Thursday, February 13th, 2025

Doctors cannot be protected by law alone…Former CJI NV Ramana told what is necessary

Author: NV Ramana, former CJIThe rape and murder of a trainee doctor at Kolkata’s RG Kar Medical College and Hospital has brought the issue of doctors’ safety to the centre of national debate. Protests have been seen in cities across India. As people protest, these should inspire governments to take corrective actions that are long overdue. Our constitutional aspirations of a healthy and dignified life for all can only be realised through a strong public health system in which doctors get all the respect they deserve.

Doctors do not get the respect they deserve

Unfortunately, one government after another has come and gone but healthcare has not got the space it deserves. Over time, all the government failures have today culminated in the corporatisation of the healthcare system. This in turn has created a wide gap in the quality of healthcare available to different sections of society. A large population of India cannot afford private healthcare. They are dependent on the government healthcare system, hence the high patient count.

There is a lot of pressure on government doctors

It follows that government doctors are under a lot of pressure. But factors that make their job difficult include the acute lack of infrastructure in government hospitals. Government doctors as well as paramedical staff face several challenges. These include lack of infrastructure and resources, poor working conditions and harassment of doctors, paramedical staff, and lack of a safe environment and adequate infrastructure. Women doctors suffer more because of these. All this is made worse by the inability of medical organisations to address the issues effectively.

The central and state governments and the courts have intervened from time to time to facilitate and monitor the health and safety of healthcare professionals. Given the need of the hour, the Epidemic (Amendment) Ordinance, 2020 was passed. The memories of the pandemic are fresh, but clearly the drive to ensure proper and safe working conditions for doctors and other healthcare professionals has not gained momentum.

Doctors experience violence at workplace

Doctors often work in volatile environments, often in overcrowded hospitals, exposing patients and their families to pain and suffering. Several surveys indicate that the percentage of doctors who experienced workplace violence was as high as 75% in India and 47% in the US, with the aggressors typically being patients and their relatives.

A recent survey by the Indian Medical Association revealed that 82.7% of doctors feel stressed, 62.8% fear violence and 46.3% say violence is the main cause of their stress. Young doctors with less experience and female doctors are more vulnerable to violence. This is why the demand to pass and implement the ‘Prevention of Violence against Doctors Bill, 2022’ introduced in 2022 has taken centre stage.

There is a need to make similar laws in all states

Since 2007, the Protection of Medical Service Institutions (Prevention of Violence and Damage to Property) Act, also known as the Medical Protection Act (MPA), has been implemented in about 23 states in India, although its effectiveness remains questionable. The number of cases registered, convictions and awareness of stakeholders are issues that need to be explored in depth.

Like other laws, there should be an audit system to understand the statistics of complaint registration, chargesheets and convictions under this law. Just making laws is not enough. Among other things, with the exception of Tamil Nadu and Pondicherry, which have provided for punishment ranging from 3 to 10 years, other states have limited the punishment to 3 years with fine. If there is disparity in punishment across states, the Centre should step in to make a uniform model law in consultation with the states.

There is a need to make laws regarding safety concerns of doctors

Talking about other industries, the Parliament had earlier introduced the Occupational Safety, Health and Working Conditions Code, 2020. This law does not specifically cover or incorporate the healthcare industry. Hence, there is an urgent need to legislate to address the safety concerns of doctors across India. In fact, the Centre should come up with a model law for implementation across states.

Safety of medical staff a policy issue

The safety of government medical staff is a policy issue that requires long-term planning. For this, the courts will have to make way for the government to consider the issue and bring about equitable change. A similar horrific incident involving a judicial officer in Jharkhand happened during my tenure as Chief Justice. The matter was taken up by the Supreme Court on a suo motu basis, in which the court ordered the Jharkhand High Court to monitor the investigation.

Finally, we must create an environment where more and more young people want to become doctors and serve society. Many aspiring doctors from small towns and rural areas depend on the government for education, support and employment. But, beyond this initial support, the government must look after the welfare of its doctors and improve their working conditions. The absence of such an environment will only lead to a brain drain where young and talented doctors do not see a future in India.

Medical institutions and government agencies must work together to address major concerns such as higher salaries, pension benefits, social security, safety measures and better working conditions. The magnitude of the RG tax and the resentment it has generated reflects the failure to give doctors their due in India.

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