Why do doctors want a central law to protect themselves from attacks and violence?

Doctors have long demanded a separate law to protect healthcare professionals, and a draft law was prepared in 2019 after a nationwide protest. In the context of the recent agitation, however, officials from the Union Health Ministry have said that new central legislation is unlikely to be useful in a situation where already existing versions of similar state laws in as many as 26 states and Union Territories have failed to effectively deter attacks against doctors.

Why have the doctors been demanding a central Act?

Incidents of violence against healthcare workers are reported frequently from around the country, and doctors say that a tough Act could be a deterrent.

Existing laws do have provisions to punish violence, whether against healthcare professionals or others — however, doctors want a separate, targeted law with longer prison sentences and larger fines.

A report by the Vidhi Centre for Legal Policy has listed at least 56 incidents of violence against healthcare professionals between January 2018 and September 2019, when the central Bill was drafted.

Lending their support to the demands of the protesting doctors, 70 Padma awardee doctors wrote to Prime Minister Narendra Modi on August 18, saying that a central law was urgently needed.

One of the signatories, Dr Harsh Mahajan, said: “There is a need for a separate law for doctors because the conditions they face are different from other professions. Many a times doctors have to work for 36 hours at a time and yet they may not have access to a duty room to sleep. They may live in hostels far away, and have to walk in the dark. Just count the number of incidents we have seen in the last five years, something needs to be done.”

One of the reasons why the doctors were adamant on continuing with their recent strike, despite the government promising to set up a committee and the Supreme Court setting one up later, was that the demand has not been met for long.

What is the Centre’s stance on the issue?

Health Ministry officials have argued that the RG Kar incident cannot be linked to the absence of a central law of the kind the doctors have been demanding, because it was a rape-murder to which existing provisions of criminal law will be applicable. Any law for the protection of healthcare workers can only cover violence in hospitals by, say, relatives of patients.

The officials said that several of the 26 state laws on this issue make the offence cognizable and non-bailable — yet the problem continues. There is a need, rather, to address systemic issues such as removing dark spots, ensuring that hospitals are not permeable by random people, and providing adequate security personnel and CCTV camera coverage, they said.

What were the provisions in the 2019 draft law?

The Bill was drafted after a nationwide protest following violence against doctors in another medical college in West Bengal. A committee was set up at the time with representatives of resident doctors’ associations, the Indian Medical Association, and the Health Ministry. Officials from the Law and Finance Ministries were also part of the process.

The Bill reportedly said violence against healthcare personnel and damage of property would be punishable with imprisonment between six months and five years, and a fine between Rs 50,000 and Rs 5 lakh.

In case of “grievous hurt”, the punishment will be three-10 years in jail, and Rs 2-10 lakh fine.

The draft bill reportedly also said that the compensation would be twice the fair market value of the damaged property and loss caused.

What happened to that draft from 2019?

The draft law was rejected during consultations with the Home Ministry. “We were informed that it is being rejected because many of the provisions are already in the penal code, there was insufficient stakeholder consultation, and there was a concern over federal structure,” said Dr Amrinder Singh Malhi, who was then the head of the resident doctors’ association of AIIMS, and one of the members of the drafting committee.

The draft Bill was never put in the public domain for consultations.

Private MPs have tried to introduce variations of this Bill at least thrice — in 2019, 2022, and 2023.

A Bill proposed by Shrikant Eknath Shinde in 2019 had provisions of imprisonment up to five years and fine up to Rs 5 lakh, but not for compensation.

A Bill proposed by DNV Senthil Kumar in 2022 had provisions of up to 10 years imprisonment and up to Rs 10 lakh fine.

A Bill proposed by Shashi Tharoor in 2023 had a provision for imprisonment up to seven years and fine up to Rs 10 lakh.

Importantly, after several instances of violence were reported during the Covid-19 pandemic, the government brought an Ordinance in 2020 that amended the Epidemic Diseases Act, with provisions for imprisonment up to seven years and fine up to Rs 5 lakh.

What do the state laws say?

Dr Malhi said that the 2019 draft had tougher provisions than in any state law.

“During the drafting phase, we went through the laws in several states and took the parts that were good and left out the parts that weren’t. The important thing is that the punishment in all the state laws is less than what is there in the draft Bill. In most states, the highest punishment offered is three years of imprisonment, with Kerala having the highest of up to seven years for grievous injury.

How common are incidents of violence against doctors?

More than 75% of doctors and health personnel in India have faced some form of violence, with 12% being physical attack, says the Vidhi report, quoting a survey done by the Indian Medical Association.

The study found that attendants of patients caused violence in 70% of the cases. Almost 50% of violent incidents occurred in ICUs or after surgery.

Quoting another study, the Vidhi report says that factors such as poor communication skills, poor conflict resolution, and drug addiction were the reasons behind the violence.