Here comes a voice: “Government of India increases spending on healthcare sector.” The demand was not by a social worker or political activist. It was from - don’t be surprised - multibillionaire Bill Gates (Times of India,15.8.2014). Why so many people including Bill Gates demand it in laud voice? It is because of pathetic spending of Indian government - just 1.1 per cent of GDP, the lowest among the developing countries - on health of Indian people.
As a result of this, we have less number of hospitals, doctor-people ratio, people-para medics ratio, malnutrition, infectious diseases, high infant mortality rate, and what not? Instead of investing more in people’s health, our governments are promoting private investment in this vital sector. People who invest crores of rupees for starting hospitals or medical colleges are not philanthropists as in 1940s or 1950s, but big entrepreneurs who expect profit for their investment.
Hence, we hear or read news flashes, like the following samples, periodically and more frequently in the recent past: ‘Doctoring medicine’ [Editorial, Times of India, 29. 7. 2014] ‘Doctors, diagnostic cartels fleecing patients’ - Health Minister! [ToI 23.7.2014] ‘Vardhan [Union health minister] orders probe into graft in healthcare [The Hindu - 23.7.2014] ‘Hospitals making huge profit on disposables in collusion with stockists’ [Pharmabiz – 7.8.2014].
Diseases of healthcare industry!
All these news points out something are rotten in Indian healthcare industry. Let us list the malpractices wide spread in this life saving [?] sector. Doctors on their own or under pressure from their managements:
1] Write prescriptions for unwanted and costly drugs. [Get gifts including foreign trips offered by drug companies]
2] Write unwanted diagnostic tests including costly scan [receive commissions from diagnostic laboratories, sometimes up to 60 per cent of laboratory fee]
3] Prolong treatment or delay discharge of patient. [Thereby ensure hospital bed occupancy and consequent income for hospitals]
4] Use many costly or imported medical devices or implants for the patients [At very high prices often four times that of import cost, as there is no price control, or supervisory authority to question]
5] Arrange illegal unrelated organ donors for transplantation at high cost [including their fee, broker’s commission and a pittance for poor, illiterate donor]
Huge wealth
All the above ensure huge profit for the hospitals which are not normal trade profit, but by sheer exploitation of ignorant public through unfair and illegal trade practices. As though it is not enough, big hospitals have recently invented a new channel of income by opening paramedical courses in their hospitals like colleges. The advantages are hospital senior staffs like doctors and nurses themselves are shown as teachers and no need for investing in infrastructure. Extra benefit is that these students can be used to do manual works in the hospital after reducing regular employees thus saving on the salary bill.
Doctor’s view
If we confront the doctors of big hospitals with the above crime list, they show us the other side of the story. They point out corporate hospitals are forcing or bribing doctors to write unwanted tests and procedures for patients admitted in their hospitals.
Nothing new about the above revealing, many of us knew it already. What is new is eminent doctors started admitting it and openly coming out against these practices, as it has reached intolerable level. Dr. Samiran Nundy of Sir Gangaram Hospital has wrote an article in British Medical Journal [BMJ] titled ‘Corruption: Medicine’s Dirty Open Secret’ in which he has elaborated all the bad practices in the Indian healthcare system starting from admission to medical colleges with huge capitation fees. Dr. M. K. Mani of Chennai Apollo Hospital has said that he had filed a complaint with proof as early as 1995, with Medical Council of India and yet Council took no action. This author personally know, an eminent, foreign return doctor - father of a pharmacy professor - has to resign, some 15 years back, because of his hospital management’s daily pressure to write unwanted tests and drugs to his patients. The same complaint echoed in USA also by an Indian American cardiologist Sandeep [Times of India, 24.8.2014]. Thus, doctors who are not able to kill their inner voice are struggling, suffocating and suffering because of this dangerous infection of the system. Dr. Nundy says, if the income generated by a doctor fall short of targets set for him, these hospitals ask him to justify his salary. At the end, even up to 30 per cent of his salary is cut or he is forced to resign, he fumes. Thus, these hospitals bring pressure, tension, disappointment and depression to humiliation and unemployment for good doctors and debt, worry and even death for patients.
It is not the climax of how big hospitals make money. A recent letter by Tamil Nadu government lawyer to a reputed Tamil daily [The Hindu Tamil, 9. 9. 2014] reveals it which has shocked the readers.
Money from dead body
No, it is not about doctors pretend to continue treatment for the patient already dead! It is about suspicion in the harvesting of brain dead patient’s multiple organs for transplantation. The lawyer suspects it is actually sold to the highest bidding hospital through secret code words. He has explained a client’s case in this connection and concludes it is the reason why these transplantations are mainly taking place in private hospitals, not in government hospitals. It is for the Government criminal investigating agencies to probe further. But think of the brain dead patient’s parents or spouse who donated the organs in good faith even amidst their huge loss and grief. Has our medical profession become a heartless profession?
Remedy
Above problems can be solved to a great extend if only our governments come forward to invest more in healthcare sector as demanded by Bill Gates. If more and more government hospitals and medical colleges are opened in all the districts of India, people need not depend on these cheating private hospitals. At the same time good doctors should come out more openly against these greedy hospitals and try to weed out black sheep from their [once] noble profession.
For that, those who are good at heart should unite and raise their voice. (Now a day it is easy via social media net work.) Will they?
(Author is ex president, Indian Pharmacy Graduates Association, Madurai, T.N.)