothpaste!
Health issues have received the priority attention that they deserve in all the campaigns and activities undertaken by Consumers India at national and international fora.
Consumers India has taken up vigorous advocacy campaigns regarding major concerns relating to unethical medical practices, access to affordable drugs and other issues concerning health and well being of consumers. Multi-pronged strategies are being adopted including research, making appeals to Prime Minister, Chairman, National Human Rights Commission, Health Minister and others in position of power etc
Some such campaigns are briefly mentioned below.
Save us from unethical medical practices, Mr Prime Minister
The Medical Council of India (MCI) was set up to regulate medical profession. MCI and State Medical Councils are empowered to take disciplinary action when prescribed Code of Ethics is not observed by the doctors. They are even empowered to debar doctors from practicing medicine. Had they acted on their mandate, Courts would have been spared of thousands of cases being filed due to unethical medical practices! It is time, Regulatory Agencies are made to deliver on their mandate! Series of letters were sent to authorities in this regard.
Implement Supreme Court Judgment regarding treatment of poor patients in Private Hospitals in letter and spirit
Supreme Court had ordered that 10 per cent of the total beds in IPD must be reserved and 25 per cent of the patients in the OPD should be treated free of cost in private hospitals in Delhi if the patient belonged to the Economically Weaker Sections. Despite this judgment, newspapers have been reporting ‘50% beds for poor vacant in 45 pvt hospitals’ etc. This too at a time when most city hospitals were flooded with patients and there was a crisis of beds! A group of interns with Consumers India had also studied ‘Implementation of Supreme Court Judgement regarding treatment of poor patients in private hospitals’ and highlighted several inadequacies in implementation of this judgment. This issue was taken up with Chief Minister of Delhi, National Human Rights Commission and others.
We want Action, not Lip-service for Affordable Drugs, Mr Prime Minister
As a results of strong advocacy campaign regarding access to affordable drugs launched by Consumers India and others, the Govt has increased the number of drugs in the National List of Essential Medicines (NLEM) from 74 to 348 and has approved the criteria of fixing the ceiling price of these 348 drugs by adopting the simple average price of all the brands having market share of 1% or more. Though this is not as good as Consumers India had campaigned for, it has definitely provided some relief to consumers and paved the way for many more campaigns along the way!
The inadequacies within the Drug Pricing Policy and Drug Price Control Order (DPCO-13) were brought to the notice of Prime Minister and others. For example, Fixed Dose Combinations (FDCs) have not been brought within ambit of price control. This would mean that about 80% of the paracetamol market and 70% of anti-diabetic market would remain outside DPCO 2013!
Make Organ Donation a Viable Option, Mr Prime Minister
A group of students, led by Nyamat Bindra (Pol Sc (H)- JMC, DU) found in their study titled ‘A Study of Organ Donation in India - in Theory and Practice’ during internship with Consumers India that even though 71% agreed that they would donate their organs, India’s organ donation record is abysmally low, leading to avoidable human suffering and deaths. The major findings emanating from this study have been shared with Prime Minister, Health Minister and others with an appeal to ensure that the benefits of scientific advancements in the field of organ donation reach the masses.
Here are some facts
- There is a huge gap between demand and supply of human organs and tissues. In our country around 1.5 lakh patients require kidney transplantation but only 4000 patients receive it. Similarly, 1 lakh patients are in need of corneal transplantation but only 25000 patients undergo corneal transplant. In case of heart transplantation, the scenario is much more dismal.
- It is necessary to introduce ‘Presumed Consent’ system to fulfil this tremendous gap between demand and supply. In this system, every citizen donates his/her organs upon death, by law, unless opted otherwise. Several European countries are following this system, resulting in much higher donation rates as compared to others.
- Another option could be to adopt a policy of "mandated choice", on the pattern adopted by Illinois State of USA. This requires driver's license registrants to answer the question “Do you want to be an organ donor?”
- The organ trafficking trade is flourishing in India. Vulnerable people are duped into selling their organs. It is estimated that 10,000 black market operations involving purchase of human organs take place annually.
- There is immediate need to launch a National Helpline for Organ Donation. This Helpline should not only help people register as donor but also maintain liaison with hospitals having facility for organ retrieval to facilitate timely retrieval in the event of the death of a willing donor. The family of the Organ Donor should not feel harassed due to delays and cumbersome procedures. The Telephone Number to be contacted for organ retrieval from the deceased should be widely publicized.
When will you save us from medical waste?
Hospital wastes are causing widespread damage to human health and environment due to spread of infection and disease through vectors, unauthorized recycling of disposable items, reaction due to use of discarded medicines, indiscriminate disposal of incinerator ash/ residues and percolation of radioactive drugs into the soil and ground water, to name a few. The National Green Tribunal has reportedly said that nine hospitals in Delhi are flouting with impunity rules laid down for safe disposal of highly infectious biomedical waste.
Aditi Chaturvedi, B Tech in Electronics & Communication from DCE and Bhanu, B Com (H) student of Delhi University had highlighted serious concerns for consumers in the study conducted by them on this subject during internship with Consumers India. The issues highlighted by them were taken up with the Chief Minister of Delhi and others.
The Future We Want For the Health of the Nations of the World
With ‘Millennium Development Goals’ (MDGs) set by United Nations at the beginning of the 21st century reaching full circle by 2015, this is the time to think about new generation of development goals. A detailed write up titled ‘The Future We Want For the Health of the Nations of the World’ was prepared by Dr Jayashree Gupta, President, Consumers India and was widely circulated amongst policy makers, UN organizations and others. It has been suggested that Post-MDG Agenda for health care should have following major goals:
Goal 1. Sustain the momentum for health-care built by MDGs.
Goal 2. Ensure Access to Affordable Drugs.
Goal 3. Reduce the Incidence of Non Communicable Diseases.
Goal 4. Stop Unethical Medical Practices.
Goal 5. Provide Geriatric and Palliative Care.
Full text of write up can be seen at the following link :-
Further details may be seen on following link :-