Right to Health Bill #(RTH)-Rajasthan – An imposed unfair, undemocratic dictate for doctors?

Will Rajasthan’s Right to health bill do more harm than Good

In the new ‘ Right to Health- Bill- Rajasthan’, because of government inability to provide basic and essential services, private hospitals are dictated to render services. As services at Government hospitals are inadequate and have failed to provide facilities to handle the emergencies. Since the patients cannot be left without treatment, provision for emergency services should be made available to country’s population. That is the Government’s duty which the administrators have failed to fulfil. Therefore co-operation from private sector is expected, but it should be sought as help rather than an imposed dictate. This act, though may have a noble intention in mind, should be analysed by all stakeholders in an objective manners.

• Will government render some support in any manner to private health organizations, which they may need genuinely in order to do this difficult task, as the Government itself has been unable to do in so many years?

• In order to provide these essential services especially emergency and lifesaving, is government asking the private players for help for this noble cause or does this act simply dictates its wish onto the private players bulldozing their genuine concerns in doing so?

Will Government increase its’ own responsibility and accountability and shoulder more responsibility towards ‘Health to All’ or it is only for private doctors to provide?

• Will government provide physical and legal protection to doctors and health establishments on the issues arising from the act?

• Although the RTH looks like is a democratic action, but is it democratic to doctors and private health players as well? Are their genuine problems and views addressed and accommodated?

• What are government’s plans in the long term to improve such services? Does it plan to continue forcing the private setups (without ant help to them) or are there any plans to improve the government health facilities in future to a level commiserate with the need of the hour.

Imposing such dictates will definitely force the aspiring doctors to think, whether to choose medical career or not.

Will Rajasthan’s Right to health bill do more harm than Good

The Rajasthan government’s proposed right to health bill has landed in deep controversy due to objections from the private healthcare sector, which is dishonouring as a part of the protests the provision of cashless treatment under existing state-run schemes. The draft bill has been criticised as a hasty job that overlooks ground realities and suffers from lacunae that the Ashok Gehlot government is apparently resisting taking note of.

Chief minister Gehlot, on February 17, urged private hospitals to end their boycott of the Chiranjeevi scheme and the Rajasthan Government Health Scheme (RGHS), which provide mostly cashless treatment to private individuals and government employees, respectively, terming it improper on humanitarian grounds. “The private sector has a role to play in making Rajasthan a model state in healthcare, and we will clarify all doubts of private hospitals about the right to health bill,” Gehlot said. It remains to be seen if his appeal has any impact, given that private doctors’ associations have accused the government of intimidating private hospitals to end the boycott of the bill.

Social activists backing the bill have opened a separate front by criticising private hospitals for opposing the proposed legislation. The moot question is this: Does right to health only include private healthcare, which the bill aims at, or also things like potable water, clean air, unadulterated edibles and quality roads? In short, factors determining a healthy life but excluded from the ambit of the proposed law.

The bill has been in the pipeline for some months now. It was tabled in the state assembly in September 2022 but referred to a select committee subsequently because the Opposition and doctors’ fraternity wanted it be debated thoroughly. On February 15, the select committee deferred its scheduled meeting as private doctors threatened to step up their stir against the bill. Earlier, the state government had expressed its resolve to push ahead with passage of the bill.

A key contentious point in the bill is that no medical facility—whether government or private—can deny a patient ‘emergency’ care. The bill, however, falls short of defining ‘emergency condition’ and how the cost of treatment is to be reimbursed to private hospitals. Private doctors and private medical institutions feel the bill will give extraordinary powers to designated government officials to enter their premises and harass them.

Rajasthan has been witnessing a sharp rise in patient-doctor conflicts, both in government hospitals where doctors are accused of negligence as well as private medical facilities, which are accused of charging patients exorbitantly. Critics of the bill say it fails to address the concerns of doctors. Initially, private doctors had protested against the clause to compulsorily provide ‘emergency’ care to patients. They cited various aspects of their concern, such as someone with even a minor injury demanding emergency treatment at a hospital or a person suffering a heart attack approaching a hospital or nursing home that lacks facilities to deal with such a case.

As details of the draft bill emerged, there was also apprehension in the private healthcare sector that the bill may become a tool to bring ‘inspector raj’ into the medical sector. “Once you give officials open access to enter our premises, it is bound to be misused. The bill is a ploy of bureaucrats to control the private medical sector,” alleges Dr Vijay Kapoor, secretary, Private Hospitals and Nursing Home Societies, Jaipur. Highlighting ‘discrepancies’ in the bill, Kapoor points out that while a person who wheels in an accident victim to a hospital is entitled to a reward of Rs 5,000, the bill is silent on how the hospital would be reimbursed for treating the patient. “The bill

Private hospitals have been the backbone of the Gehlot government’s flagship Chiranjeevi scheme, under which beneficiaries are entitled to free treatment worth up to Rs 25 lakh in government and affiliated private hospitals. The scheme has been hit by the alleged refusal of many private hospitals to admit patients—as a symbol of protest against the right to health bill.

