Need For A Law To Protect Doctors [UPSC Notes for GS II]

This article will describe in detail the need for a law to protect doctors from assault and violence.

These UPSC Notes on the need for a law protecting doctors in India are aligned with the UPSC Syllabus and aspirants should prepare this topic for General Studies Paper-II.

In recent times, there has been a rise in assault cases on doctors in the country. This is an important issue and one that needs to be taken seriously and hence is often seen in the news; and is relevant for the IAS Mains.

IAS Exam aspirants can find more notes for UPSC Mains General Studies topics from the links given at the end of the article.

Aspirants can also read health-related articles linked below:

Need For A Law To Protect Doctors

Context:

2020:

• In the wake of COVID-19 pandemic outbreak, the news of house owners asked doctors residing as tenants in their houses to vacate. 
• The body of deceased Chennai doctor (who died to COVID-19) was denied burial in two cemeteries while his family was attacked by the mob.
• A doctor at Hyderabad’s Coronavirus facility was attacked by the family of a deceased patient (who succumbed to Covid-19).
• More than 200 post-graduate doctors went on a strike in July 2020 demanding protection and justice to doctors who become the victim of assaults.

2019: In view of the recent assault on doctors in West Bengal, need for a central legislation to protect Human Resources in Health (HRH) in India.

Human Resources for Health

Current Situation:

• India’s health workforce is characterised by a diversity of providers delivering services in allopathy and alternative systems of medicine like Ayurveda, Homoeopathy, Unani and Siddha. 

• As of January 2020, the doctor population ratio is 1:1456. 

• The current nurse-population ratio is 1.7:1000. Because of the substandard quality of training offered by several institutions that have sprouted up over the years, restricted career prospects and bad working conditions, especially in the private sector, there is a significant shortage of skilled nurses in the country. 

• Moreover, the distribution of doctors and nurses across the country is uneven. There are 4 times as many medicos in the urban areas when compared to the rural areas and in the case of nurses, there are 3 times more number of nurses in the urban areas.

• Nurses and ASHA workers are underpaid, especially in rural areas and do not have any career prospects. 

• There are also severe shortages in the category of allied health professionals (AHPs) including medical lab technicians, optometrists and radiologists. 

• As far as specialists are concerned, a large number of posts are vacant all over the country. According to estimates, India needs close to 0.5 million additional specialists. Ayushman Bharat has triggered the need for even more human resources for health (HRH). There is also an acute shortage of medical faculty.

Constraints:

• The regulatory system (Medical Council of India, Nursing Council of India) has failed to ensure adequate availability and quality of health professionals. 
• There is an inadequate capacity to train doctors, especially specialists and super-specialists.
• Medical faculty in teaching institutions engaged in private practice is pervasive in several states, compromising on the commitment to teaching and institutional clinical work.
• Many state and private medical/nursing/dental colleges have poor infrastructure.
• There is no comprehensive and consistent HRH policy. 
• A major problem is a shortfall in the number, and uneven distribution of doctors, nurses, specialists and related health professionals. 
• The quality of health professional training and adherence to standards is sub-optimal, including in the private sector. 
• Health professionals in the public sector are insufficiently compensated and motivation levels are extremely low. Fair compensation in the private sector, e.g., for nurses, is also a problem area. 
• There is a paucity of data on HRH in the country. 

Measures need to be taken:

• Reform the governance of medical, nursing, dentistry and pharmacy education in India through the passage of the National Medical Commission (NMC) Bill, 2017, the establishment of a Council for Allied Health Professionals and so on. (Read about the National Medical Commission Bill, 2019 in the linked article.)

• Take steps to revamp the regulatory system of nursing education, ensure quality training in nursing schools, develop specialities in nursing, develop centres of excellence in nursing and enhance the stature of government nurses. 

• Enhance the production of doctors (especially specialists and super- specialists) through training of doctors in specialities and super-specialities at private hospitals (certification, short courses, exchange programmes, etc.). 

• Doctors spend a lot of time taking non-medical decisions, mostly administrative and management decisions. The good support system must be put in place so that doctors can focus on their work. 

• Formulation of a comprehensive Human Resources in Health policy in states for all categories, develop a model policy covering issues pertaining to staff recruitment, retention, transfer, incentive structures for posting in difficult areas including access to housing facilities, performance management and competency-based career tracks for professional advancement. 

• Skill and deploy non-physicians and other health providers. 

• Develop plans for training a full range of allied health professionals such that it meets national requirements as well as creates a surplus for placements abroad.

• Generate data on Human Resources in Health, track progress.

• Engage the private sector for skilling and training Human Resources in Health. 

Aspirants can refer the UPSC Mains Syllabus at the linked article.

Read reforms-related articles:

Violence against Doctors:

According to a study by the Indian Medical Association (IMA), more than 75% of doctors have faced physical or verbal violence during their lifetime. Our doctors face verbal abuse almost every day.

Reasons:

• Poor doctor-patient ratio 

• Lack of infrastructure – 

• Poor quality of emergency care in hospitals. 

• Poor pre-hospital emergency care network about which hospital patient needs to be admitted based on type of medical illness/emergency. 

• Lack of emergency resources i.e blood, laboratory services workforce, relevant drugs, etc. 

• Emergency service capacity is critically low. 

• Nursing homes run emergency services without proper training. 

• Absence of postgraduate training in emergency medicine in India 

• Poor communication skills of healthcare workers, administrative staff and also no specific training regarding Public relationship management. 

• Poor grievance redressal mechanism – Majority of the hospitals in India do not have a good grievance redressal system in place. A legal procedure in India also takes an inordinately long time. 

• Lack of civic responsibility in the public. 

• Lack of proper enforcement of laws protecting doctors 

• The negative image of doctors portrayed in the media. 

• Feeling of wrongdoing by the doctors for financial gain or for avoiding his/her duties.

• In a majority of cases, the perpetrators of violence go unpunished. 

At least 19 states have enacted laws to protect doctors and other health-care personnel from violence, which is a cognisable and non-bailable offence in many states. But laws currently in place are simply not working which is evident from the frequent assaults on doctors reported from various parts of the country. For 10 years Maharashtra has legislation to protect the doctors. But nobody has ever been convicted under that law because of its poor implementation. No one takes the law seriously, which remains only on paper. Recently Union Minister for Health and Family Welfare wrote a letter to the Chief Ministers of all States and UTs drawing their attention for strict action against any person who assaults doctors. 

As ‘Health’ is a state subject and considering various issues like lack of enforcement of various legal safeguards available, there is a demand for Central legislation for the protection of doctors. Indian Medical Association has many times raised the demand for a central law. IMA also drafted “The Protection of Medical Service Persons and Medical Service Institutions (Prevention of Violence and Damage or Loss of Property) Act, 2017. It was also circulated to the States vide the 2017 letter from the Ministry of Health last year. The draft Act includes clauses on penalty and recovery in case of loss/damage to property. 

Way forward: 

The issue is complex both from legal and implementation points of view. But treating issues as a law and order situation is just one way. The real solution may lie in enhancing health infrastructure in India, counselling patients about possible adverse impacts or results of treatment, and giving security in medical institutions and effective execution of legal provisions. Doctors in India are highly rated in the world and work for long hours under stressful conditions, grappling with a huge load of patients. It is the duty of State to ensure the safety and security of doctors who assure that the healthcare needs of society are met.

Need For A Law To Protect Doctors (UPSC Notes – GS 2) –Download PDF Here

Aspirants can check BYJU’S UPSC Notes page for free GS1, GS2, and GS 3 notes.

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