The rising violence against the fraternity of doctors all across the country has been the center of all discussions for the past week. The inception of this uproar took place last Sunday at Nil Ratan Sircar (NRS) Medical College and Hospital, Kolkata, where scores of hooligans came in and assaulted the junior doctors over the death of an 85 year old cardiac arrest patient, Mohammed Sayeed, blaming them for medical negligence and malpractice.
The assault rendered one of the doctors in a near coma and injured others severely. This catapulted into a state-wide spree of vandalism of hospitals and violence. Following this, the doctors went on strike to protest against the injustice and demand a safe working environment. They have set six conditions for the State Government; meeting of which, the strike would be called off.
Doctors of other government hospitals came forth to show solidarity to their colleagues by joining the strike, resulting in an almost shutdown of healthcare services across Bengal. The CPM-backed Service Doctors Forum called for a shutdown of outpatient departments (OPDs) at all private and government hospitals on Wednesday to condemn the attack on junior doctors and interns.
The doctors are demanding a direct intervention from the Chief Minister and action against the police personnel who had not stepped up to stop the violence.
The uproar spread further when the Indian Medical Association launched a three-day nationwide protest from Friday to express its solidarity and called for a strike on June 17 – withdrawing all non-essential and non-immediate healthcare services.
“Since no resolution is coming across after all the solidarity shown by the medical fraternity, IMA calls for the withdrawal of all non-emergency services including OPDs on Monday, June 17 across the nation in all healthcare institutions and all the medical colleges,” Dr R V Ashokan, Secretary General of IMA said in a press conference in New Delhi.
Major demands of the agitating doctors’ include better security in government hospitals. Union Health Minister Harsh Vardhan has appealed to the medical practitioners’ all over the country to end their agitation and return to work so that patients do not have to go through any more suffering. He also wrote to Banerjee to find an ‘amicable end’ to the stir.
RG Kar Medical College was the first from where 107 doctors submitted their resignation, followed by 175 from SSKM, 16 from Chittaranjan National Medical College, 100 from NRS Medical College and Hospital and 33 from School of Tropical Medicine. A sum total of 119 doctors of North Bengal Medical College and Hospital in Darjeeling have resigned over the alleged violence against the fraternity in the state. Till now, over 700 doctors in Bengal have tendered resignation in an unprecedented expression of solidarity against the erupting violence in the state.
Doctors at the Centre-run Safdarjung Hospital, Lady Hardinge Medical College and Hospital, RML Hospital, as well as Delhi government facilities such as GTB Hospital, Dr. Baba Saheb Ambedkar Hospital, Sanjay Gandhi Memorial Hospital, and Deen Dayal Upadhyay Hospital are joining the strike, in solidarity with their Bengal counterparts.
The West Bengal CM described the injuries sustained by the two doctors as “unfortunate”, adding that five persons have been arrested in connection with the incident. She said a probe has been ordered to look into the complaint of negligence in treatment, which led to the death of the patient.
Mamata Banerjee, reportedly, also wrote to senior doctors of all medical colleges and hospitals in the state, requesting them to keep attending to the patients who are in a lurch.
With nation-wide demonstrations of solidarity, the state’s healthcare has been in shambles since last Tuesday due to ceased-work. The complete shutdown of OPDs has left the patients in a tough spot, with everyone hoping for a quick and steady resolution.
On Monday, the agitating doctors decided to call off the week-long strikes after a meeting with the Chief Minister at the State Secretariat where they were assured of upscaled security at their place of work. However, a declaratory statement in this regard by the NRS Hospital is yet to be given.
Doctors and medical practitioners dedicate the better part of their lives to serve and tend to the people in need. They are the backbone of our society and without them, it would crumble. Already working with minimum wage and subpar infrastructure just to help the people in need, the least we owe to the caretakers of the society is provide them a safe working environment; a place where they can go to work without being in constant fear for their life. Security should be provided to them as we expect them to treat the others at risk. One can only imagine the extent to which the doctors must have been tested, which made them call this strike. Undergoing immense psychological distress and ethical conflict, they broke the Hippocratic Oath; something that every doctor lives by –
“I will turn away no patient.”
The growing instance of assault and violence against the medical fraternity exposes a deep-rooted problem in the medical scenario of this country – something which desperately calls for speedy redressal. A survey by the Indian Medical Association (IMA) in 2015 revealed that nearly 75% of doctors in India have faced some form of violence or threat at some point in their careers.[1] The IMA on Sunday demanded a comprehensive law to deal with violence against healthcare personnel.
