FROM THE PRESS
Doctors and the CAT
scam
With the arrest of Ranjit Singh, the CBI exposed an
enormous racket in papers for management and medical entrance examinations. Some
interesting bits of information given to the press by CBI ‘sources’: Ranjit
Singh is a qualified doctor. Some 150 doctors are reported to have been
involved, acting as touts for Singh; several of them were formerly his clients.
The medical entrance examination question papers cost between Rs 10 lakh and 12
lakh. The service was promoted by word of mouth, by satisfied ‘students’ and
their parents who found it cheaper than paying donations to private colleges.
His list of clients included a large number of doctors with whom he had an
unwritten agreement that they would prescribe medicines manufactured by his
pharmaceutical company Redon till their wards completed the course. Redon
registered a turnover of Rs 60 crore in its first year. Singh is reported to
have made Rs 100 crore a year through the CBSE medical exam papers alone.
Pratyush Kanth. Doctors acted as paper touts.
The Times of India. November 26, 2003
Dipak Mishra. Few knew that Ranjit was a CAT
‘king’. The Times of India. November 26, 2003
Surgery by the beach
What do you get if you combine Ajanta–Ellora,
Mahabaleshwar and the Konkan coast with 20,000-odd medical specialists and
hi-tech tertiary care hospitals?
On November 19, 2003 the Medical Tourism Council of
Maharashtra was formally launched in the presence of health minister Digvijay
Khanvilkar, chief secretary Ajit Nimbalkar, medical education secretary G S
Gill, FICCC-WRC chairman Sushil Jiwrajka and union minister of state for
commerce and industry S B Mookherjee.
The point: Maharashtra has a ‘winning combination’
of tourist destinations and world-class healthcare facilities which can provide
treatment at one-fifth the cost in western countries. The medical tourism
industry is expected to grow at 30 % annually. Public hospitals are also a part
of the deal. Khanvilkar declared that the government was upgrading these
hospitals to attract the middle-class medical tourist.
Times News Network. Government launches medical
tourism council. November 20, 2003
Need to protect nurses in
hospitals
The Delhi High Court has admitted a petition
seeking registration of an FIR against Shanti Mukund Hospital, GTB Hospital and
their doctors for allegedly failing to take proper care of a nurse who was raped
and blinded by an employee of the Shanti Mukund Hospital in September 2003. The
National Commission for Women (NCW) had held both hospitals guilty of medical
negligence and called for cancellation of Shanti Mukund’s licence. The victim
was left unattended for hours after the rape became known, and eventually
referred to the GTB hospital which delayed treatment. The NCW also issued
recommendations for protection of nurses.
Rape of nurse: NCW blames 2 hospitals The
Hindu. September 20, 2003
Tribune News Service. Assault on nurse: HC
admits petition against hospitals. October 17, 2003
Code of ethics for hospitals in
Andhra
Private nursing homes and hospitals in Hyderabad
will now have to follow a code of ethics requiring them to standardise their
rates, make their billing transparent, counsel patients and follow clear
procedures for diagnosis and treatment. The code is to be followed by all the
450 institutions registered under the Andhra Pradesh Private Hospitals and
Nursing Homes Association’s Hyderabad and Rangareddy district branch. Inpatients
must be told why they are being admitted, results of preliminary tests, plan of
treatment and the estimated cost.
Bureau report. Code of ethics laid down for
Andhra nursing homes. Pharmabiz Hospital Review. September 16–20, 2003
HC directive to review Nursing Homes
Registration Rules
The Delhi High Court has asked the Delhi state
government to review the Delhi Nursing Homes Registration Rules, 1993, to
improve services offered by ICUs in nursing homes in the state. It also asked
the government to implement the recommendations of an expert committee on
nursing homes. These recommendations cover space, drugs, equipment and staff
requirements in nursing homes and ICUs, including specialist ICUs. The committee
was formed after the doctors and management of Sunderlal Jain Charitable
Hospital were held liable for the death of a patient in the ICU.
