In the present era, Doctors are ebbed from all sides, need to earn back the dignity of profession and resist oppression. The phenomenon of oppression in the name of medical- regulation is a global issue. The oppressive schemes in the misleading names like #RTH Rajasthan (RIGHT TO HEALTH) are prevalent everywhere globally in some form or another.
Doctors and nurses have been reduced to no more than moral and economical slaves either by industry or administrators, not infrequently pulled by legal bridle in their noses.
Doctors in Rajasthan India have shown first of its kind revolt, that is just waiting to happen globally at some stage.
It is not easy to practice as doctor these days. Media full of doctors bashing, credibility crisis and regulators perpetually hounding doctors, who are forced to work under imposed medico-legal sword. There is no day that passes when system does not perpetuate negativity against medical profession.
By certain laws and Acts like RTH, an effort is on to place medicine under State control. Acquiring kind of skill , the years of passionate, merciless excruciating medical learning is placed at the disposal of administrators, who themselves have already failed to develop a good health care system in real sense.
Doctors have become soft targets for populist attention mongering and transforming social nuisance into messiah of the deprived by administrators -by sprouting the fraudulent generalities.
All the calculations that usually precede the enslavement of medicine, everything gets discussed by administrators and industry – except the well-being of the doctors and nurses.
Doctors have often wondered at the smugness with which administrators assert their right to enslave them, to control their work, to force their will, to violate their conscience, to stifle their mind. Irony is that while administrators do this, still they depend on the same doctors for saving lives -whose life they have throttled, who resent the treatment meted out to the health care workers. Like the failed medical system, administrators have failed to realize that all the negativity perpetuated against doctors, who are working with the burden of mistrust under medico-legal sword is going to make them less safe.
Administrators, who have never treated a patient in their lifetimes, not only try to control treatment of thousands of patients, but project themselves messiah by demonizing doctors. Lowly educated celebrities and administrators have found a new easy way to project themselves on higher pedestrian by publicly insulting highly educated but vulnerable doctors. The biggest tragedy to the medical profession in the present era is the new fad of administrators to discourage and demonize the medical profession for their popularity gains. Being so distant from the ground reality, their role should not have been more than facilitators, but they have become medical administrators. To control the health system, administrators have a tendency to pretend that shortcomings in the patient care can be rectified by punishing the doctors and nurses.
Slow or acute revolt is long due. Doctors have only two ways- either to persist, fight or perish. Silently quitting their beloved profession is going on for some time all over the world. Even in developed countries, there has been a fading enthusiasm to be a doctor. But doctors of Rajasthan have shown the way. The way to persist and resist the indignity handed over to medical profession. The have shown that the struggle was not that difficult that it looked to be. They have chosen the correct path of struggle for Independence (Professional). That makes them global leaders without any doubt.
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.
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.
Evolution of Medical profession-Extinction of good doctors 