The Chiranjeevi scheme allows private hospitals to bill patients for certain costs incurred so as to partially compensate for the high cost of diagnostics and treatment. Private hospitals expect a similar consideration in the right to health bill, besides widening the scope of factors determining ‘healthy life’.

Some doctors wonder if a separate bill like this was necessary at all since right to health was enshrined as a fundamental right under Article 21 of the Constitution. Moreover, private doctors say they hardly have any representation in the various committees proposed to implement the provisions of the bill, grassroots level up.

Social activists like Nikhil Dey of the Rajasthan Soochna Evam Rozgar Adhikar Abhiyan and Kavita Srivastava of the Peoples Union of Civil Liberties (PUCL) are dismissive of the opposition to the bill. “It cannot be acceptable that the life of a rich individual is saved but not of a poor for want of money,” says Dey. Srivastava adds that while some objections of doctors could be genuine, the bill cannot be rejected outright.

Private doctors claim schemes to provide healthcare through the private sector under insurance coverage by the state government have been marred by corruption. “Hefty bribes are sought for empanelment of hospitals under these schemes, reimbursement of claims and settlement of complaints if any,” alleges Kapoor.

With more and more private hospitals allegedly refusing cashless treatment to private individuals and government employees under state-run health schemes, patients are suffering. Besides, given the accusation that officials demand bribes and some government doctors patronise certain private hospitals, Gehlot’s right to health bill appears caught in rough weather, all the more since it’s perceived as been hastily drafted.

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March 22, 2023 0

Obesity-a growing epidemic & relation to climate

Twelve years from now, 4 billion people, or more than half the world’s population, will be overweight or obese, according to a recent report. While obesity is an issue more commonly associated with high-income countries, the World Obesity Federation (WOF) points out that lower income countries are facing rapid increases in its prevalence. The economic and environmental costs of obesity aside, there is also the impact on the climate to contend with in the battle of the bulge. A $4tn crisis

The World Obesity Atlas 2023 says the cost of obesity-related issues would be more than $4 trillion globally by 2035. Apart from health, high BMI – obesity is defined as a Body Mass Index (BMI) equal to or more than 30 – also impacts economic productivity, including through premature retirement or death. The biggest presence of obese people will continue to be in high-income countries, the report says, but it is the low and lower middle income countries that are likely to experience major increases in the prevalence of obesity by 2035. The total economic costs linked to a rise in obesity in these countries would be more than $350 billion but the burden for upper middle and high income countries would be close to $4 trillion. The share of obese people in middle-income countries could jump to 66% among men and 70% for women even as the rate of increase in obesity prevalence appears to be slowing down in some rich countries. The chief reasons for rising obesity in poorer countries include a shift towards more highly processed foods and greater levels of sedentary behaviour.

What climate change has to do with it.

Rising temperature and rainfall due to climate change could lead to higher obesity rates by hampering physical activity, studies say. The impact of extreme weather on fruit and vegetable production could also make it harder to maintain a healthy diet owing to rising prices. Higher prices could prompt a shift towards processed foods, which are linked to obesity. A 2019 Lancet report says severe food insecurity and hunger are associated with lower obesity prevalence, but mild to moderate food insecurity is “associated with higher obesity prevalence”. Another 2019 study says obesity is linked to about “20% greater GHG emissions compared with the normal weight state”. The total impact of obesity “may be extra emissions of (about) 700 megatons per year of CO2 equivalent. about 1. 6% of worldwide GHG emissions”.

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

Medical-Consumer protection Act- Pros and Cons

Expensive Medical College seat- Is it worth it?

NEET- Not so Neat- percentile system

The Myth of cost of spending on medical education needs to be made transparent.

Exorbitantly expensive medical education and lowered merit

March 9, 2023 0

Singed with hot rod to ‘cure pneumonia’- the child dies: Illogical distribution of health care

BHOPAL: A newborn has died after being singed more than 50 times with a red hot iron rod in a bizarre ritual to 'cure pneumonia' in MP's Shahdol district. A local anganwadi worker saw this horror being inflicted upon the child by a quack and persuaded the parents to take her to a hospital, say sources. They did, but it was too late. The baby's body was exhumed on Friday evening for post-mortem examination. Even as police were grappling with this horror, a similar case was reported in a nearby village. This infant is in hospital. Police are yet to arrest anyone in either case and it's not yet known if the same quack, a woman, was behind singeing both babies. The Child Welfare Committee has written to police to take action under section 75 of Juvenile Justice Act, but nothing has been done. When TOI spoke with Singhpur police, they said they were taking legal opinion on how to proceed with the

In a heart wrenching and unfortunate incident from Bhopal (Madhya Pradesh), a 2.5 month child was singed with hot iron 50 times by a quack for treatment of pneumonia. He died and the incident appeared in newspapers, but similar kind of treatments must be going on at many places and gullible patients keep on suffering .The suffering is of two types; one, that they are deprived of correct treatment and other is the tremendous suffering because of such nature of cruel practices in the garb of treatment.

