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Revamp regulatory regime to cease medical negligence in India

In India, the cases of medical negligence are on the rise because people are becoming more aware about their rights and are raising a voice against so-called malpractice. A study by Supreme Court advocate Mahendra Kumar Bajpai, who specialises in medical law, shows a 110 per cent rise in number of medical carelessness cases in India every year. Ninety per cent of all cases in medical negligence involve hospitals, and 12 per cent of all the cases decided by consumer courts are on medical negligence. Between 60 to 66 per cent of the filed cases are because of hospitals taking improper consent from relatives before performing certain procedures or switching hospitals, or improper documentation throughout the course of diagnosis and treatment.

Sometimes, mistakes can be fatal. Gross medical negligence is a serious offence and punishable under the law. Complaints of medical negligence have increased over the past five years and each case takes at least a few years to be investigated, Medical Councils has the mandate to probe medical negligence cases. It gets 20 to 25 complaints every month. Of these, five or six are accepted for review, based on evidence, there is an urgent need to regulate India’s pluralistic medical landscape, especially when about 80 per cent of the country’s healthcare delivery system is managed by the private sector. It is mostly the state councils that hear cases and the Medical Council of India (MCI) comes into the picture only when the accused challenges the verdict or the state medical council is sitting over a verdict for long, which rarely happens.

The irony is that regulatory bodies have got diluted over the years and it is high time that these are revamped. As the public is becoming more aware, these bodies should be stricter and create a mechanism to build confidence among people. With the loss of faith in regulatory bodies, people are moving to courts for justice. More than the backlog, it is also the prevalent belief that the investigation won’t be impartial because doctors are part of the investigating team and that is driving people away. To avoid that, one should try to have these bodies chaired by some ex-judge, or someone from the social sector or some ex public servant with a social standing.

Wrong treatment is the most common reason for people to complain about medical negligence followed by lack of care, no treatment and forced discharge. Carelessness claims were found to be more common in age groups of children and adolescent (50 per cent) with a declining trend with increase in age. The super-specialty hospitals are accused of negligence in 65 per cent cases. The allegation against the hospitals, both private and government, is in the ratio of 1.8:1. Erroneous treatment/procedure was the main reason. Recently, Delhi Medical Council deregistered two orthopaedic surgeons for six months for operating the wrong leg of a 24-year-old man who was admitted at Fortis Hospital in Shalimar Bagh after fracturing his right foot. Yesterday, patient called Abdul Khader Bagalkot bled to death after dentist Dr Veeresh Magalad extracted three of his teeth.

65-year-old Waman Zare died in Sion hospital during a minor operation to drain fluid from his lungs, after the operation began, a first-year resident doctor, who was operating on the patient, suffered from a panic attack and “ran away from the ward”. The replacement doctor punctured the patient’s left lung instead of his right lung, due to which the patient died.

At the time, barring Government facilities with certified doctors and good equipment, the healthcare options available to most middle-class Indians were dismal. Private nursing homes existed, but they were largely unregulated and did not offer specialist services that were badly needed. Prosperous neighbourhood doctors usually converted bungalow-style homes into ‘hospitals’, and periodically called in their specialist colleagues whenever a difficult case walked in. Given this depressing backdrop and coupled with an overwhelming and seemingly endless demand for high quality medical care, the business case for a corporate style hospital was never better.

Unfortunately, today success no longer corresponds to an individual doctor’s reputation or ability; it has transformed into an intangible adjective abused by some corporate hospitals that treat patients as revenue generating clumps of tissue — to be pricked, prodded and cut open at the slightest pretext. However, when goals shift from honest treatment to cold revenue targets, unnecessary intervention becomes the norm.

The cycle goes on and on, till the unfortunate time a patient actually suffers from a serious underlying condition that needs urgent treatment. Hundreds of tests will be performed. The same diagnostic findings will be corroborated a dozen times, and finally an array of invasive options will be provided to the patient, like a menu card — where perhaps non-invasive options might have been safer and quicker. The net result, notwithstanding the financial condition of the patient, is that the treating physician and the hospital administration raise astronomical bills. Sadly, expensive treatment is not even half the story. The real danger from needless medical intervention is avoidable damage to the health of a patient. In the rush to perform as many surgeries and procedures as possible, doctors often neglect their duty to warn their patients about the high risks involved in such procedures. Consent forms are treated as a mere formality, and are often left blank at the time of obtaining signatures from patients or their caregivers.

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Dr Vaidehi Taman
Dr Vaidehi an Accredited Journalist from Maharashtra is bestowed with Honourary Doctorate in Journalism, Investigative Journalist, Editor, Ethical Hacker, Philanthropist, and Author. She is Editor-in-Chief of Newsmakers Broadcasting and Communications Pvt. Ltd. for 11 years, which features an English daily tabloid – Afternoon Voice, a Marathi web portal – Mumbai Manoos, monthly magazines like Hackers5, Beyond The News (international) and Maritime Bridges. She is also an EC Council Certified Ethical Hacker, Certified Security Analyst and is also a Licensed Penetration Tester which caters to her freelance jobs.

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