Medical Regulation:Is it time to regulate medical business/ administrators of healthcare? “Oxygen cut, 30 children die in Gorakhpur hospital” who is responsible?


The inconsolable   catastrophic calamity in Gorakhpur Hospital is a mishap, which should be  preventable by good medical governance.   This is a real life example of negligence by poorly managed system, which has resulted in loss of multiple lives. Poor competence of administrators is more damaging, less containable, more damaging institutionally than smaller unintentional human errors by doctors. More than sadness, it is a painful surprise that such things can happen in present era of mammoth advancements! Until now, discussion on every such incidence stopped with blame on doctors in the end. No body will even try to look beyond doctor’s faults as it is easier to find some mistake or the other by retrospective analysis in doctor’s work or documents. That helps in cover up of system faults. Since ultimately it is only the doctor who is visible with the patient, doctor has to bear onus of each medical or non medical problems of health system. In routine circumstances, after the unanticipated death, one or two doctors  are made scapegoat, thrashed or harassed, unless proved innocent few years on, that also if they are lucky enough to have impartial investigation. Doctors carry the burden of universal expectations, thanklessness, threats and vandalism for bad outcomes, even in absence of proper health facilities. That is how, rest of medical industry, administrator  and non doctors associated with the health care,  mainly responsible for the problems,  enjoy   strange kind of immunity. But since now problems are overflowing  and big enough to unmask the real hidden people responsible for poor health care system in case an impartial inquiry is done.  Is it time to regulate all people including non doctors and medical businesses who are associated with health sector, in the manner doctors are regulated?

Oxygen cut, 30 children die in Gorakhpur hospital. Criminal negligence, row over unpaid bills hit encephalitis, neonatal wards.( Hindustan times)

 

Foremost admission is that we do not have a proper foolproof health care system. Strangely, the perpetual inadequacy of state healthcare infrastructure is never questioned.  Problems of electricity, oxygen, quality of drugs, medicine, quality of consumables, heath insurance implants and stents have very important role to play in treatment of the patient and cost associated with it. Doctors need essential items and can not work without  drugs and equipment , which are supplied by industry and procured by administrators.  Marketing, sales, pricing, insurance, quality  and all business deals  of these items are  beyond doctors preview. Therefore the  actual number of  non doctors  involved in health sector are beyond any imagination and these people  are not regulated in any manner. Ultimate blame is wrapped up by incriminating whole community of doctors, resulting  in misguided  conclusions. All these complex issues ends up with society inflicting a mode of self harm by mistrusting their savior.  In fact, there has been an article feeling a need for regulation of NHS managers, in a way same as doctors.

NHS Managers should face same regulation as doctors, says Francis

https://doi.org/10.1136/bmj.j2055 ( 25 April 2017)

Possibly it is time to unmask   and unveil the whole mammoth industry and regulate each and every person associated with health, in a manner same as doctors.  Role of non doctors , touts, different streams of medicine, administrators,  sales and marketing , medical  finance,  electricity, oxygen, cost and  quality medicine, drugs, consumables, implants and stents has very important   role to play and doctors should not be   burdened  with criticism for  all the mess created by all other people. Good health care system should be designed to prevent tragedies. Strict action after the event is just finding scapegoats.

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