That brings to the fore the basic question; why such type of treatments are being practiced and allowed to be conducted in 21th century. Why people allow and consent for such treatments by quacks?

These incidents simply reflect that the health system has not been able to travel the last mile and has failed to touch the last man.

Most important reason for such disparity is illogical distribution of health care. Corporatization of health care has projected medicine as a purchasable commodity and consequently resulted in an Illogical distribution of health care

People, who can afford, spend millions in the last few days of their life, just to have only a few more days to live. Resources spent in such a futile quest are equivalent to thousands of times the money for food and medicines for the poor who lose lives for fraction of that expense.

It seems humanity has legalized the hoarding of medical care; give it to the rich, bundled with consumerism though not necessarily the needy. It is the same as hoarding of the food that is sold to rich, letting the poor die somewhere in the world without food, which remains invisible to all.

Another worrisome aspect of the incident is that avoidance of people to seek treatment from appropriate clinics and hospitals. Anganwadi worker was there in the village, so it was possible to seek help from the health system. Is the mistrust and malice generated by media towards doctors and medical professionals is the reason to avoid seeking help from them?

BHOPAL: A newborn has died after being singed more than 50 times with a red hot iron rod in a bizarre ritual to ‘cure pneumonia’ in MP’s Shahdol district. A local anganwadi worker saw this horror being inflicted upon the child by a quack and persuaded the parents to take her to a hospital, say sources. They did, but it was too late. The baby’s body was exhumed on Friday evening for post-mortem examination. Even as police were grappling with this horror, a similar case was reported in a nearby village. This infant is in hospital. Police are yet to arrest anyone in either case and it’s not yet known if the same quack, a woman, was behind singeing both babies. The Child Welfare Committee has written to police to take action under section 75 of Juvenile Justice Act, but nothing has been done. When TOI spoke with Singhpur police, they said they were taking legal opinion on how to proceed with the case. An officer said they are waiting for the autopsy report to see what charges can be pressed. The baby who died was two and a half months old and suffering from pneumonia. Her parents live in Kathotiya village, around 520km from Bhopal and close to Chhattisgarh. “The infant was ‘torched’ as a method of ‘treatment’ on January 10.” Singhpur police station in charge, MP Ahirwar told TOI. The second incident happened in Samtapur villagee. The baby’s parents deny they put the girl through the burning ritual.

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

Medical-Consumer protection Act- Pros and Cons

Expensive Medical College seat- Is it worth it?

NEET- Not so Neat- percentile system

The Myth of cost of spending on medical education needs to be made transparent.

February 6, 2023 0

Budget outlay on medical insurance up, public health infrastructure down

Whether it is better to buy fish for years or provide people with fishing net? This applies to public health care system in India. Times of India analysis points out the need to build and strengthen the public health care system. Building of infrastructure for massive population requires funds, but ultimately the investment will bring down the cost of treatment and better delivery of health care to the country.

NEW DELHI: The health budget is good news for the private health sector as there has been a substantial increase in allocation for health insurance schemes such as the Central Government Health Scheme (CGHS), treatment for CGHS pensioners and the Ayushman Bharat scheme. Government’s own data has shown that the private health sector corners the bulk of the spending under these schemes, which saw a nearly 22% jump in allocation in the 2023-24 budget.

In contrast, the allocation for schemes aimed at improvement in public health infrastructure has declined when adjusted for inflation. These include the National Health Mission (NHM), Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PMABHIM), human resources for health and medical education and Pradhan Mantri Swasthya Suraksha Yojana (PMSSY).

The overall allocation for health after rising during Covid, has come down in real terms though it seems like an increase in nominal terms from Rs 83,000 in the budget estimates (BE) for the current year to Rs 86, 175 crore in BE 2023-24. The revised estimates (RE) for the current year indicate a 9% decline from the BE to Rs 76,370 crore. The allocation for insurance schemes, however increased substantially in RE 2022-23; more than 75% hike in allocation for CGHS pensioners from Rs 2,645 crore to Rs 4,640 crore and for the first time since the launch of Ayushman Bharat scheme, the RE is the same as the BE at Rs 6,400 crore. In the past, only about half the budgeted amount for Ayushman was getting spent. However, the allocation for all the public infrastructure schemes put together has been slashed by 16% in the RE for the current year. In comparison to the Rs 13,266 crore allocated for insurance schemes, which cover only a section of the population, about Rs 30,000 crore has been allocated for the National Health Mission and a separate Rs 6,500 crore for human resources for health and medical education, which was earlier part of the NHM budget.

