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Dear Sir,

With regard to the Karnataka Private Medical Establishments (Amendment) Bill, 2017, tabled in the Karnataka Assembly in June 2017, we support the government’s decision of regulating private medical establishments, introducing a Charter of patients right’s, creating a grievance redressal committee and fixing a cap on rates.

Karnataka has seen a massive overgrowth of the private sector which has neither self-regulated nor allowed any form of government control. This has led to rampart overcharging, denial of patient rights, negligence, unnecessary procedures and tests. Patients have been over-charged and held to ransom. The cost to life and the burden that private healthcare has imposed on patients has been well documented in India as well as other countries. Government health services, on the other hand, have systems of monitoring and oversight, even if the implementation has generally been poor.
When the government health system is strong, health has shown to improve, easily measured by maternal and child mortality rates. The government health system, apart from its curative role, plays an important role in prevention, promotion of health and rehabilitation. The private sector has never taken up preventive roles because that has low economic value. While the public sector undergoes rigorous training on management of diseases of public health importance such as tuberculosis, HIV, non-communicable disease, dengue etc., the private sector has often initiated treatments that not only lead to bad outcomes for the patient, but create major public health problems such as antibiotic resistance, Multi-drug resistance and other complications which are then left for the public health system to manage. Rather than working on prevention of public health diseases like dengue, the private sector often capitalises on the fear syndrome for its own private gain.

It is also well known that private hospitals have no mechanism of reporting data on morbidity, mortality, caesarean sections, hysterectomies and other surgeries. There is poor documentation and maintenance of records of rationale for investigations and treatment, referral patterns and cause of death, if it occurs. Patients therefore have very little access to information if they would like a second opinion, which they are entitled to, or if they suspect negligence and would like to follow the case legally. The public health system has a more rigorous system of data collection and transmission, which helps to understand disease and mortality, as well as diseases of public health concern.

It is also well known that expert doctors very rarely testify against colleagues even in the face of obvious denial of care or negligence. This makes patients and their relatives extremely vulnerable and puts them completely at the mercy of a medical establishment with doctors as experts.

With the Vajpayee Arogyashree scheme (VAS), the private empanelled hospitals have demonstrated how they are quite ready to manipulate the government for economic gains, pick and choose lucrative patients, while closing the door on patients who are terminally ill or requiring protracted care. They have also been shown to bring on several added costs for the patient over and above the money received through VAS. This has created a burden on patients, with out of pocket expenditure with the VAS ranging from anywhere between 10,000 to more than 1 lakh.

We therefore feel that your move to regulate the private medical establishment is urgently required and long overdue. We feel that the government should not give in to the pressure by the corporate private sector lobby and instead do whatever is required to ensure that all patients, irrespective of their ability to pay, are offered access to comprehensive preventive, promotive, curative and rehabilitative health care.

This would go a long way in making the government people centric instead of market centric, and make Karnataka a model in comprehensive health care for other states to follow.

In solidarity

  1. Dr. Ambrose Pinto SJ, Principal, St. Aloysius Degree College, