BACK TO THE FUTURE

A person had been studying a lot all his life, always trying to be amongst the toppers. He had to become a doctor, after all. All of his friends had started with their jobs / business, while he still took money from his home. Five years of graduation, then post graduation, which might be followed by super specialization. He had to become a doctor, after all.

In spite of all this, neither did his study ever ceased, nor his learning. After all, he wishes to become not just a doctor, but an excellent one. And that too in a country like India, where for the last 65 years, the policy of our government has failed to achieve in the field of healthcare. The government spends thousands of crores of rupees in the name of healthcare. But what a common man gets of it is no secret, and can be appreciated in almost every government hospital of the country.

On the other hand, private healthcare providers have always invested in the latest technologies, acquired new skills, all at their own expense, raising the standard of medical and healthcare facilities. Today people residing in small towns can have a sigh of relief that they do not have to go to big cities and metros for basic medical facilities.

But why is all this being discussed here? It is because all of a doctor’s hard work is going to be undone by some policy-makers, back to the era of the British Raj, through what they call “CLINICAL ESTABLISHMENT ACT”.

It is a long act, which everyone should read, to know that the bureaucrats, without giving much thought, without taking the doctors along, without realizing its long-term effects, are keen to implement as a law.

It is imperative to know the effects of the act on the doctors as well as the common man. As soon as the act is implemented, medical practitioners would have to get themselves registered with the state and district councils, paying the heaviest fee in the country. As if the hefty amount spent in education was not enough. These councils would be headed by bureaucrats and politicians, or people nominated by them. The key word here is “nominated”, and not “elected”.

These councils would also inspect medical practitioners on a regular basis to check for their competency and standards being maintained. The government is trying to regulate something which is already regulated by the state medical council, the medical council of India and 41 other acts. Now an official would be instructing a doctor how to run a clinic and which medicines to prescribe, with the powers to even seal the establishment if he does not like something. Now a doctor would have to either do as was prevalent in the “License Raj”, keeping the babus happy, year after year, or shut down his practice. There would be no further hearing once the establishment is sealed. A doctor would not even be allowed to appeal in the court as these councils would be the ultimate authority in this matter. It also opens the door to abuse of power, as authorities can penalize or shut down the clinic of a good doctor for reasons not connected with his medical expertise.

Besides, the records of the patients would no longer remain confidential. The records would have to be shared “electronically” with the government. The government wants to know everything, who is suffering from what disease, is prescribed what medication or has undergone what surgery.

Moreover, the consultation fees of a medical practitioner would also be governed by the government. It is of no concern whether the doctor is a general practitioner, specialist or a super specialist. The consultation fee for all would be the same. This would result in a lack of interest within the medical fraternity to go for post graduation or super specialization, leading to a loss for the entire community. Similarly, the rates of surgeries would be the same for both old and modern techniques. This does not seem to be a very sensible idea as the expenses involved in attaining a higher qualification or establishing latest equipments for surgery are immense.

Medical insurance has never been implemented by the government. Instead, the throats of doctors are being sliced. On one hand there are talks of deregulating the prices of petrol and diesel to make the market economics work, and on the other, medical practitioners are about to be made scapegoats.

The state council also has been formed very precariously. There would be only one representative from modern medicine and allopathy, which is being practiced by more than 95% of the doctors. Other systems, being practiced by less than 5%, would be having three representatives. If passed, this act would open the doors for unqualified persons to get registered as doctors in the guise of Yoga, Unani, Siddha, Nursing and Pharmacy branches. This is like taking a step backward to check the misuse of allopathic and ayurvedic medicine by unqualified persons. What is really happening? In which era are we living?

There is even more to this. No separate registration would be required to run a laboratory along with an establishment. No emphasis has been given to whether the laboratory technician is suitably qualified or not.

Furthermore, a doctor would be required to “stabilize” a patient before sending him across to the nearest referral hospital, failing which he could face a non-bailable warrant. The definition of “stabilize” is unclear. Besides, it is not realistic to expect a regular general practitioner to be equipped with ventilators and so on. The equipment is expensive, and if individual doctors were to invest in such equipment, who would be sharing their costs? To expect all clinics to be at least 500 square feet is practically impossible in bigger cities, where the cost of real estate is exorbitant. If a doctor had that kind of money, there would not be any need for him to practice.

Having invested in a large room, expensive equipments and so on, a doctor would be under pressure to recover the costs and the most likely victims would be the patients. The act’s stiff requirements and penalties would encourage corporatization of healthcare. The small, neighborhood doctor would eventually be forced to shut down. Such “draconian” measures would also keep young people away from becoming doctors.

Someone would indeed be benefitted from this act. But that someone would not be the common man or the doctor.