Most of the allocation for the insurance schemes usually ends up in the coffers of the private sector. Despite private hospitals accounting for only 46% of empanelled hospitals under Ayushman Bharat, for instance, they accounted for 54% of hospitals admissions and since private healthcare is more expensive, that could account for a much higher proportion of the money spent. Most CGHS beneficiaries too go to private hospitals as noted by Dr Rakesh Sarwal, who was advisor health in Niti Aayog, in a study of the scheme. Dr Sarwal stated that CGHS had a higher cost of service because of its greater reliance on private facilities. Incidentally, though the finance minister announced a mission to eliminate sickle cell anaemia, there is no separate budget line for it. Thus even the money for a totally new scheme might have to come from within the NHM budget, further eating into the allocation. The tertiary care programme, which provides for transfer to states for implementing national programmes on control of blindness, tobacco control, capacity building for trauma centres and for prevention and control of non-communicable diseases such as cancer, diabetes, cardiovascular diseases and stroke, has had its allocation slashed to just Rs 290 crore, less than the actual spending of Rs 300 crore in 2020-21, and 42% less than the allocation of Rs 500 in the last budget.

The budget for the establishment and strengthening of the branches of the National Centre for Disease Control and for preparation and control of zoonotic and other neglected tropical diseases and for diseases surveillance, which had gone up during Covid, has been slashed from Rs 71.6 crore to just Rs 55.6 crore, despite the WHO asking countries to prepare for future pandemics by strengthening surveillance. Even the budget for the Indian Council for Medical Research, which played a crucial role during Covid, has been slashed along with a cut in the overall allocation for health research.

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

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February 5, 2023 0

Supreme Court simplifies rules on passive euthanasia& Living Will

NEW DELHI: The Supreme Court on Tuesday modified its 2018 order on passive euthanasia to make the procedure of removal of (or withholding) life support from terminally ill patients less cumbersome for the patients, their families and the doctors by limiting the role played by government officials. While the requirement of setting up two medical boards — one primary and other review — to examine the medical condition of the patient has been retained, the SC has done away with the rule mandating that the district collector set up the review board. The court said both boards will be constituted by the hospital and there would be one nominee doctor of the district medical officer in the review board. The medical boards must take a decision on such cases preferably within 48 hours, it added.

While the current rules state that the consent of the judicial magistrate is required for conducting passive euthanasia, the new order by a five-judge bench of justices K M Joseph, Ajay Rastogi, Aniruddha Bose, Hrishikesh Roy and C T Ravikumar says the magistrate just needs to be informed. While making the procedure for passive euthanasia less cumbersome, the Supreme Court on Tuesday also simplified the process of making a “living will”, an advance directive by a person wishing not to be put on artificial life support. While the earlier rule stipulated that a living will had to be made in the presence of two attesting witnesses and countersigned by the jurisdictional JMFC, the new order says such a will can be attested by notary or a gazetted rank officer. The process prescribed in2018 was onerous as it not only involved family members and doctors but also a judicial magistrate and collector as well as setting up of two medical boards before removal of life support systems and there was no prescribed time period for medical boards to give their opinion. As per 2018 guidelines, in the event a person became terminally ill with no hope of recovery, the treating physician had to ascertain the authenticity of the case from the JMFC. If the physician was satisfied, the hospital then constituted a medical board consisting of the head of the treating department and at least three expert doctors with 20 years of experience.

If the medical board certified that life support system could be removed, the hospital had to inform the collector who then had to constitute another medical board comprising the chief district medical officer and three expert doctors. If the review board allowed withdrawal of treatment, it had to convey the decision to the JMFC. The JMFC then had to visit the patient and, after examining all aspects, decide on whether the euthanasia directive could be implemented. Modifying the order, the bench said that medical practitioners with five year of experience can be part of the medical board. The court also agreed with the petition that there was no need to involve JMFC in the process of preparation of the living will. Times View: The new guidelines have been issued because the earlier guidelines were proving to be unworkable. It is good that the apex court has taken a relook on the subject. It is entirely possible that even these new guidelines may need to be revised in future. But the principle must be about making things easier for consent-givers without increasing the risk of misuse.

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

Medical-Consumer protection Act- Pros and Cons

Expensive Medical College seat- Is it worth it?

NEET- Not so Neat- percentile system

The Myth of cost of spending on medical education needs to be made transparent.

January 25, 2023 0

Comparison of AIIMS (medical) and IIT (Engineer) graduate with 5 years invested. Do doctors deserve better salaries?

Comparison of AIIMS (medical) and IIT (engineer) graduate with 5 years invested. Why doctors do not deserve better salaries? Let us compare the start of career for medical and engineering graduates. To have a balance, comparing apples to apples, comparison of AIIMS graduates (premier institute –medical) to IIT graduates (Premier institute -Engineering) looks justified. This goes without any need to emphasize that students selected in both are exceptionally brilliant and toppers of the country. Although this comparison is not a secret and everyone knows about it, but still it need an attention from a different point of view. It should be an eye opener not only to medical students or aspiring doctors but to the society as well. It projects the severe disparity to an extent of blatant injustice towards medical students. When engineering students after a course of 4 years (at 21 years of age )are placed with package of 1.2 to 3.6 crores (1-4 lakh dollars), the medical students are starting with internship. Medical students still need to study for at least 5 years more (at 21 years of age ) to start earning maximum 12 -15 lakh per annum

Let us compare the start of career for medical and engineering graduates. To have a balance, comparing apples to apples, comparison of AIIMS graduates (premier institute –medical) to IIT graduates (Premier institute -Engineering) looks justified. This goes without any need to emphasize that students selected in both are exceptionally brilliant and toppers of the country.

