The Assam Public Health Bill, 2010: another bill to curb medics’ liberty?
Assam Health Minister Himanta Biswa Sarma has come forward with yet another heroic act ‘The Assam Public Health Bill, 2010’. It sounds very fantastic to the common people. But there is fear abound that the poor doctors may be on the receiving end. The bill which has been moved to the current Assam legislative assembly session says that all emergency patients must be given full free standard treatment for first 24 hours in both government and private hospitals, failing which the patient may claim compensation including transportation cost to the private hospitals which would be borne by the state health department in case of non-availability of service at government hospitals.
One thing is not clear, how the private hospitals are going to bear the impact of economic burden towards the cost of medicines, investigations and other procedures besides the man power involved in managing such a single case. Who is going to bear the huge cost involved in the process? To provide such care ‘free’ by private hospitals is ridiculous unless the government or an insurance company bears it. The reimbursement from the government or the insurance company may be lengthy and corruption-laden like most of the government procedures like the Assam Health Establishment Act under which an aspirant doctor or a small health establishment in a rural area has to go through all the humiliating procedures like obtaining certificates from local municipality/Panchayat, electricity, PWD, pollution control board, fire service, etc., etc., which is rarely available ‘free’. Nursing Homes or the private health institutions live mostly on emergency services. Will this act deprive them of the right to live? What happens to thousands of young medical students carrying out medical studies in private medical colleges by paying huge amounts of fees? Will they be able to recover it in their life time?
The proposed patient welfare society (Rogi Kalyan Samity) would be chaired by the Deputy Commissioner of the concerned district or the Principal Secretaries of the Autonomous Councils with the district health authority having no role except carrying out instructions. This may further increase the resentments among the government doctors who have been made puppets by the district administrative officials due to provision of over-interference by non-medical persons over medical professionals. The recent amendment of pay-scale which gives the general administrative officers a higher slab over the highly educated doctors who had been enjoying an equal status hitherto has been opposed by the AMSA (Assam Medical Service Association).
The medical profession is one of the oldest professions of human race. It is heartening to learn that there is some word about health care providers to be ‘treated with respect and dignity’ which is in oblivion in recent decades when doctors are being physically assaulted for many minor and unjustified reasons. Enactments of bills which make doctors more powerless and helpless will surely discourage new entrants to the profession or force doctors who are already in the profession to pack up. It is hoped that the honourable members of the Assam legislative assembly will consider the bill from the doctors’ point of view as well before giving it a final shape.
The doctors in the government service are already over burdened with numerous government schemes for which they are doing over works at the cost of their family and social lives. The government should ensure posting of required number of excess doctors and paramedics before enacting such a bill. The private doctors are ridiculed into Assam Health establishment act, which make small entrepreneurs shy away from new ventures due to some impractical preconditions and red tape over the procedures. The act needs some revisions to remove some oppressing preconditions especially to the small and rural practitioners. Providing access to basic rights of a citizen should be shouldered by the government and not by an individual professional alone as long as ethics are maintained like other fellow citizens.
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From the patient point of view.One,will they get the money so easily without feeding ten government servants mouth ? two, in the private set up if they are referred to higher centre on immediate basis what they will do? they cannot demand the expertise of doctor in all cases.Also a doctor has the right to refer a patient for good treatment. But this bill will force doctors to refer more patients to higher centres, specially from small private hospitals..three, if the doctor defers the operation to second or third day what will be their response ? for example a fracture thigh bone if presented after 6 hours of the accident is always deferred 4-5 days..so in this type of situation there will be clash between the doctors and the patient party.four,the expected bill will always be more..the cost of first 24 hours will be adjusted..which will be borne by the patient..only on papers it will be shown free.
lastly, this bill is nothing but a political gimmick..no one will be benefited..ultimately it is the common people who suffer..the political parties collect money from the banias and the banias collect from the common people but in double rate..no minister can utter a single word against it..not even the so called powerful health minister of Assam.
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