Joe C Mathew. Delhi HC demands review of
Nursing Homes Registration Rules. Pharmabiz Hospital Review. September 16–20,
2003
Tooth extraction or heart
surgery?
How much could it cost to get some teeth extracted?
Well, it could be Rs 1,16,777, if you happen to be the dependant of a Bharat
Sanchar Nigam Limited (BSNL) employee. That is the bill handed over by a
Kolkata-based employee for getting his son’s teeth extracted at the private
Suraksha Hospital. The hospital says the extraordinary charge is because the
patient developed complications and had to be shifted to the ICU.
The result at BSNL: a circular stating: ‘It is
imperative that a thorough analysis be made... regarding empanelment of
hospitals and the rates applicable there.’
Sunando Sarkar. A lakh and more to pull out
teeth—clinic bill sends telecom giant staggering. Telegraph November 20,
2003
The state of public hospitals in
Kolkata
If private hospitals charge exorbitant rates, the
state of government hospitals in Kolkata is surely of far more concern. A number
of reports in the Telegraph in October and November describe scenes of patients
dying for want of care, or because the necessary drugs and equipment are not
available. Touts lurk in the hallways and everything, from drugs to a hospital
bed, is available at a price. The government responded by suspending doctors,
cutting pay, and other such punishments. Aggrieved patients attacked doctors,
sending them on strike, and naturally, political parties have made use of the
situation.
12 medical colleges
derecognised
The Maharashtra University of Health Sciences has
prevented 12 medical colleges in the state from admitting new students and asked
them to re-apply for recognition when their infrastructure meets the guidelines
of the Medical Council of India. These include two government-run colleges, five
ayurvedic colleges, one homoeopathic college and one dental
college.
Express News Service. Univ derecognises 12
medical colleges. The Indian Express. November 7, 2003
Videoconference to testify on medical
negligence
A Mumbai court will hear the evidence of a New
York-based doctor through videoconference in a criminal case alleging medical
negligence. The case was filed by P C Singhi who claimed that his wife died at
the Bombay Hospital due to the medical negligence of Dr Praful Desai, honorary
surgeon and head of the Department of Oncology. The US doctor who will give
evidence supporting Singhi’s case is unable to make the trip to India.
Express News Service. Hearing evidence, from New
York to city court. The Indian Express. November 11, 2003
Doctor commits
suicide
The apparent suicide of Dr Vinod Gobind Baramera, a
resident MBBS doctor, has triggered off discussion on the stress faced by
medical students who must cope with long working hours and the emotional
attachment to patients in distress. This is worse for students coming from small
towns or underprivileged backgrounds, who may have difficulty in socialising
with urban and well-off students.
Shailesh Bhatia. Doctor commits suicide in
Nanavati Hospital. Mid-day. October 1, 2003
Publicity-seeking doctors
criticised
Members of the Karnataka Legislative Council
expressed their displeasure over the ‘undue publicity’ gained by a heart
hospital in Bangalore ‘in violation of medical ethics’. The AIPJD member, M P
Prakash, asked the Medical Council of India to take action against
publicity-seeking institutions.
Staff reporter. ‘Bangalore doctors crave
publicity’. The Hindu, Bangalore. July 23, 2003
Nepal hospital regulations: can we have an
update?
In July 2002, the Nepal government announced plans
to regulate health services effective from January 2003. This was announced at a
workshop organised by the Ministry of Health in Kathmandu on ‘Review of criteria
for private health institutions in Nepal’. The guidelines laid down include the
following: (i) Medical professionals would not be allowed to work at more than
two institutions. (ii) Private hospitals and nursing homes would have to provide
facilities for emergency, outpatient and surgery services, among others. (iii)
Hospitals with over 100 beds would have to have a blood bank. (iv) Charges would
be determined by a committee formed by the government.