Although this comparison is not a secret and everyone knows about it, but still it need an attention from a different point of view. It should be an eye opener not only to medical students or aspiring doctors but to the society as well. It projects the severe disparity to an extent of blatant injustice towards medical students.

When engineering students after a course of 4 years (at 21 years of age )are placed with package of 1.2 to 3.6 crores (1-4 lakh dollars), the medical students are starting with internship. Medical students still need to study for at least 5 years more (at 21 years of age ) to start earning maximum 12 -15 lakh per annum ( 15 thousand dollars). It may be raised to 24-30 lakhs (30000 dollars) per annum after 10 years, still one tenth of their contemporaries from IIT. Remember we are talking about only premier institutes, what happens to others is still a matter of luck.

When engineering students earn crores, do jobs and get experience about the real world, medical students are worrying about the problems, which should not have been there in the first place. The common issues bogging down the medical students are trying to get into post graduate courses, inhuman duties lasting 24-48 hours, payment of unjustified fee of medical colleges, trying to fend off bond policies, court cases, bearing with assault on doctors, working in poor and inept health care infrastructure- just to name a few. With all these problems lingering for years, doctors remain unwise in worldly matters, financially illiterate and sitting ducks for punishments due to excessive regulation and unjustified moral burden.

This comparison is essential to be kept in mind by aspiring doctors when they choose medical career. The respect and money associated with the hard work to be a good doctor is no more available even to the best.

A Point to ponder for everyone, what is the reason for such disparity? Why doctors do not deserve better salaries? What is the need for aspiring doctors to choose lowly paid jobs for more hard work and more noble work? A fodder for thought for society and administrators as well.

IIT hiring: Domestic offer hits record Rs 1.8 crore

MUMBAI: After a lull in the first pandemic year, crore-plus job packages returned with a bang on premier IIT campuses. On the opening day of the season, several IITians entered the crore-plus salary club, as the highest domestic package touched an all-time high of Rs 1.8 crore and international offers crossed the Rs 2 crore mark. While Uber picked one student each from at least five IITs, including IITBombay and Madras, for a package of Rs 2.05 crore (or $274,000), one student at IIT-Roorkee received an international offer of Rs 2.15 crore ($287,550) and three others got domestic offers ranging from Rs 1.30 crore to Rs 1.8 crore. In the first slot at IITB, the highest offer after Uber came from cloud data management company Rubrik, with a Rs 90.6 lakh (or $121,000) package. Of the domestic roles, investment management firm Millennium picked students for a package of Rs 62 lakh in the first slot, while WorldQuant offered Rs 52.7 lakh and Blackstone Rs 46.6 lakh. IIT-Madras students get 176 offers in first session on day 1 ALSO READ IIT-BHU student bags Rs 2 crore package from US company in placement . The highest numbers of domestic offers were made by Google, Microsoft, Qualcomm, Boston Consulting Group (BCG), Airbus and Bain & Company. IT/software, core engineering and consulting were the leading sectors to hire from the institute in the first slot. As many as 11 international offers were made at IIT-Madras on day one, said professor CS Shankar Ram, adviser (training and placement), IIT Madras. The institute recorded 407 offers in the first session of the placements, its best ever, including 231 PPOs. In all, 11 students received offers that crossed Rs 1 crore and of them 10 got domestic offers and 13 students signed up for an international offer, of which 12 opted for packages less than Rs 1 crore to take up jobs in Japan and Singapore.

Record Rs 3.6cr offers to 3 from Delhi, Bombay, Madras IITs for Hong Kong posting

MUMBAI: Hong Kong and Singapore seems to be the destinations where IITians are heading to this placement season, with most big-ticket offers being offered by trading firms there. Jane Street, a quantitative trading firm, has picked at least one student each from IIT-Bombay, Delhi and Kanpur for its Hong Kong office for a record package of Rs 3.6 crore. These, however, were made as pre-placement offers (PPOs) before the season kicked off on December 1. Another high-frequency trading firm Quantbox Research has made an offer of Rs 1.6 crore at multiple IITs for its Singapore office. one IIT-Bombay student, there are other PPOs that have made offers to students of close to Rs 2 crore,” said a source at IIT-B. On-campus job offers have not touched the Rs 2 crore mark. “There are several Rs 1 crore job offers and there are 15 companies with international locations, On the first day of placements, IIT-Bombay had 46 companies interviewing candidates either online or in-person. Of the 250 job offers on Day 1, more than 175 were accepted. On Day 2, a total of 48 companies were at IIT-B. The highest package so far this year domestically is Rs 1.9 crore, while there are a good number of packages from international recruiters as well.

