Friday 8 January 2016

‘Private hospitals need effective grievance redressal cells’

The much-awaited public hearing of the National Human Right Commission (NHRC) concluded on Thursday but many complainants of medical negligence cases had to go back home empty-handed after the body refused to hear cases against private hospitals. However, during the two days of hearing, the commission also highlighted several lapses in the health services and raised the need for effective grievance redressal cells (GRC) at private hospitals.
The commission will submit its suggestions to the Medical Council of India (MCI) and its state bodies with the observation made during the hearings. Though the official website of NHRC stated that the body would hear cases against public and private health services, the latter was refused on Wednesday.

Commenting on the confusion that left many patients unsatisfied, Justice Cyriac Joseph, acting chairperson, NHRC said, “It was a mistake that led to the confusion.” “My heart goes out to these patients, but as per the rules, we can enquire about alleged violation of human rights only against public bodies,” he added.
Focusing on the need to improve GRC at private hospitals, Justice Joseph said that in 75 per cent of the cases that were presented in the hearing from all the three states — Maharashtra, Gujarat and Rajasthan, GRCs have to be developed in all private hospitals to address the cases of medical negligence. Also, it is observed that patients are unnecessarily referred to private hospitals, he added. He also highlighted the need to address issues such as shortage of doctors and absence of hospitals in rural areas, inadequate number of drugs, and behavioural problems of doctors. The body also upheld the need to introduce the Clinical Establishment Act based on the line of the Central government to make some positive modifications to strengthen the provisions to safeguard patients’ rights.
During the session, the state health department informed that in the past 10 years, Rs 41 crore have been collected by the government for refusal to follow one-year bonds. “Till a doctor becomes a specialist, he keeps postponing the rural posting under the bond. And when he comes a specialist, we can’t post him to a rural primary health centre. That’s why there are vacancies in PHCs,” said Dr Satish Pawar, director, health service.
In these two days, 88 cases were heard out of the 106 registered complaints of medical negligence. Out of these, 38 cases were heard from Maharashtra, 30 from Gujarat and 20 from Rajasthan.
Suggestions for complaints
The body suggested that complaints be registered with the state medical council and that an FIR be filed. If no step is taken within one year of filing the complaint or FIR, then the complainant can approach the state or NHRC for help which can ask the government agencies to take adequate steps to provide justice. But cases that are already registered with courts cannot be entertained by the NHRC.

Med groups flay NHRC hearing of negligence cases
Several medical bodies, including the Medical Council of India (MCI) have flayed NHRC’s hearing of medical negligence cases.
Dr Shivkumar Utture, executive member of MCI said, “There are already four forums available to relieve the complainants grievances, namely Maharashtra medical council, consumer court, civil court and if any criminality is involved then there is the police station, where complainants can get justice. I fail to understand what is the need and significance of adding one more (forum) which does not have proper jurisdiction to do so.”
It is not correct to subject a medical doctor to investigation and harassment simultaneously by the police, consumer court, NHRC court and the ethics committee of medical council, and this is why we are mulling to file a writ petition to challenge such hearings, Jayant Lele, president of IMA-Maharashtra Chapter said.
Indian Medical Association (IMA), a national organisation of doctors, has also questioned the validity of such hearings and said it would only create confusion.
“We feel that creating an additional forum for patients to complain without any clear-cut rules or guidelines in place will only add confusion and it may trigger violence against doctors in the coming days,” said Mr Lele.
Dr Sagar Mundada, president of Maharashtra Association of Resident Doctors (Mard) also said that the NHRC should have formed a committee that looks after these cases with medical professionals and decision of the committee should be final only if they find substantial evidence of negligence.
“The ambit and scope of term ‘medical negligence’ should be defined properly. Complications are inherent in the science of medicine also, as it’s not a 100 per cent fool-proof science,” Dr Mundada said ,adding that inability to make the patient well is not and should not be made equivalent to medical negligence.

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