Three days after a mob beat a doctor to death at a tea-estate hospital in Assam, the Union Ministry of Health and Family Welfare has placed in the public domain a draft bill “to address the issue of violence faced by healthcare professionals”. The provisions of the draft law, uploaded on the ministry’s website on Monday, are stringent — they deal with mental and physical abuse targeting doctors, and cover not just hospitals and a radius of 50 metres around them, but also ambulances and home visits by healthcare professionals. The draft proposes a maximum imprisonment of 10 years and a fine of Rs 10 lakh for assaulting doctors, para-medical staff, medical students and diagnostic service providers in healthcare facilities.
It addresses a long-standing demand of doctors for a Central law to curb violence against healthcare professionals. Cleaning the unholy mess involving doctors, patients and hospitals will, however, require much more than punitive measures.
The debate on medical ethics in the country has largely been framed by the doctor-patient binary. This has not only come in the way of a satisfactory resolution of the complex problems pertaining to the rights of patients and doctors but has also resulted in doctors becoming the face of the failure of the country’s healthcare system.
At one government doctor for 10,000 people, India’s doctor-patient ratio is far lower than the World Health Organisation’s recommended ratio of 1:1,000. Moreover, the atmosphere in most public and several private hospitals is hardly congenial for those suffering serious illness. Tempers often run high when patients have to contend with unhygienic and overcrowded facilities, the waiting time to consult a specialist is painfully long and there are queues for even routine diagnostic tests. With most hospitals lacking grievance redressal mechanisms, patients often vent their frustration on healthcare professionals.
A study published in The Lancet in 2017 noted that nearly 75 per cent Indian doctors have faced some form of hostility during their career.
The rising incidents of violence against doctors point to an aspect of healthcare that hasn’t received much attention in policy circles: There is hardly any meaningful communication between doctors and patients. The doctor-patient relationship in India is largely paternalistic. A doctor rarely communicates to patients — or their relatives — the complexities of the ailment in jargon-free language or prepares them for long-drawn therapy.
The medical school doesn’t equip a young doctor with the communication skills to convey bad news to patients’ relatives with empathy. Violence in any setting is reprehensible. But the hostility against doctors points to a trust deficit between them and patients. A law against such violence will address, at best, the symptoms of the problem. The new regulator of the medical profession in the country, the National Medical Commission, must evolve protocols to heal the doctor-patient relationship.