Doctors cry for ‘clerical-error’ jail shield

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Doctors nationwide today asked the Centre to protect them against violence from patients’ relatives and modify multiple laws, including one they said threatens doctors with jail for “clerical errors” and another that might close down the smaller clinics.

The Indian Medical Association (IMA), a private body of doctors, has organised what it describes as the country’s largest congregation of medics here to articulate a “memorandum of demands” that association officials say seeks to address issues detrimental to doctors and patients.

A senior IMA official said that 53,767 doctors had signed a petition sent to the Union health ministry demanding a law or ordinance to curb violence against doctors and independent modifications to the Clinical Establishments Act of 2010 and the law that prohibits foetal sex determination.

The memorandum also urges the government to abandon a proposal to replace the Medical Council of India, an elected body, with a medical regulatory panel of nominated members.

“Doctors in India are unhappy – the government needs to take up each of these major issues,” IMA national president Krishan Kumar Aggarwal told PG Times.

“We’ve explained these concerns to senior health ministry officials; we now want the government to act quickly.”

Praveen Togadia, a cancer surgeon and international president of the Vishwa Hindu Parishad, was at the meeting and joined the calls for changes to the Clinical Establishments Act.

Although states such as Assam, Bihar, Jharkhand, Rajasthan and Uttar Pradesh have adopted the act, health activists say none of them has implemented its rules in full.

Togadia said: “The Clinical Establishment Act should be amended because in its present form, it will only hurt people.”

The act’s rules require nursing homes and hospitals to maintain what some IMA members say are “unrealistic standards”, including specific ratios of beds, doctors, paramedical staff and floor area.

Doctors fear that the smaller nursing homes and clinics might be forced to shut for their inability to maintain the required ratios.

“Most patients still seek treatment from small clinics. If they shut down, the patients will be forced to turn to corporate hospitals, which lack the capacity to meet the demand,” Togadia said.

He cited an example of how a corporate hospital might charge Rs 100,000 for a treatment service available at a smaller private clinic for Rs 10,000.

Sunil Kumar, a medical practitioner from Patna who was at the meeting, said the implementation of the Clinical Establishments Act would cause “nearly half of all clinics in rural Bihar” to shut down.

At least three private hospitals in Delhi kept their outpatient departments shut till 2pm today in “solidarity” with the IMA campaign, a senior doctor at one of these hospitals said.

“The most important thing that is uniting us is the violence against doctors. There is poor understanding of disease among most patients and their families, but the patients’ expectations are always high,” the doctor said.

The IMA estimates that three in four doctors in the country have during their career experienced violence from patients or their relatives.

Sex test row

The IMA is also demanding changes to the law that bans foetal sex determination and requires doctors to maintain detailed records of the ultrasound scans performed on every pregnant woman. The association says that doctors should not be punished for “clerical errors”, referring to lapses in record-keeping.

But this demand has angered health activists and women’s organisations, who view it as an “insidious attempt” to protect wrongdoing by doctors who reveal foetal sex for a price.

“The IMA has shrewdly combined this demand with its other demand of protecting doctors from violence,” said Sabu George, an activist tracking female foeticide for three decades.

“No one supports violence against doctors, but they are also trying to dilute the provisions in the sex determination law that will allow doctors to violate the law and escape scrutiny.”

George added: “The crime of revealing foetal sex and contributing to abortions of female foetuses cannot be dismissed as a clerical error.”