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Patient in Rajasthan denied admission: Doctor cries foul, says action taken without inquiry
| Alwar (Rajasthan) [India] Jul 05, 2017 11:07 PM IST
After reports emerged that an eight-month pregnant woman was allegedly refused admission in three different hospitals in Rajasthan’s Alwar district before she finally delivered her baby outside a Community Health Centre (CHC), the accused doctor, who has been relieved with an APO (Awaiting Posting Order), has decried the order by the Chief Medical and Health Officer (CMHO), saying that the action was taken without a proper inquiry into the matter.
“No inquiry has taken place. I wasn’t asked anything. The Reproductive and Child Health Officer (RCHO) came to me on July 3 and asked whether the admission ticket that was found with the patient was made in the hospital. I said it was made by me. In fact, I got the information that the patient, instead of going inside had gone away through the media only,” Dr. Kanchan Batra, the doctor on duty at the time of the incident, said.
“We have 16 beds in our labour room and more than 40 patients are admitted on a single day. That day, between 8 a.m. to 2 p.m., out of 216 patients, 35 were admitted to the labour room. Her ticket was made at 11.38 a.m. and since it was a computerised ticket, the time is the ultimate proof. And after that neither the CMHO, nor the RCHO took any statement from me. They just took the action. I am now on Awaiting Posting Order (APO) without any inquiry,” the doctor added.
Dr. Batra further said that there were no complications in her pregnancy and that’s why she delivered on her own.
The doctors of the district hospital, however, are presenting a united front in support of Dr. Batra even as they held a strike for two hours on Wednesday.
“We’ll see what more we can do in case the administration doesn’t do anything,” she said.
“Along with me, action has been taken against the Akbarpur CHC doctor and the nurse who didn’t check on the patient. They were relieved on July 1. I got the information last night. They have taken the action on the behalf of the media. They are being partial,” she added.
Dr. Bhagwan Sahay, the Principal Medical Officer (PMO), has assured of a proper inquiry.
“We have set up a committee and will do an inquiry. According to the CMHO, who produced the order, the doctor is at fault for not properly counselling the patient. But prima facie, it doesn’t look like it’s the doctor’s fault. A doctor cannot escort every patient till the ward. The doctor made the ticket and asked the patient to get admitted. Now why she didn’t do it will be found after the inquiry only,” he said.
“Today, a two-hour strike was held. It’s expected to continue tomorrow, though I haven’t got anything in written,” he added.
It was earlier reported that on July 1, Lacha Devi, along with her husband, visited the Akbarpur CHC for consultation from where they were sent to the Alwar district hospital.
The woman was then taken to the Satellite Hospital in Alwar’s Kala Kuan area where she was referred to the Zanana Hospital from where they returned home.
Devi then experienced intense labour pain and was rushed to the Akbarpur CHC again where she delivered a baby girl outside the hospital.
Meanwhile, Alwar CMHO Shyam Sundar Agarwal said an action would be taken after an inquiry report is tabled after which two on-duty doctors and a nurse were relieved for APO.
The State Women Commission has also sought an inquiry into the matter.
Dean, senior doctors booked for abetting suicide of resident doctor
SURAT: Five doctors, including the dean of the Government Medical College (GMC) Surat, were booked in Khatodara police station on Wednesday for allegedly abetting suicide of a 24-year-old resident doctor. The victim had ended life on Tuesday by jumping from an under-construction hospital building on New Civil Hospital (NCH) campus. The accused were also booked under Prevention of Atrocities Act following allegations levelled by father of the deceased. Read more
Govt to curb ‘cut practice’ in medical profession
Maharashtra Government is all set to curb ‘Cut Practice’ in medical profession. Soon, Government will introduce ‘Prevention of Cut Practices in Medical Services Act 2017.’
S Srinivasan of All India Drugs Network (AIDAN) through e-pharmail has mentioned that State Government has formed a nine member committee to study regulations in other countries for preventing cut practices including anti kickback laws in USA and UK and suggest measures to be incorporated in the proposed Act.
