The CauseIndia spends only 1.4% of GDP on healthcare compared to 8.3% in US and 7.6% in UK. Even many African countries spend more on healthcare than India. As per World Health Statistics 2015, India’s per capita government expenditure on health in 2012 was a meagre $60, while the US spent $4,153. Central, State Governments and Municipal Corporations have evaded investing in healthcare for decades which has compounded the worsening of the situation. To make matters worse, Fadnavis led Government has actually reduced the health budget allocation for 2017-18 by ₹569 crores. The health budget of 2016-17 was in turn ₹1,308 crore less than in 2015-16. Maharashtra will also spend ₹900 crores less on nutrition schemes. Many ministers and spokesperson have repeatedly assured about increment in health budget, bu the reality is quite different. Public hospitals are constantly hit by shortage of medicines and staff. Patients being told to buy even IV and inhalational drugs in the casualty is a common sight, which obviously angers them. Resident doctors are at the front end of an inefficient, unjust and poorly funded public healthcare system. IMA survey says 70% of attacks are due to relatives accompanying patients. Dozens of relatives, of which half are drunk accompany a patient in the casualty late at night. Even after constant complaints to the administration, this issue is never sorted out. Be it Dhule or Sion incident, every major assault was carried out by scores of relatives. On paper, only 1 relative is issued a visitor pass to be with the patient. As every other rule, this one lies in the dustbin too. One can’t expect a doctor to work properly who is under the constant threat of an assault. One can’t expect a surgeon to have a steady hand when he is perspiring due to fear. Dilapidated infrastructure and horrible planning is the cornerstone of every Government project which is 10 times amplified in a public hospital. The X-ray room is situated almost 500 metres away from the casualty. There is always a shortage of wheelchairs and trolleys due to which, again, the junior doctors have to face the brunt, as they are the only ones present there. MRI, USG, CT scan appointments have a waiting period of months. Apart from the well-equipped trauma ward, every other ward has an issue. The resident doctors and interns do the job of class 4 employees due to lack of staff for tracing medical reports, carrying blood from blood bank, shifting patients to other ward. Many a times, I have personally trolleyed the patient to USG and X-ray. There is no clear distribution of duties among staff. Public frustration of this chaos is unleashed on doctors as we are the only ones they could identify. Normally, only 2 or 3 resident doctors are present in the casualty at night. They are bound to provide only emergency care and diagnostics. Full treatment can only be issued after consulting with senior doctors. This process takes time which agitates patients. There is no counsellor to talk to patient. As the resident doctor has to take history, write notes, examine and provide emergency care; the not so important talking part takes the back seat. A faulty system like this, promotes more attacks on doctors. Not to mention, a resident doctor in a public hospital is overburdened. He/she normally works 14-18 hours a day with at least one 36 hours continuous shift once a week. In towns, such 36 hours shift is almost on every alternate day. Even a basic function like sleep becomes a privilege. To avoid long queues in OPD, many patients come directly to casualty for instant treatment. Doctors can easily differentiate patients requiring an emergency or an elective care. Indian patients don’t accept oral drugs as they always expect IV drugs in a casualty. This delays the treatment of those who require urgent care. Most of them sit at home and visit the doctor only when the disease takes a severe turn. Diabetes Mellitus and Hypertension can be easily managed by drugs, but due to non-compliance, patients come with severe complications requiring surgeries. OPDs managed by 6-8 doctors have 300-400 patients on a daily basis. Sion hospital itself caters to 20 lakh OPD patients annually. Despite all this, the Government isn’t interested in increasing the number of hospitals. Only 1 out of every 20 MBBS graduate gets a PG seat. There is no fear of law among mobs assaulting healthcare professionals. Relatives of the arrested Dhule assaulters tried attacking a nursing staff outside the campus. A doctor in Sion hospital threatened of the same consequence of Dhule doctor if the patient doesn’t get well. A rural hospital ransacked in Sangli for an alleged delay in post-mortem. A casualty officer in Bhabha hospital, Bandra slapped. All within the past 24 hours, during the ongoing strike!
The DemandResidents doctors are fed up with constant fake assurances and lack of proper implementation of current laws. Gov’t keeps on repeating the same promises with a different date. The main demand revolves around providing improved security and limiting entry of relatives.
- Appointment of more security and police personnel immediately
- 2 pass system per patient
- To start the installation work of effective alarm system in every casualty
- To revoke all charges and action taken against resident doctors
- Strengthening of 2010 law, no bail for accused for at least 3 months
- Filing of FIR by the institution itself
- To release funds to implement the law and appoint a brand ambassador to spread awareness for the safety and security of doctors
- To enact a strict law to prevent trespassing in hospital
- Formation of a vigilance team within 15 days
- Formation of a legal cell withing 15 days