Emerging answers to the issue of health-worker safety continue to remain reflexive and simplistic, and could show an incomplete understanding of the malady beneath
डॉक्टरों की तरफ़ से हड़ताल क्यों की जाती है ?
1 The year 2017
saw protests by resident doctors in Maharashtra, following a series of attacks on medical personnel
.
2 But the solution was
bolstering security in public hospitals and strengthening legal instruments to bring the malefactors to rapid justice.
3 Similar incidents
came and went, with much happening during the COVID-19 pandemic.
There lies a deeper problem
kolkata case
In its proceedings on August 20, the Court decreed the constitution of a national task force to work out measures to strengthen hospital safety.
Improved infrastructure and closed-circuit television surveillance, a greater security presence at hospitals, and safe night transport are reportedly some areas that will receive attention.
In the same vein, the West Bengal government has announced the ‘Rattierer Saathi(night companion’) programme aimed at improving the safety of women working in night shifts, particularly in medical colleges and hospitals. While such initiatives are critical, they implicitly conflate this issue with archetypal health worker violence, which is initiated by disgruntled patients due to perceived poor health-care services, or women’s safety at large. What lurks underneath is the much more insidious problem of corruption of criminal proportions.
Conventional answers to health worker violence, such as improving hospital security and newer legislation, have miserably failed in tackling the problem over the years. These include reasons such as underfunding which are no different than why our health systems continue to remain frail in general. But the extent to which corruption contributes to the overall loss of lives has been vastly under-appreciated.
If emerging accounts are anything to go by, there is a strong likelihood of deep-rooted, organised corruption having contributed to the gruesome crime in question, not to mention other incidents and the steady erosion of public health services that may have hitherto gone unheeded. The fact that this concerns an apex health-care institution in an already underfunded state public health system is acutely disconcerting.
WHO estimates
The World Health Organization estimates that corruption claims nearly $455 billion annually worldwide, more than what it would cost to extend universal health coverage to all. In a good part of the developing world, corruption rather than a lack of funds is what majorly contributes to health-care crises and poor health outcomes. While often sensationalised, the discourse on medical corruption in India has largely concentrated on private losses and malfeasances, while its criminal dimensions have been largely underappreciated. Human resource-intensive health-care systems provide rapid breeding grounds for expansionary corruption, including the worst forms of sextortion, particularly in political systems where underfunding and poor oversight run rife.
In such circumstances, it is hard to conceive how much help would realistically accrue from merely improving the state of health workers’ security and hospital infrastructure, even if they are somehow adequately implemented. Being painfully galvanised to the fact that medical corruption can claim the lives of health-care workers in addition to that of patients serves to indicate that the public health system and its drivers may be up for a rigorous self-examination.
Speedy delivery of justice in the Kolkata case is inarguably paramount, for nothing else said or done can ever serve as a consequential deterrent. Needless to say that we have traditionally fallen short in this respect, and the ramifications are for all to see.
The steps that are needed
But the national task force has a job that is arguably more monumental than simply recommending safety measures — which is to devise a potent road map to prevent and arrest medical corruption, particularly in the public sector. Certainly, this cannot be approached solely by a team of medical doctors. It requires expert inputs from public health, medico-legal, and other allied competencies, besides meriting the participation and the sanction of the larger governing and administrative community. And, the strategies so devised have to look much beyond instituting yet another novel legislative tool.
Apart from reforms centering on administrative transparency, accountability, and oversight, effective whistle-blower reporting and protection mechanisms and thorough digitalisation of public management systems are crucial. The need for ombudsmanship and other instruments to minimise political intrusion and manoeuvring cannot be overstated. Inspiration may be drawn from how fellow nations such as Brazil continue to battle political corruption in medicine.
Much also remains to be done in the way of modernising the typical ‘control and command’ Indian public hospital, which remains steeped in anachronistic ways. While efficiency reasons for such a modernisation abound, their pressing moral and regulatory bases have glaringly presented today and can no longer be overlooked.
Source the hindu
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