The committee will be headed by former Director General of Police, Pravin Dixit. The committee consists of Dr Avinash Supe, Director of Medical Education and major BMC hospitals; Dr Sanjay Oak, Director of Prince Aly Khan Hospital, Byculla; Dr Abhay Chowdhary, President of Maharashtra Medical Council; Dr Ramakant Panda, Vice Chairman of Asian Heart Institute, Mumbai; Indian Medical Association (IMA) representative, Dr Yeshwant Amdekar, pediatrician; Dr Amit Karkhanis, dermatologist; and Dr Himmatrao Bawaskar, Mahad.
Srinivasan mentioned that during the first meeting of the committee held on Tuesday, the panel of members discussed different provisions of proposed act in details. Section I of the act contains definition of the Act which reads any person believed to be medical experts having received a patient for treatment, refers him to other medical experts, hospitals, laboratory for further treatment/examination/ tests and in turn receives any pecuniary benefits from such medical experts/hospitals/laboratory, would be committing an act of indulging in ‘Cut practices in Medical Services’.
Section II says, “Cut practice in medical services is an offence and would be charged under cognisable offence tried by JMFC, 1st Class. Any person who indulges in such acts repeatedly, would be treated as repeat offender.”
Section III deals with punishment for the offence. It reads punishment for the offence of “Cut practice in medical services” would be simple punishment up to three months and fine up to Rs 5,000. Repeated offender would be punishable by simple imprisonment up to six months and fine of Rs 25,000.
This committee was formed by the State Government following Dr Ramakant Panda’s representation to Directorate of Medical Education and Research, Government of Maharashtra over rampant growth of cut practice in medical field. It is to be recalled that Dr Panda’s Asian Heart Institute in Mumbai had put up a poster stating ‘No commission. Only honest medical opinion’ in the city which invoked sharp response from IMA. The hospital has also installed 10 banners in the city in response to IMA’s warning to remove the first one.
Reacting to IMA remark, Dr Panda stated “instead of protecting wrongdoers, IMA should sensitise its members on the need to do away with cut practice. It’s not that all of its members are engaged in such practice. There are a number of doctors who were never involved in it.” Dr Panda said “We have found that at least one third of the patients who were asked to go for angioplasty or bypass surgery did not need it. The expense of treatment will decrease by 25% if cut practice is curbed.”
Considering the rampant growth of cut practice, Asian Heart Institute has initiated debate on the issue. A number of medical professionals including Dr Gautam Sen, Dr Vikrant Desai, Dr Sanjay Nagral, Dr Himmatrao Bawaskar, Dr Devi Shetty, Dr G N Rao, Dr Soma Raju, Dr Srinath Reddy, Dr Samiran Nundy etc had extended their support to the hospital crusade against cut practice in medical services.
All Rajasthan In Service Doctors Association
सरकारी चिकित्सक क्या है ?
राजस्थान प्रदेश में कार्यरत प्रत्येक वो चिकित्सक जो कि चिकित्सा एवं स्वास्थ्य विभाग में कार्यरत है वो सरकारी चिकित्सक है ।
मेडिकल कॉलेज के चिकित्सकों का अलग कैडर है, अलग नियम हैं और अलग भर्ती होती है, दोनों विभागों में समान डिग्री और अनुभव आदि होंने पर भी मेडिकल एजुकेशन वालों के पे ग्रेड, सेलरी, प्रमोशन व अन्य सुविधाएं सरकारी चिकित्सक के बजाय काफी बढ़िया हैं, जो कि निश्चित रूप से सरकार का दोगलापन है ।
अरिसदा क्या है ?
फ्री दवा जांच योजना से पहले सरकारी डॉक्टर जीवन यापन सही से कर रहे थे और एक दूसरे की आवश्यकता नही थी, आजकल सब फ्री हो जाने के बाद डॉक्टर सैलरीड एम्प्लॉयी हो गए हैं और इसीलिए तनख्वाह, भत्ते, प्रमोशन की तरफ आस लगाए हुए हैं, इसी आस का आधार बना है “अरिसदा” । 2011 में एक इतिहास इस संघ के बैनर तले लिखा गया लेकिन आपसी खींचतान और कुछ अन्य कारणों से इसके बाद इस संघ में केवल बिखराव ही आया है ।
अरिसदा सेवारत चिकित्सकों का अलोकतांत्रिक संघ है जिसमें निर्वाचन के बजाय मनोनयन की परंपरा ज्यादा है जिसमें जिलों में अधिकारियों को मुख्य पद दिए जाते हैं और राज्य स्तर पर जयपुर वालों पर जबरदस्ती कई पद थोपे जाते हैं और यही इस संघ की कमजोरी का सबसे बड़ा कारण है ।
अरिसदा मजबूत कैसे हो ?
