What is that we are opposing?

By Dr. K.S. Kumar, Consultant Paediatric Surgeon, Mysuru

Lakhs of patients are facing untold misery by the ongoing tussle between doctors and the Karnataka Government. They are caught in the crossfire for no fault of theirs. Doctors want them to understand their plight and why they are forced to take to the streets.

The KPME Act (Karnataka Private Medical Establishment) was introduced in 2007 with an intention to weed out quacks and identify genuine medical practitioners. What it turned out to be is nothing but a sham, only to harass genuine doctors and registered hospitals.

Doctors and hospitals had to produce a certificate from the State Pollution Control Board (SPCB) every year and also have a tie-up with a biomedical waste disposal agency renewed annually. The license of the clinic/ hospital was to be renewed every 5 years and it turned out to be a money-making LICENCE RAJ.

With elections round the corner and with the Government Health Sector in a shambles, Karnataka Health Minister convinced the Chief Minister to get the KPME Act amended.

A Committee formed under the former Chief Justice Vikramjit Sen and had submitted its report to include government hospitals too in the Act to bring standard of care and professionalism into the Health sector.

The powers that be realised that the Government Sector is grappling with problems of a different century — (one can see statements in newspapers that wheelchair and stretchers will be procured and henceforth,  there will be no shortages of the same in Government Hospitals) The Government Health Sector was happily removed from Justice Vikramjit Sen’s recommendation and only private medical establishments were included.

What are the points that every practising doctor finds difficult to accept?

• The constitution of a Grievance Redressal Forum at every district: The members of which are more ‘babus’ than professionals (Zilla Panchayat CEO, Superintendent of Police, Public Prosecutor, Ayush Department representative and appointees from the Government, along with one District Health Officer).

Now everyone can see between lines that this committee is going to be nothing but an extortion method by the people in power. The doctors are already covered by the District/ State/ Central Consumer Redressal Forums.

In addition, if there are any lapses on the part of the doctors they are liable in various civil and criminal courts and also the Medical Council (State and Central).

With so many Grievance Redressal Forums, the Health Minister wants to add one more and the reason he has publicly stated is that the above mechanisms are time-consuming and cumbersome. Now will the same people in power do the same to crores of cases pending in various courts and establish Kangaroo courts without judges but ‘babus’ for faster justice??

Also, please note that in the new forum that is being constituted, doctors have to present themselves personally and cannot be represented by a lawyer.

Even a dreaded terrorist like Kasab was provided with a lawyer but why prevent doctors from defending themselves with a lawyer?

• The Government is going to fix rates of all treatments at all private hospitals and any expenditure exceeding it will attract stiff penalty (Rs. 5 lakh) and a jail term up to 3 years. We do agree that there are a small miniscule of hospitals which overcharge patients but that doesn’t mean all the doctors are doing it.

This Act will virtually prevent many small hospitals from accepting critical and high-risk cases as the complications may be unforeseen at the beginning and no doctor would like to sit behind bars for 3 years.

• The renewal of licence which was once in 5 years has been brought down to every 3 years to make more money.
• There cannot be any private clinical establishment with laboratory facilities within 250 metres of any Government hospital (Now if Government hospitals had all the required labs and investigations why would anyone go outside or why would any private investor invest and waste his money?)

It would be prudent to mention that there are hospital accreditation agencies like JCI and NABH.

These agencies have stringent standards to be met regarding quality of care/ patient safety and nursing.

There are many private hospitals which are already accredited across the State. But can the honourable Health Minister show even one Government Hospital with the same standards?

With these amendments in the Act the government is just portraying that doctors are fighting only for money and this amendment is to rein them in.

To protest against the said amendment being tabled, we have tried all sorts of talks and had meetings with everyone including the Chief Minister and have even resorted to a token strike on Nov. 3.

When all these have failed we are forced to undertake the ‘Belagavi Chalo’ protest and the subsequent fast and the indefinite closure of services from Nov. 13.