19 June 2017
With regard to the Karnataka Private Medical Establishments (Amendment) Bill, 2017, tabled in the Karnataka Assembly in June 2017, we support the government’s decision of regulating private medical establishments, introducing a Charter of patients right’s, creating a grievance redressal committee and fixing a cap on rates.
Karnataka has seen a massive growth of the private sector which has neither self-regulated nor allowed any form of government control. This has led to rampart overcharging, denial of patients’ rights, negligence, unnecessary procedures and tests. Patients have been over-charged and held to ransom. The cost to life and the burden that private healthcare has imposed on patients has been well documented in India as well as other countries. Government health services, on the other hand, have systems of monitoring and oversight, even if the implementation has generally been poor.
When the government health system is strong, health has shown to improve, easily measured by maternal and child mortality rates. The government health system, apart from its curative role, plays an important role in prevention, promotion of health and rehabilitation. The private sector has never taken up preventive roles because it has low economic value. While the public sector undergoes rigorous training on management of diseases of public health importance such as tuberculosis, HIV, non-communicable diseases, dengue etc., the private sector has often initiated treatments that not only lead to bad outcomes for the patient, but create major public health problems such as antibiotic resistance, Multi-drug resistance and other complications which are then left for the public health system to manage. Rather than working on prevention of public health diseases like dengue, the private sector often capitalises on the fear syndrome for its own private gain.
It is also well known that private hospitals have no mechanism of reporting data on morbidity, mortality, caesarean sections, hysterectomies and other surgeries. There is poor documentation and maintenance of records for the rationale (if any) behind investigations and treatment, referral patterns and cause of death, if it occurs. Patients therefore have very little access to information if they would like to have a second opinion, which they are entitled to, or if they suspect negligence and would like to pursue the case legally. The public health system has a more rigorous system of data collection and transmission, which helps to understand disease and mortality, as well as diseases of public health concern.
It is also well known that expert doctors very rarely testify against colleagues even in the face of obvious denial of care or negligence. This makes patients and their relatives extremely vulnerable and puts them completely at the mercy of medical establishments, with doctors as experts.
With the Vajpayee Arogyashree scheme (VAS), private empanelled hospitals have demonstrated how they are quite ready to manipulate the government for economic gains, pick and choose lucrative patients, while closing the door on patients who are terminally ill or requiring protracted care. They have also been shown to bring on several added costs for patients over and above the money received through VAS. This has created a burden on patients, with out of pocket expenditure under the scheme ranging between Rs. 10,000 to more than Rs. 1 lakh.
We therefore feel that your move to regulate private medical establishments is urgently required and long overdue. We feel that the government should not give in to the pressure exerted by the private sector lobby and instead do whatever is required to ensure that all patients, irrespective of their ability to pay, are offered access to comprehensive preventive, promotive, curative and rehabilitative health care.
This would go a long way in making the government people centric instead of market centric, and make Karnataka a model of comprehensive health care for other states to follow.
- Dr. Ambrose Pinto SJ, Principal, St. Aloysius Degree College, Cox Town, Bangalore 560005
- Brinda Pancholi
- Meena P, Azim Premji University.
- Teena Xavier, Karnataka Janarogya Chaluvali (Kalaburgi)
- Chethan BV
- G. Ravi, Jana Chinthana Kendra
- Vishal Kumar, Theatre research scholar
- Sumathy Nagendra, Bhumika media
- Dr. Sunil Kumar Hebbi
- Rajesh Umadevi Srinivas, Sangama
- Jayaram, People’s Union for Civil Liberties, Bangalore
- Dr. Venkat Pandu
- Karthik Ranganathan
- Lohith Sharanappa
- Sujatha Mody
- Safiya, Movement for Justice
- Pushpa Achanta, Journalist and trainer
- Dr. Sylvia Karpagam, Public health doctor
- Dr. Karthik Bittu, Biologist
- Nagarjun Kandukuru
- Geeta Thatra, Researcher, Jawaharlal Nehru University
- Meera Sanghamitra, National Alliance of People’s Movement
- Cynthia Stephen, Independent policy researcher and journalist
- Siddharth K Joshi
- Bala Krishnan
- S.S.Rajani, Consultant, development sector
- Sowjanya B, IT employee
- Gee Imaan Semmalar, Sampoorna
- Kamayani Bali Mahabal, health and human rights activist
- Rajesh Umadevi Srinivas, Sangama
- Stanley Thangaraj
- Leon Luis
- Nidhin S, IT employee
- Guru, Associate director, Basic needs India
- Dr. Akhila Vasan, Karnataka Janarogya Chaluvali
- Vijayakumar S, Karnataka Janarogya Chaluvali
- Vinay K Sreenivasa. Alternative Law Forum
- Doddipalya Narasimhamurthy, Swaraj Abhiyan
- Dr. Vasu. Karnataka Jana Shakti
- Karnataka Janaarogya Chaluvali
- Karnataka Janashakti
- Karnataka loading and unloading workers union
- Safai Karmachari Kavalu samiti
- Alternative Law Forum
- Slum Janandolana Karnataka
- Right to Water Campaign
- Karnataka Jana Shakti
- Mahila Munnade
- Swaraj Sanghatane
- Movement for Justice
- Swaraj Abhiyan
- Sangama, Karnataka Sex Workers’ Union
- Garment and Textile Workers’ Union
- Karnataka Rajya Raitha Sangha
- Janaandolanagala Mahamaitri
- Samanathegaagi Janaandolana
- Manthan Law
- Dalit Sangarsh Samiti (DSS)
- Jana Sangram Parishat
- Samaana Shikshekaagi Jandandolana
- People’s Union for Civil Liberties (PUCL)