Institutions would be required to display, for the
general public, information about their services, names of attending doctors and
their academic qualifications, available health equipment and manpower, and the
fees charged. Institutions registered as research centres would have to carry
out research on a minimum of two new subjects in a year.
Himalayan News Service Kathmandu. Medical
professionals can’t work in more than two organisations from 2003. The Himalayan
Times. July 31, 2002
Bangladesh: how to reduce long lines at
public hospitals
Over 1,500 people visit outpatient departments at
the Dhaka Medical College Hospital, Bangladesh’s largest hospital, every day.
Two medical officers in each department struggle to provide treatment of some
sort to the crowd, despite the shortage of equipment and drug. The rush is
regulated by brokers who direct patients to the same doctors’ private chambers
for speedy treatment—where these patients, who are the poorest of the poor, will
have to pay. Patients who need inpatient treatment must give a bribe to get a
bed. All this happens under the nose of the hospital authorities.
When in doubt, take it
out
When the Pakistan Medical Association investigated
an epidemic of abdominal pain and other symptoms from what seemed to be a
water-borne disease, it came up with surprising results. Doctors in Chokera
village near Sargodha had not identified the cause of the problem, but that did
not stop them from making some money by performing appendectomies on more than
120 people.
The local health officer expressed inability to
comment on the cause of the problem and also avoided comments on the surgery
conducted by private medical practitioners.
By our correspondent. Appendectomy performed
without any ‘justification’. Dawn, Sargodha. August 18, 2003
Doctors must protect themselves in
Pakistan
In the light of doctors being killed in Karachi,
Pakistan, the Forum of General Medical Practitioners has taken up the
responsibility of helping doctors get an arms licence and train them in the use
of these weapons. A letter-writer provides phone numbers of doctors to contact
for this service.
Letter in Dawn, Karachi. October 8, 2003
Sri Lanka: healthcare workers’
strike
Some 80,000 Sri Lankan healthcare workers went on
strike demanding salary increases, paralysing work in public hospitals in the
island.
This was the latest of a series of strikes in 2003
beginning with registered medical practitioners, doctors, nurses, paramedics,
technicians and minor staff, mostly over salary anomalies. They crippled
services—resulting in a few deaths from lack of medical attention—and prompted
the mobilisation of hundreds of soldiers to help out in state hospitals.
Trade union activists called the use of the armed
forces a violation of the Constitution and a repression of trade union rights.
Others expressed anger at the striking medical staff and supported the
government’s use of unarmed soldiers to help poor patients.
Patient rights groups such as the National Movement
for the Rights of Patients support an arbitration process for the Health
Ministry and trade unions to settle disputes and prevent recurring strikes by
healthcare workers.
Khabir Ahmad. Sri Lankan health workers strike
over “salary anomaly” Lancet 2003;362:1049
Feizal Samath. Is it proper to strike at health
services? The HimalayanTimes, Kathmandu. October 25, 2003
Missing girls
The continued skewing of the child sex ratio in
India has shocked demographers and policy-makers. Calculated as the number of
girls per 1000 boys in the age group of 0–6 years, the ratio declined from 945
girls per 1,000 boys in the 1991 census to 927 in the 2001 census. (It was 976
in 1961.)
In the 2001 census, four states—Punjab, Haryana,
Himachal Pradesh and Gujarat—had less than 800 girls per 1000 boys. The reason:
an epidemic of sex-selective abortion supported by cheap ultrasound machines
used for sex determination, used even in remote areas despite
legislation.
These ‘missing girls’ essentially means that
millions of medical consultations leading to abortions have taken place with the
active connivance of the medical community, who make a quick buck out of them,
says Dr Puneet Bedi, a Delhi-based gynaecologist.
The United Nations Population Fund’s report
‘Missing’ can be accessed athttp://www.unfpa.org.in/Sanjay
Kumar. Ratio of girls to boys in India continues to decline. BMJ
2003;327:1007.
