The attack on four doctors by the kin of a patient, who died at the K.R. Hospital in Mysore recently, is not the first such incident that has taken place. Several such assaults have occurred on the hapless doctors and even paramedical staff, who have been left to fend for themselves. Issues such as the safety of the doctors and paramedical staff and the lack of security arrangements come to the fore and assume significance. Surprisingly, the fracas involving the relatives of the patients and the doctors are reported most of the times from government hospitals, not private clinics or hospitals.
Most of those visiting the government hospitals are from the middle or lower middle or poorer strata of the society. Again, most of the patients are brought in critical condition. In spite of doctors doing their best some patients die and in some cases it led to attacks on doctors, says Geeta Avadhani, Dean and Director, Mysore Medical College and Research Institute (MMC & RI), which has the K.R. Hospital, Cheluvamba Hospital and the P.K. Sanatorium Hospital under its fold. Two to three such attacks occur in a year at the K.R. Hospital.
The doctors are a worried lot. They say that complaints registered in the past with the police have not had the desired result: meting out stringent punishment to the accused. The existing laws under the Karnataka Prohibition of Violence against Medicare Service Personnel and Damage to Property in Medicare Services Institutions Act, 2009, have not been implemented strictly, they argue. Attacks on doctors are non-bailable offences. In most of the cases, the kin have been let off by the police. Dr. Avadhani said that cases such as snake bites and poisoning are attended to at the K.R. Hospital. The ‘risk consent’ letter from the kin of the patients was obtained in every case, but still assaults take place.
What does the Act say
The Act aims at prohibiting violence against medicare service personnel and damage to property in medicare service institutions. The definition of ‘medicare services’ is given as all institutions providing medicare services to people which are under the control of the State government or Central government or local bodies, including private hospitals having facilities for the treatment of the sick.
The ‘medicare service personnel’ included registered medical practitioners including those having provisional registrations, registered nurses, medical students, nursing students, and paramedical workers employed and working in medicare service institutions. The term ‘offender’ is described in the Act as any person who either by himself or as a member or a leader of a group of persons or organisation commits or attempts to commit or abets or incites the commission of violence under the Act.
Violence could be causing any harm or injury or endangering the life or intimidation, obstruction, hindrance to any medicare service personnel. The person found guilty could be jailed for a period of three years with fines stretching up to Rs. 50,000. And, importantly, it would amount to a non-bailable offence. The quantum of fine for causing damage to property reaching up to two times the amount of the property damaged could be levied by the courts. If the person fails to pay the fine, it could be recovered under the Karnataka Land Revenue Act, 1964, as if it were to be the arrears of land revenue.
Hospital needs ‘surgery’
The K.R. Hospital, it appears, also needs a ‘surgery’ as it lacks many essential facilities. A good number of drunken attendants stay with the patients or loiter on the hospital premises at night. They would pick up quarrels with the doctors on duty over frivolous matters. The doctors coming under fire in such cases receive the choicest abuses. The recent attack on the doctors also happened in the same manner. It could be terrible if it involves a woman doctor. The hospital does not have separate toilets for the staff as the ones located in the duty rooms are used by all, including the patients’ attendants and security personnel. Even dogs could be found sleeping sometimes there, a doctor said.
Some of the security guards who are posted to the hospital through agencies are old and lacked the drive to bring complications under control. The laboratories are defunct at night for want of personnel and there is an urgent need for improving the laboratory facilities. The attendants of the patients would have to go to private laboratories located outside the hospital at night for emergency lab investigations. The heads of departments, professors, assistant professors, senior resident, and postgraduate medical students make up the strength in the hospital rendering service to the needy. There is no shortage of doctors to attend on the patients on a given day, both in-patients and out-patients, says Dr. Avadhani.
She stated that 120 postgraduate medical students joined the K.R. Hospital every year to render service to the needy apart from the regular faculty. Doctors should be allowed to do their duty freely, she says. They get irritated when the kin of patients make mobile calls to MLAs and Ministers and hand over the phone to the doctors to take instructions from them. The attitude of the people ought to change towards doctors, Dr. Avadhani says.
On providing adequate security cover to doctors and other staff at the hospital, she said police had agreed to do so at important areas such as emergency and casualty wards. But the doctors could not always work under police protection, she says.
An armed policemen carrying out night beat in the hospital premise can act a deterrent, she feels. About 1,000 patients visit the K.R. Hospital every day, mainly from the rural areas. On any given day there at about 600 to 700 patients admitted in different wards.
Rally for awareness
Doctors and paramedical staff from different hospitals in the city and the MMC & RI, took out a procession in the city recently, spreading awareness among the public to stop assaults on medicare personnel while dealing with the patients admitted to the hospitals. The doctors made it clear that they could not work under threat or fear induced by the kin of patients. The doctors and the paramedical staff strived to save the lives of the patients, not neglect them for any reason, they stated. The District Health and Family Welfare Department too had extended support to the cause.
The president of the Indian Medical Association, Mysore unit, C. Sharath Kumar, who addressed the participants on the occasion, urged the authorities to provide adequate protection to the doctors to function in a free and fearless atmosphere.
The doctors drove home the point that none of them would neglect patients since they enter the profession by taking an oath to save lives. Copies of the memorandum were submitted to the Chief Minister, Siddaramaiah, through the district administration.
K. Jeevan Chinnappa
When kin of patients take the law into their own hands...