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

Medical-Consumer protection Act- Pros and Cons

Expensive Medical College seat- Is it worth it?

NEET- Not so Neat- percentile system

The Myth of cost of spending on medical education needs to be made transparent.

December 4, 2022 1

SC Rejects Greedy decision by Govt & Private Medical College-Fee Hike

The Supreme Court set aside an Andhra Pradesh government order of 2017 prescribing a seven-fold increase in MBBS fees that made it ₹24 lakh per annum.

The Supreme Court in a judgment on Monday held that education is not a business to earn profit as it set aside an Andhra Pradesh government order of 2017 prescribing a seven-fold increase in MBBS fees that made it ₹24 lakh per annum.

Directing the private colleges to refund the amount collected in excess of the fees last fixed by the state government in 2011, a bench of justices MR Shah and Sudhanshu Dhulia said, “Education is not the business to earn profit. The tuition fee shall always be affordable.”

The order came on a petition filed by the Narayana Medical College challenging a September 2019 decision of the Andhra Pradesh high court striking down the fee increase and ordering refund to students admitted in the college since the academic year 2017-18. The apex court dismissed the petition with cost of ₹5 lakh to be borne equally by the petitioner college and state government and deposited in court within six weeks. The amount was directed for use in legal services by the Supreme Court Mediation and Conciliation Committee and the National Legal Services Authority.

The top court agreed with the conclusion made by the high court and said, “To enhance the fee to ₹24 lakh per annum, I.e., seven times more than the fee fixed earlier was not justifiable at all.” The aggrieved medical students who had to pay through their nose had said that the government order raising the fees issued on September 6, 2017 was done without awaiting the recommendation of the Admission and Fee Regulatory Committee (AFRC).

The bench held the order passed by the state government to be “wholly impermissible and most arbitrary”. The court even went to the extent of saying that the hike was done “only with a view to favour or oblige the private medical colleges.”

“Any enhancement of the tuition fee without the recommendation of the AFRC shall be contrary to the decision of this court in case of P.A Inamdar in 2005 and the relevant provisions of the 2006 AFRC Rules (prevailing in the state). The high court has rightly quashed and set aside the GO dated September 6, 2017.”

The students pointed out that in 2011, the tuition fee hike was introduced by the state after consulting AFRC. However, in 2019, the state acted solely on representations received from private medical colleges. Rule 4 of the Admission and Fee Regulatory Committee (for Professional Courses offered in Private, Unaided Professional Institutions) Rules, 2006 mandated the state to seek a prior report from AFRC before altering the fee.

This rule required AFRC to factor in the location of the institution, nature of professional course, cost of available infrastructure, expenditure on administration and maintenance, reasonable surplus required for growth and development of the institution, revenue foregone on account of waiver of fee in respect of students from reserved category or economically weaker sections (EWS) of the society.

The top court said, “Determination of fee/review of fee shall be within the parameters of the fixation rules and shall have the direct nexus on the factors mentioned in Rule 4 of the 2006 Rules…the state government enhanced the tuition fee at an exorbitant rate of ₹24 lakh per annum, almost seven times the tuition fee notified for the previous block period.”

The next question arose regarding refund as ordered by the high court in its order of September 24, 2019. The high court said that the colleges cannot take benefit of the unjust enrichment in fees that was wrongly increased. Accordingly, it asked the colleges to refund the students after adjusting the amounts payable under the earlier fee structure recommended by AFRC and issued in June 2011.

The bench upheld this part of the high court order and said, “The medical colleges are the beneficiaries of the illegal GO which is rightly set aside by the high court.” The bench was conscious of the hardships faced by students who arranged to pay the amount by obtaining loan from banks and financial institutions at high rate of interest. “The management cannot be permitted to retain the amount recovered or collected pursuant to the illegal GO,” it held.

The college told the Supreme Court that between 2011 and 2017, they incurred added expenses due to the requirement introduced in 2016 to pay stipend to students even as the fee remained unchanged since 2011. The bench told the college that this component would be compensated as and when the higher tuition fee is fixed by AFRC. However, the court did not permit the college to retain the illegally collected amount.

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

Medical-Consumer protection Act- Pros and Cons

Expensive Medical College seat- Is it worth it?

NEET- Not so Neat- percentile system

The Myth of cost of spending on medical education needs to be made transparent.

November 12, 2022 0

India-UK FTA may tighten screws on Generic drugs. Britain doing Big Pharma Bidding?

Several international organisations working to improve people’s access to medicines have written to the UK government protesting against provisions in a proposed India-UK FTA after the chapter on intellectual property was leaked. The provisions related to pharmaceutical IP could prevent India from making affordable generics on which the National Health Service (NHS) of the UK and several other countries depend. India’s ability to produce generics is crucial not only to the Global South but to the UK too.

