Jan Arogya Abhiyan’s Jan sunwai for Patients:

The Indian Medical Association (IMA) has publicly criticized the Jan Sunwai for patients, which was organised by Jan Arogya Abhiyan (JAA) on 5th February. This Jan sunwai has highlighted overcharging of COVID patients by certain large hospitals, and other violations of patients rights. These hospitals flouted the Maharashtra government directive to charge COVID patients only at government determined rates. While IMA’s criticism is based on misreading of the Jan-sunwai press reports, JAA welcomes dialogue with IMA while clarifying the following points:

  • IMA alleging that Jan-sunwais are ‘contempt of court’ seems based on ignorance.  During last 25 years, in government programmes like MNREGA, thousands of Jan-sunwais have been held, besides such programmes being organised by many social organizations across the country. Even CAG has recognized Jan-sunwais as a valid tool for accountability.
  • The complaints in this Jan-sunwai were not concerning doctors, but were about overcharging, profiteering and insensitivity towards patients by certain big hospitals (mostly corporate and  large commercial hospitals). Many of these are included in the Govt. funded Mahatma Phule Jan Arogya Yojana (MPJAY), but they did not adequately ensure entitlements to patients under this programme.

Majority of doctors in such hospitals actually are not responsible for management of the hospital. In fact many patients stated that they had no complaints against doctors and other staff. At JAA we support doctors and healthcare professionals who follow medical science and ethics. But it is a bitter truth that today many private hospital managements indulge in major profiteering.

  • Generally among the vulnerable people who suffer some injustice, very few come forward to complain publicly. Therefore, it is very insensitive by IMA to point out the number of patients involved in the Jan sunwai, and based on this to ignore these complaints, or to demand of the complainants why they did not lodge a complaint with the concerned authorities. This remark also ignores the fact that many people are not informed about the formal redressal mechanisms, since they are not adequately publicized even by many implementing hospitals. That many patients received unresponsive and insensitive behaviour from the redressal mechanism even when they approached these, was also highlighted in this Jan-sunwai.
  • The problems mentioned by IMA regarding availability of reasonably priced PPE-kits, oxygen cylinders, or staff absenteeism can’t justify gross overcharging of COVID patients by taking undue advantage of their vulnerability. Making the patient pay Rs. 1.5 lakhs without even giving a bill, an ambulance charging Rs. 16,000 for a 2 km drive to take the dead body for cremation, billing for oxygen without actually giving it to the patient – can such instances be ignored or justified?
  • Standardization of hospital fees has been widely accepted when private hospitals regularly accept packages under government health insurance-schemes and private insurance. Then why is IMA objecting to legal standardization of hospital-rates, on the grounds of doctor’s “fundamental right to decide professional charges”?
  • JAA has been involved in generating public awareness, carrying out advocacy for policies to achieve the goal of health and health care for all, since last two decades. At the same time, IMA needs to keep in mind that during the COVID epidemic, JAA activists in many parts of Maharashtra – in urban areas like Mumbai and Pune, as well as in many rural areas – carried out relief work and actively thousands of COVID patients to access health care. Hence IMA comments regarding JAA in this regard are misinformed. However there is a larger point here. Can we question how someone not providing healthcare, can raise issues regarding healthcare? This would imply that common people and social activists should not be allowed to raise any questions on various social issues which concern them.

Overall, if instead of criticising JAA’s initiatives to support patients, if IMA decides to join hands with JAA for challenging unbridled marketization of health care, and opposes the profiteering by pharma companies, diagnostic industry, private medical colleges, corporate hospitals, and supports rational, ethical medical practice, then the public interest would be served much better.

