The Ban Caught in Contest

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Bilal Handoo

SRINAGAR

representational Pic

Representational Pic

Days before he was landed in fresh controversy over his inappropriate collar-correction conduct, Mufti Sayeed’s health minister Lal Singh spoke in his usual ‘authoritative’ demeanour: Private practice of doctors must go!

It wasn’t first time Lal Singh talked tough on doctors—with whom his tiff is quite apparent. But the conduct of this BJP man—an erstwhile “trump card” of Congress’ “crisis manager”, Ghulam Nabi Azad—is making certain sections to reckon that he acts more of a “crusader” than Mufti’s any other minister.

Since March this year—ever since the unexpected PDP-BJP coalition was set forth in state, Singh has been making ‘white apron’ flock to feel jittery. He can slap, speak tough and can lay his hands on anyone’s collar to ‘enforce’ “discipline” in state’s “disarrayed” health sector.

To begin with, this government tread an old route: by mulling to ban private practice of government doctors for striking some change in state’s health services. In previous dispensation headed by Abdullah Jr, when cylinders were running out of oxygen at GB Pant Hospital, the authorities inadvertently chose to blame the private practice of medicos for the mess. And when a stark untidiness was reported inside Lal Ded Maternity Hospital, the authorities again blamed doctor’s private practice.

The very blame game, however, fell flat on its face as it couldn’t help these health institutes to get any better.

Those who are running these private clinics have been long arguing—“Look, we are doing it after our office timing. Why should it be such a big issue? Aren’t government teachers doing the same thing? Why isn’t it a big issue there?” In comparison, many doctors attempt to salvage their clinical sojourns—another reason for them to make some quick bucks. “Even if they make good bucks, what’s wrong with that?” asks a doctor, working in SKIMS Soura for Rs 35,000 a month. “They ensure equally speedily treatment, which otherwise ordinary patient can’t get while queuing up in government hospitals.”

Every week, this young doctor, has to give three to four night shifts, attending unabated rush in the hospital. “My friends working outside the state are earning more than one lakh a month—that too by putting up relatively lesser hours of work. But here, while we talk about banning private practice, we never talk about the peanuts we feed government doctors with.”

Like this SKIMS doctor, many others who bat for the private practice maintain: private clinics often come to rescue to patients who need medical treatment immediately—“which otherwise isn’t a case in government hospitals.”

To stress on their point, they quote an example of medical tests being done in government hospitals. “Though one has to pay relatively more to do the tests at private clinics, but it is faster—and many a times, it is speed that matters the most for patient’s well being than some additional bucks.”

Akin to tests, the manner with which the treatment is being done at government hospitals often leaves the patients to run for pillar to post to overcome red-tapism before finally availing treatment, many argue. “And then, at the end of the day, let it be a person’s choice to either go for private treatment or not. Let’s have this facility, which isn’t all that bad. Why to scrap it, just for the heck of it,” says a man, who often takes his ailing mother to private clinics to avail what he calls “hassle-free” treatment without subjecting himself to government hospital’s “irking” crowd.

The man says only influential persons manage to see the doctors at government hospitals by one way or the other, “but the commoners have to wait for days to consult the doctor of his/ her choice. At private clinic, I have a luxury to turn for consultation and treatment anytime and with ease.”

But not everyone is proponent of private practice of government doctors in Kashmir, including the state government itself. There is a doctor body—Doctors Association Kashmir (DAK), termed as “dissenters” in larger medical flock. They often argue that private practice has eroded health institutions and created mess in healthcare. “If a doctor entertains huge number of patients in morning and evening at his/her private clinic, with tired mind, what justice he can deliver to patients at hospitals,” DAK asks, adding these private patients ultimately land up in government hospitals for procedures and surgeries prioritized at the cost of poor patients.

The doctor body also says patient care was the biggest casualty of private practice.

After infant deaths were reported at GB Pant hospital in 2012, the state assembly set up a commission to inquire deaths besides calling for complete ban on private practice of all doctors of teaching hospitals. And one year before that private practice of government doctors was banned by state high court in a public interest litigation on November 18, 2011.

Lately when CM Mufti sternly warned SKIMS doctors—”choose between Job and Clinic”, some doctors believed that the move might trigger fresh “brain drain” in SKIMS, as some top doctors have already “tendered resignation”.

The exit of doctors, it is said, would cripple the entire healthcare system in the State as SKIMS is the only institution where specialized surgeries like brain surgeries, cardiovascular surgeries and kidney transplants are performed. “Once doctors quit, the Medical Council of India would have no option other than de-recognizing the courses due to shortage of faculty members,” says one SKIMS doctor, terming the “criminalization” of their private practice as “gross injustice” with them.

Amid arguments and counter-arguments regarding private practice of doctors, the proponents of private practice say: “the days lost in waiting in government hospitals is terrible compared to pay a small fee in the evening to avail swift and effective treatment”. And, the opponents argue: “Banning the private practice is mandatory to restore larger public confidence in state-run hospitals.” And therefore, the debates rages on.

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