इसे मनोनयन की संस्था से लोकतांत्रिक संस्था बनाया जाए ताकि दूरस्थ phc पर कार्यरत चिकित्सक को भी राज्य कमेटी में अपनी भूमिका लगे ।
आज के दिन मुख्य मांगे क्या हैं?
1. चिकित्सा विभाग में सेवारत चिकित्सकों का कैडर (भारत सरकार/हरियाणा के अनुरूप) बनाया जाए ।
2. एक पारी में अस्पतालों का संचालन ।
3. केंद्र के समान वेतनमान, भत्ते और पदोन्नति मिलें, पूर्व में डीएसीपी में रही विसंगतियों को दूर किया जावे ।
प्रमोशन में वन टाइम रिलेक्सेशन मेडिकल एजुकेशन विभाग की भांति दिया जावे ।
4. पीजी प्रवेश परीक्षा हेतु पूर्व में डिफाइन (2017 में डिफाइन किये गए रिमोट/डिफिकल्ट) किये गए ग्रामीण क्षेत्र (रिमोट/डिफिकल्ट), जिसमें ग्रामीण भत्ता मिलता है को यथावत रखा जाए ।
5. ग्रामीण भत्ता मूल वेतन पर 50 प्रतिशत दिया जावे ।
6. ट्रांसफर पालिसी बनाई जावे, चिकित्सा अधिकारियों को नियम 22A के तहत प्रारम्भ में ग्रामीण क्षेत्र में लगाया जाए फिर शहरी क्षेत्र में शिफ्ट किया जावे एवं ग्रामीण क्षेत्रों में कार्यरत चिकित्सकों के रहने हेतु नजदीकी शहरों में क्वार्टर उपलब्ध करवाए जावें, इमेरजेंसी ड्यूटी हेतु ट्रांसपोर्ट की सुविधा अन्य राजपत्रित अधिकारियों की भांति उपलब्ध करवाई जावे ।
7. चिकित्सकों की वार्षिक प्रगति प्रतिवेदन (ACR) के रिव्यू अधिकार पंचायती राज के अधिकारियों से हटाकर पूर्व की भांति CMHO/JD/DMHS को दिए जावें । (कैडर बनते ही यह मांग खत्म)
8. कई जगह सीएमएचओ जिला परिषद कार्यालयों आदि अन्य जगहों पर बैठते हैं, इनके लिए अलग से ऑफिस बनाये जावें । (कैडर बनते ही यह मांग खत्म)
9. चिकित्सा स्वास्थ्य विभाग में नई पॉलिसी/योजना/बजट घोषणा करने से पहले इसकी विस्तृत चर्चा सेवारत चिकित्सक संघ से की जाए ताकि इनकी प्रभावी क्रियान्विति हो ।
10. चिकित्सालयों में बनी सोसायटी RMRS के अध्यक्ष चिकित्सा विभाग के अधिकारियों को बनाया जावे । (कैडर बनते ही यह मांग खत्म)
11. सभी चिकित्सालयों में IPHS norms के अनुसार जनता को चिकित्सा सुविधा उपलब्ध करवाई जावे ।
12. सभी चिकित्सकों को समय समय पर ट्रेनिंग/कॉन्फ्रेंस, प्रत्येक वर्ष में कम से कम 3 बार राज्य सरकार के व्यय पर करवाई जावे ।
13. नए जोइनिंग करने वाले चिकित्सा अधिकारियों के लिए जोइनिंग के एक माह में ही रिफ्रेशर कोर्स/इंडक्शन ट्रेनिंग करवाई जाए, उसी के बाद इनको पदस्थापित किया जावे ।
14. दंत चिकित्सकों का प्रोबेशन पीरियड एमबीबीएस चिकित्सकों की तरह एक वर्ष का किया जावे ।
15. चूंकि दंत चिकित्सकों की नियुक्ति शहरी क्षेत्र में ही होती है अतः उनके शहरी क्षेत्र में की गई सेवा अवधि के आधार पर ही उन्हें पीजी परीक्षा में 10-20-30 प्रतिशत बोनस दें ।
एक चिकित्सक से क्या अपेक्षा है ?