Four out of five drugs used in the NHS are generics and a third of these are produced in India. So about 25% of the drugs in the NHS come from India. Between 2011 and 2016, the NHS started to experience a crisis in the amount of money it was spending on new, very expensive drugs. The amount the NHS spent rose in those years by £3.8 billion. That is more than twice the total NHS deficit at that time – £1.85 billion. The crisis was so severe that the NHS began to look for ways to save money, including importing more generics. It worked.

International non-profit calls upon calls upon India to stay vigilant and asks the U.K. to withdraw intellectual property proposals.

The proposals on intellectual property (IP) rights in the draft India-United Kingdom Free Trade Agreement (FTA) will hurt the global supply of generic medicines, Doctors Without Borders (Médecins Sans Frontières or MSF) warned on Wednesday. In a press note, the international organisation said low medicine prices help save lives in vulnerable communities across the world but the intellectual property chapter of the India-U.K. FTA contains “harmful IP provisions”. The IP-related chapter, leaked on October 31, showed that the controversial provisions tabled by the U.K. to “tighten the screws on producing, supplying and exporting affordable generic medicines from India”.

“Given the disastrous consequences, this leaked IP chapter could have on the global supply of generic medicines, the U.K. government should withdraw it completely. India should stay vigilant and not allow barriers to affordable medicines to be written into FTA negotiations,” Leena Menghaney, South Asia head of MSF’s Access Campaign, said.

U.K.-India trade talks continuing

In a “Fact Sheet”, MSF has argued that the demand for “harmonisation” of Indian patent law with the U.K.’s laws will lead to dilution of important provisions in the Indian patent system that are necessary for manufacturing generic medicines and vaccines.

“Article E.10 of the leaked IP chapter stipulates that both parties “shall not” make patent opposition proceedings available BEFORE the grant of a patent. In effect, this provision applies only to India as the U.K. does not have a pre-grant opposition system – this goes directly against the current Indian patent law, which allows patent opposition proceedings both before and after the grant of a patent,” the MSF said in its observations on the IP provisions.

MSF pointed out that under the proposals from the U.K., even treatment providers could be subjected to legal actions for prescribing generic medicines for which India is one of the largest manufacturing hubs. MSF said that the IP provisions brought up by the U.K. opened up possibilities for “excessive enforcement” that are likely to create difficulties for both Indian pharmaceutical companies as well as the legal set-up.

MSF highlighted that another problematic provision is Article J.11 of the leaked IP chapter. Under this provision, Customs officials could block legitimate medicines from leaving India for other developing countries if a multinational pharmaceutical corporation was to claim that their patents were being infringed upon by the Indian product. “Furthermore, Article J.5 and J.7 prescribe how courts should adjudicate IP disputes, which could impact [Indian] judicial discretion,” MSF said.

A British government spokesperson said they would not comment on the “alleged leaks” and will only sign “a deal that is fair, reciprocal, and ultimately in the best interests of the British people and the economy”.

“The U.K. and India are negotiating an ambitious Free Trade Agreement that will boost our current trading relationship, already worth more than ₤24 billion last year,” the spokesperson told The Hindu.

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November 11, 2022 0

How to Reduce Social Media Addiction-Digital Minimalism

The Demons of social media and online gaming has rewired the people’s mind to live life and remain in virtual world. The chaos and turmoil in the society can be linked to social media that exploits the deep wired craving of masses to know more about the “realities”. Once a curiosity is fired, each one at social media starts feeding something or other. In the mad game of TRP’s, clouts and engagements, these players cross ethical lines and create rifts. They literally hunt and scavenge news items that suit their narrative. They embellish it with more provocative words and share it with their name hoping to drive more engagement Conspiratorial and alarmist thinking is likely to keep people glued to social media.

Covid-19 pandemic worsened addiction to the internet among children. The footfall at psychiatric out-patient departments in hospitals, especially those offering help to kids hooked to the net, be it for online gaming, chatting with friends or sharing videos, offers a glimpse of the problem.

Digital Minimalism- break free from “internet compulsions”

Freedom, Cold Turkey, RescueTime, Toggl, StayFocusd, FocusMe, SelfControl, AntiSocial… They are not random words pulsed together in a blender, but names of some of the top apps that, ironically, help you stay away from your digital addictions. As Thakur said in Sholay, “loha lohe ko kaat-ta hai”, so now we need apps to stay away from apps. This farcical situation hides a deeper reality – too many of us are spending too much time online. So, amid the launch of 5G and other high-speed tech, a growing army of people doesn’t want to be addicted to social media and googling. They aspire to live frugal, almost ascetic, digital lives without completely switching off from the internet. It’s a trend called ‘digital minimalism’, and it is different from a ‘digital detox’ where you unplug completely. To illustrate, detox is what Mohityanche Vadgaon village in Maharashtra’s Sangli district does. A siren goes off at 7pm, and residents put their electronic devices away for 90 minutes. Children are encouraged to read while the older people meet and chat.