According to the Indian Medical Journal, innumerable incidents of violence against doctors are reported on a daily basis across India, some resulting in grievous injuries. Even institutions such as the All India Institute of Medical Sciences, New Delhi, the premier medical institute of the country is not spared.[2] Nineteen states of India have some kind of Medicare Service Persons and Medicare Service Institutions (Prevention of violence or damage or loss of property) Acts passed and notified in the past 10 years. Under the Right to Information (RTI) Act, the Medicos Legal Action Group Trust (MLAG) asked all senior superintendents of police in Punjab and Haryana, the two states where the Prevention of Violence against Doctors Act is in place for over 8 years, for the following information.
- How many complaints by doctors or hospitals were registered under these Acts against patients or attendants?
- How many of those accused of assault were punished under these Acts from 2010 to 2015?
According to the replies, most complaints were not registered as a first information report (FIR), which is a mandatory procedure to be followed by all police officials as per the judgment delivered by the Supreme Court of India in the case of Lalita Kumari v. State of Uttar Pradesh.[3] In a few cases where the FIR was lodged based on the complaint, it was canceled after a compromise was reached between the aggrieved parties and a cancellation report was filed with the local magistrate. Very few cases have reached courts after filling of a challan but no person accused of assault on a medicare establishment has yet been penalized under the Medicare Service Persons and Medicare Service Institutions (Prevention of violence or damage or loss of property) Acts of Punjab and Haryana.
In another shocking revelation by the data released by National Medical Journal of India, such instances of violence against medical practitioners have become a global phenomenon. In the U.S.A. more than 100 healthcare personnel died due to violence between 1980 and 1990.[4] In Israel, 70% of the physicians and 90% of the supporting staff have faced verbal abuse and violence at some point in time in their careers.[5] Another survey conducted on 600 doctors of England by the British Medical Association; revealed that one-third of the respondents had been a victim of verbal or physical attack in the past one year and more than half of them (52%) did not report the incident.[6]
Post the incident of the Bengal junior doctors assault, a Public Interest Litigation was also filed before the Hon’ble Supreme Court of India demanding security for doctors across the country. However, as the strike has been called off, on Tuesday the Supreme Court deferred the hearing of the matter saying since the strike is over, there is no urgency to hear the matter. A division bench comprising of Justices Deepak Gupta and Surya Kant said that they shall not issue any notice to the Central Government, however; they shall keep the larger issue of protection of doctors open and shall try resolving the issue by taking a holistic view of the entire situation.
A lot of people are still scrutinizing the moral and ethical aspects of the strike and how it affected the poor people who cannot afford expensive private hospitals. Going by the statements of the agitating doctors, the emergency wards of the public hospitals were open throughout and the doctors only turned away cases which were non-emergent; while still tending to the critical patients. This shows that the doctors are just trying to protest against the injustice meted out to them at their workplace and demanding what is rightfully owed to them by the State government, without jeopardizing any patient’s life. Even though the act goes against the Medico Ethics which doctors are supposed to live by, how can anybody be expected to work without a safe working environment? How can doctors be expected to save other people’s lives when their own lives are at risk every single day?
Therefore, in order to make the health care structure of the country more efficient and systematic, there is an urgent need for the government to develop immediate strategies for supporting the medical fraternity. Furthermore, laws and protections given to the health care workers should be reviewed and updated regularly so that the frequency of these strikes reduce and the safety of doctors and patients alike, can be assured.
[1] Dey S. Over 75% of doctors have faced violence at work, study finds. Times of India 4 May 2015.
[2] Available at https://www.youtube.com/watch?v=lwWTl0xpUGw (accessed on 15 June 2019).
[3] Lalita Kumari v. State of Uttar Pradesh, AIR 2012 SC 1515, November 2012.
[4] Goodman RA, Jenkins EL, Mercy JA. Workplace-related homicide among health care workers in the United States, 1980 through 1990. JAMA 1994; 272: 1686–8.
[5] Pitcher G. BMA survey finds one-third of doctors attacked physically or verbally in 2007. Ethics, health and safety, HR strategy, latest news, occupational health, stress, wellbeing. 10 Jan 2008.
[6] Id.
Contego Humanitas Foundation 