The full IMA letter below

IMA MS /850/2021                                                           9th February, 2021

Press note
Stop defaming the HCWs
One NGO named Jan Aarogya Abhiyaan, conducted a program which they named ‘ Jansunawai’, meaning a public hearing on 5/2/2021 at Pune. The news about the event got a broad coverage in print media. This entire episode raises  some very serious issues, which we would like to point out for consideration by the people at large.
1) What does the NGO want to achieve by such misleading name ?
2) Are they authorised to conduct such hearings ?
3) conducting such public hearing is certainly a contempt of court. Are these so called social workers not aware of this ?
4) As per the government of Maharashtra report we had 2041398 COVID19 cases till 7/2/2021, in our state. Unfortunately 51280 succumbed to the same. By modest estimate, if we consider 10 per cent patients were hospitalized, the figure is  2.1 lakhs. This NGO received complaints from 30 patients, which is less than 0.015 per cent. This proportion is less than the percentage of adverse effects of any vaccine and definitely less than the probability of fatal road accidents. If this is the case, what these social workers want to prove by just bashing doctors and hospitals ?
5) For argument sake, let’s consider these are serious and true allegations made against the hospital. But then, why these patients and their families have not approached the concerned district administration or Maharashtra medical council or the judiciary ? Are they not aware of these legal channels to address their grievances ? Or they don’t trust these legitimate authorities ?
6) There is a government appointed auditor at every COVID hospital, without whose approval , no bill is issued to the patients. These so called social workers are not aware of this, it seems. Or  are they doubting the integrity of these officials ?
7) Having public health care in it’s name itself, has this NGO, ever (when badly needed, at the peak of corona) did anything to improve health of the society ? 
8) In the initial phase of the pandemic, all the HCWs and the patients, had to buy PPEs, hand sanitizer and essential drugs , respectively, at an exorbitant cost. Did this NGO ever made an attempt to make them available freely or at least raised their voice against this exploitation of the HCWs and patients alike? In fact, the remdesivir which was sold at multiples of the MRP some time back, is now available for less than forty percent of MRP. Why don’t this NGO dare to challenge this ?
9) At one point of time, all the hospitals purchased  oxygen cylinders, almost in grey market, to save thousands of lives. What did these social workers do to stop this  unethical price rise ?
10) During the lockdown, hospitals had to make arrangements for transport and accommodation of their staff members. All the local civic bodies raised charges of biomedical waste disposal. Many staff members had to be given monetary incentives  also, because they were risking their lives, while working for COVID patients. At the same time non- COVID work was almost negligible. Due to all these factors hospitals were in huge financial crisis. This NGO has many doctors as their active members. We are not aware about the efforts made  by these “doctors” to help reduce the maintenance cost of hospitals so that ultimately patient care cost is reduced.
11) All COVID hospitals are bound by the charges fixed by the government. And they stick to them. Apart from that thousands of  private practitioners worked in government hospitals, just in response to a whatsapp message by the administration and till date  nobody has  received a single rupee as remuneration. We did the duties as part of our social responsibility. But are ” these” doctors aware of it ?
12) Unfortunately 78 of our doctor colleagues led their lives in fighting with this COVID19 pandemic. These NGO owners, non practicing doctors and self proclaimed social workers never uttered a single word of condolences, forget about trying to give some help to the bereaved families.
13) We must find out the hidden agenda of  this NGO in trying to sensationalise a non issue. Because by making such baseless allegations, against the HCWs they are demeaning the responsible group of people who have worked in this pandemic ( without fearing for their own lives) and saved lakhs  of citizens of this country.
14) In recently concluded admission procedure for DM ,MCh and DNB seats, almost 700 seats have remained vacant. What does this indicate? This is an alarming sign that due to governmental apathy towards health care sector and the negativism spread by these self proclaimed social workers, talented young people are turning away from the medical field. This is a serious issue.
15) Are these people aware that such kind of negative propaganda by them will only increase the violence against health care workers ?
16) Lastly, this NGO has demanded a law to regulate the charges of hospitals and doctors. Are they ignorant of the fact that every professional and profession has a constitutional right to determine their own charges ?
If such unconstitutional things remain in vogue, after ten years down the lane this society will not have good, talented doctors. So we wish that these NGOs should stop such activities or the government should make them behave properly.

Dr. Ramkrishna Londhe                                Dr. Pankaj Bandarkar
President                                                          Hon. State Secretary

Dr. Rajendra Kulkarni
Chairman, Action committee