जिला स्तर पर प्रति दो माह में एक चिकित्सक मीटिंग हो जिसमें हर चिकित्सक उपस्थित होकर यूनियन की मजबूती में हिस्सेदारी प्रदान करे ।
जरूरत पड़ने पर जिला स्तर और राज्य स्तर पर होने वाले धरने प्रदर्शन मीटिंग आदि में पहुंचे ।
*चिकित्सकों का काफी नकारात्मक माहौल जनता में चल रहा है, ऐसे में सभी चिकित्सक पॉजिटिव माहौल बनावें और एक दूसरे पर कटाक्ष के बजाय एकजुटता वाली मिशाल कायम करें 🙂
Clinics closed due to poor business
PETALING JAYA: As many as 500 clinics run by general practitioners (GPs) were estimated to have closed between 2014 and 2016 due to poor business.
And the Malaysian Medical Association (MMA) is worried that the situation may worsen.
Its president Dr Ravindran R. Naidu said a study involving 1,800 GPs revealed widespread concern over the financial sustainability of their clinics.
The findings from Study on the Health Economics of General Practitioners in Malaysia: Trends, Challenges and Moving Forward in 2016 revealed that the expenses for managing GP services had increased over the years due to changes in policies as well as the involvement of the unregulated third party administrators (TPAs), said Dr Ravindran.
The findings showed almost 70% of clinics saw fewer than 30 patients a day, while the operating cost of a clinic in an urban area ranges from RM50,000 to RM60,000 a month.
“With the drop in number of patients and increasing cost, it will eventually lead to the natural death of the GP practice,” said Dr Ravindran, adding that prior to this, instances of clinics closing down were rare as they would typically be sold or passed on to others to run should the doctors retire or migrate.
Dr Ravindran argued that TPAs must take the main share of the blame as they had removed some patients from GPs.
“They negotiate with companies and take away patients from one clinic and pass them to other clinics,” he said, adding that TPAs place restrictions on consultation fees, types of medication prescribed, while charging GPs a fee for every patient they see.
Contributory factors, said Dr Ravindran, include the overproduction of doctors and the introduction of the contract system for those in public service.
He said as the Government would only take 50% of the doctors after a four-year contract, the rest are likely to become GPs, thus saturating the sector even further.
The solution to this, argued Dr Ravindran, is that the Government has to cut down on the number of students studying medicine as there were 5,000 medical students graduating each year.
“The other alternative is to build more hospitals while all medical colleges should have their own hospitals,” he said.
The vice-president of the Medical Practitioners Coalition Association of Malaysia, Dr M. Raj Kumar, agrees that clinics seeing below 30 patients a day were unsustainable.
“A clinic needs at least 30 patients, depending on locality,” he said, adding that operating costs have skyrocketed in recent years such as the various licences needed for the practice, medicine costs that increase every six months, the introduction of GST, and rise in wages for nurses and assistants.
“The poor economy is also forcing the public to visit government clinics,” he said.
Read more at http://www.thestar.com.my/news/nation/2017/06/22/clinics-closed-due-to-poor-business-gps-seeing-fewer-patients-amid-rising-operating-costs/#04xjjQQEcJClKyLz.99
Centre introduces software to catch ‘corrupt’ officers
HIGHLIGHTS
- The new system will expedite the departmental proceedings
- All documents will be stored online
- In the later phase, officers of state government will also be brought under this surveillance
NEW DELHI: Seeking to cut delays and introduce transparency in departmental proceedings against bureaucrats for alleged corruption, the government on Thursday introduced an online software that will record all processes online and use cloud-based technology to provide an interface among all stakeholders.
Minister of State for Personnel Jitendra Singh said the new system will expedite the departmental proceedings, thus ensuring that corrupt officers are brought to justice without delay even as the honest ones are spared undue harrassment and intimidation. The portal will initially be adopted in respect of IAS officers posted at the Centre but subsequently be extended to all All India Services officers as well as Group A employees serving in the Central government.