Pulse

Has ethical medicare lost its way in India?

Kamal Mahawar | Updated on January 16, 2018

bl29_pulse_Anchor Doctor

If it’s severe under-investment in rural areas, services are often priced out in towns/cities

Indian healthcare is struggling with many challenges. A man is left carrying the body of his wife for 10 km because the government hospital has no vehicle. Any person can die on the road after an accident because there is no ambulance service in vast parts of the country.

Thirteen women died in a sterilisation camp in Chhattisgarh two years ago and we don’t yet know what went wrong. We don’t have any doctors in our villages because of severe under-investment in primary healthcare and tens of thousands of Indian doctors and nurses are working abroad.

Yet, the only plan our government seems to have to address the shortage of rural manpower is to licence AYUSH (traditional remedies) doctors to practice modern systems of medicine. While the traditional doctor brings a very different expertise, efforts to licence them to practice modern system of medicine can have dangerous consequences. I feel they should practice in their area of expertise. Also, if everyone can practice modern medicine, aren’t we then fundamentally challenging the need for hundreds of medical colleges?

That said, the term “ethical doctor” has become an oxymoron, especially in the private sector that is infested with overt greed and corruption, resulting in healthcare services being priced beyond the reach of the common man. Why is an industry that operates in India using Indian resources so pricey that the majority of the people of India can’t afford its services?

Unfortunately, we do not have an effective hospital or healthcare regulator to examine the provisions of access and affordability. Doctors work in a regulatory vacuum too as the Medical Council of India, the so-called regulator of the medical profession, itself stands accused of corruption and its office bearers tainted. We all have played a part in the deterioration of this system politicians, bureaucrats, media, and civil society. There are deep systematic problems that lie at the root of our healthcare. The problem starts with the medical education where lack of independence to set fees means our government as well as private medical institutions struggle to recruit world-class academics needed to drive up the standards of education, training, and research.

Studies show that in some parts of the country doctors are no better than quacks. What would you expect when we give young professionals the licences to play with human lives without ensuring that they have the ability to cope with the challenges. These young professionals then not only have to work in a corrupt market but also somehow obtain skills and look after a family that has expectations. How can a young doctor work ethically in these circumstances?

We are a poor country and we spend a much lower percentage of our GDP on health. As a result, our state health infrastructure is struggling and the poor are the worst affected. Politicians are busy with politics and bureaucrats lack the power to bring major change. And that leaves us doctors to try and heal the system from within. But the change will not happen overnight.

The writer is Consultant General and Bariatric Surgeon, Sunderland Royal Hospital, UK. His book ‘The Ethical Doctor’ was published recently by Harper Collins India

Published on October 28, 2016

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