Digital minimalism, however, does not require complete withdrawal. Coined by author Cal Newport, it is a way of using technology in which you focus your online time on a few carefully selected tasks that strongly support the things you value. It advises against excessive use of gadgets.

Digital Minimalism- break free from “internet compulsions”

Digital minimalism is based on three tenets: clutter is expensive, optimization is critical, and intention is satisfying. The objective is that the usage should be intentional and controlled for a limited period of time. And the apps mentioned above are meant to stop you from jumping from one attention-diverting push notification to another. They can block other apps from operating, create blocklists, schedule apps to run only during a specific time of the day, and alert you about the excessive time spent online.

This philosophy is being discussed now, especially after the pandemic when people began spending more time online, adding that children aged 13-18 years have become more prone to digital addiction since the pandemic. The parents are taking their children to counsellors as they have become addicted to screens and feel isolated and tense when they have to interact with people in the real world. For them, online networking is secure and simple.” He advised gradually introducing such children to digital minimalism, to reduce their reliance and time spent on digital platforms. He also said it is critical for parents and adults to see if those who are addicted to digital devices have any anxiety issues. Because digital addiction has been observed in people who already have anxiety issues, these issues must be addressed first. WHO has classified excessive use of the internet and mobile phones as screen addiction, and provided a set of guidelines. There is certainly a 50% increase in screen time addiction cases post-pandemic, we should be more concerned about the changes that will occur with advancements, like the metaverse. Need to first introduce minimalistic practices, and then, in some cases, recommend mild medication to help people break free from their “internet compulsions”.

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The Myth of cost of spending on medical education needs to be made transparent.

November 8, 2022 1

A Child is Born Free till he chooses to be Doctor # Rohtak-Medicos-fight-Unjust-Bonds

Choosing medical career or being a doctor has become a struggle in present era. Aspiring doctors need to first think- why they want to be a doctor in such circumstances-enduring all kind of exploitation- from all corners of society?

Unable to give doctors their rightful, there has been an administrators’ wish to enslave medical profession. Arm chair preachers would just say “yes, as a doctor, they should do it as moral duty.” In a new era of consumerism, when patient is defined as consumer and medical industry controls medical profession and the financial boundaries. All components of medical industry want their pound of flesh from hard work of doctors and nurses. Every day routine issues turning into medico-legal hassles have put doctors in the corner, resulting in severe distraction from real point of intention-treatment of patients.

Struggling to get admission in medical college, slogging in wards to learn and earn degrees, work in inhuman conditions, listen to endless abuses, tolerate the false media criticism, dragged in courts for alleged negligence, work with fear of physical assaults, work without proper infrastructure and manpower, endangering their own lives, exploited by medical industry and administrators, poorly paid and still not respected.

The Myth of cost of spending on medical education needs to be made transparent.

MBBS medical students protest against Haryana Govt Bond Policy-Rohtak

Educating a doctor cost less what medical colleges claim- a global phenomenon.

Instead of often repeated statements about high expense on running medical college and projecting it as a hard fact, the amount spent on medical students by all medical colleges should be made transparent by all institutions. The frequent statement is made that cost of making a doctor is very high and gleefully propagated by the private medical colleges to extract millions out of young medical students .

Such statements without any actual public data is repeated to the extent that it is firmly entrenched in public mind without any real evidence.

Projection of high cost of making a doctor is the reason with an intention to exploit the young doctors in various ways to get cheap labour and extract millions from aspiring doctors by medical colleges.

MBBS medical students protest against Haryana Govt Bond Policy-Rohtak

MBBS medical students protest against Haryana Govt bond policy detained

In a crackdown on MBBS students protesting against Haryana government’s bond policy for government medical colleges, the Rohtak Police detained around 300 students in the early hours of Saturday and registered a First Information Report in this connection.

The police action came ahead of the visit of Governor, Chief Minister and Home Minister to PGI campus for the convocation of Pt. Bhagwat Dayal Sharma University of Health Sciences, Rohtak.

He added that the students were now co-operating with the administration and a meeting was being facilitated between them and the Chief Minister soon after the convocation.

The Haryana government had come out with a policy to incentivise doctors to opt for government service in the State on November 6, 2020, saying that the candidates selected for MBBS degree course in government medical colleges need to execute an annual bond for ₹10 lakh minus the fee at the start of every academic year. The candidate can pay the entire bond amount without recourse to the loan or the State government will facilitate them for availing an education loan for this bond amount. As per the policy, the government will repay the annual instalments of the loan if the candidate obtains employment with the State government.

However, in view of the protests, the CM had three days ago announced that students need not pay the ₹10 lakh bond amount at the time of admission, but instead have to sign a bond-cum-loan agreement of the amount with the college and the bank.

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Expensive Medical College seat- Is it worth it?

NEET- Not so Neat- percentile system

The Myth of cost of spending on medical education needs to be made transparent.