Following the brutal rape and murder of a trainee doctor in Kolkata, the issue of violence against healthcare workers has come to the forefront, with medical professionals across India demanding the enactment of a Central law to protect healthcare workers. In 2019, a Bill on this issue was drafted by the Central government, but it never saw the light of day. Can a Central law ensure security for healthcare professionals at work? R.V. Asokan and Shanthi Ravindranath discuss the question in a conversation moderated by C. Maya. Edited excerpts:
Why has violence against healthcare workers been increasing across India?
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Shanthi Ravindranath: WHO (the World Health Organization) says every country should spend at least 6% of the GDP on health. But few countries are doing this (India spend less than 2%). People need free, easily accessible, proper, and complete treatment. When they reach the hospital, they get angry because they are in distress. Ideally, this anger should be directed against the system. But unfortunately, it is taken out on the doctor who provides the treatment, who is the face of the hospital at that point, and who is in the emergency room. WHO also says violence against healthcare workers at the global level is 8%-38%. We need to increase GDP spending on health and strengthen the public health system so that people are provided proper treatment when they go to a hospital. This will help check such cases of violence.
Could better infrastructure and additional security measures in hospitals help?
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R.V. Asokan: The issues of patient-related violence can be brought down by improving communication (between doctors and patients), ensuring safety measures, and placing a security protocol in all hospitals, especially medical college hospitals. NMC has already come out with an advisory for medical colleges (emphasising the need for each medical college to develop and implement a comprehensive policy to enhance the safety of students and healthcare professionals within the campus and hospital premises). This can be really helpful.
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Shanthi Ravindranath: I also want to add that every hospital should have a hospital protection committee to check all aspects of hospital security. There should be CCTV cameras and security personnel, who should be accountable for the safety and security of all the people working in the hospital, especially healthcare workers.
In 2019, the Centre had drafted a Bill titled ‘The Healthcare Service Personnel and Clinical Establishments (Prohibition of violence and damage to property) Bill, 2019’. However, the Centre took the stand that existing State and Central laws provide adequate legal protection for our health workforce and that all that we require in addition is the beefing up of security in hospitals. Do we need a Central Act to protect healthcare workers from violence?
In 2019, under the same Health Minister, the three Ministries of Home, Law, and Health drafted this Bill. I was part of the committee which drafted it. A lot of consultations were held before the Bill was drafted, but the Bill did not go to the Cabinet. Why did they lead us down the garden path?
The Supreme Court has now set up a national task force to look into the issue of the safety of healthcare workers. How does the IMA view this development?
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Shanthi Ravindranath: We need a Central Act but at the same time, a Central Act should not take away the rights of the State and that of the patients. A law can help in reducing the incidence of violence against healthcare workers, but policymakers should also examine why these incidents are happening. It is the responsibility of the government to see to it that the expectations of a poor patient who comes to the hospital, of free, fair, and total health care, are met. The public health system should be strengthened and out-of-pocket expenditure should be reduced.
Why do you think the Centre went back on its earlier intent of enacting a Central law?
There is no dearth of laws in the country. Kerala framed legislation to prevent violence against healthcare workers in 2012, but it was not enough. While seeking a new law, what are the implementation challenges you expect?
Listen to the conversation in The Hindu Parley podcast
R.V. Asokan is national president of the Indian Medical Association; Shanthi Ravindranath, doctor-activist, is Secretary, Doctors’ Association for Social Equality
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