Healthcare or lack thereof: Addressing Medical Malpractice in India

“Clean slate for doctors on medical negligence? Are Indian medics incapable of making mistakes? The complete lack of data on cases of medical error seems to indicate as much”, reports Rema Nagarajan in TOI of December 23, 2013.

The starting point to address this malady is to diagnose how frequent and severe is it. With no data on incidence of medical errors and no authority tracking cases of medical negligence, one might be forgiven for imagining that the over 8 lakh (800,000) registered doctors in India are perfect professionals who never make any mistakes, writes Ms Nagarajan. Let us not forget the growing violent actions both in China and India, which have been alluded to in previous blogs, as a desperate attempt in trying to seek justice for the aggrieved.

“Recently, the parliamentary committee on health and family welfare expressed concern over the fact that there is negligible prosecution of medical negligence cases in India. But the committee’s observation draws attention to an even more shocking fact — there is no centralised collection of data on negligence cases filed in India or their outcome”.

State medical councils and the Medical Council of India (MCI) are supposed to maintain registers of all complaints filed against doctors, their status and the outcome of such complaints. But till today, the MCI has not bothered to put together regional data to build a central database for the nation. This means that the magnitude of the problem of medical negligence remains ignored in India notes Ms. Nagarajan.

“All members of the MCI are medical professionals and whenever any complaint of medical negligence or violation of code of ethics is brought before the council, such cases are decided by the medical professionals themselves. There are reports that the medical professionals probing into the allegations of medical negligence are very lenient towards their colleagues guilty of negligence and none of them is willing to testify another Doctor as negligent,” stated the report adding that the impact of this arrangement was that the prosecution in medical negligence cases by the MCI is dismal, highlights the author quoting the parliamentary committee’s recently submitted 73rd report on the Indian Medical Council (Amendment) Bill 2013.

According to People for Better Treatment (PBT), which was started by Dr Kunal Saha (he recently won the record settlement of over Rs 6 crore by the Supreme Court for the death of his wife due to medical negligence), hardly any doctors are found guilty by state medical councils.

For instance, PBT’s RTI enquiry found that just 515 cases were filed against doctors for either medical negligence or ethical violation in one decade (2001-10), barely four cases a month. And action was taken in just 9% — 15 doctors were removed from the council’s list of registered practitioners and 30 let off with a warning. In 91% of cases, either the case was closed or the accused let off, cites Ms Nagarajan.

“State medical councils mostly comprise doctors and most are not even functioning properly. The ones that function do not reveal any data on the complaints or their outcome,” says Dr Amar Jesani, editor, Indian Journal of Medical Ethics. In Maharashtra the medical council was not properly functional for two decades. From 1990 till 2011, it remained mired in controversies regarding malpractices in the election of council members, goes on to highlight the author.

“We had a tough time trying to get data from the different state medical councils. Even with RTI, they give vague information. There is no price to be paid when council members shield doctors in cases that come before them as the public will never know what happens,” says Dr Saha according to the TOI report.

“In other countries, non-doctors like patients and social workers are mandatorily made members of the medical council and they are known as ‘lay members’ and on occasions they may even lead the council as was the case with UK’s General Medical Council,” pointed out the report recommending that the new, revised legislation ought to make it mandatory to have such members on the council. Ms Nagarajan has indeed hit the nail here. Trust all this does not fall on deaf ears.

Not only is this matter begging attention for a fair reporting and corrective actions, we also have a serious issue with rampant quackery and spurious medical qualifications that are a blot on a profession which ought to tread the holy ground with a Hippocratic oath.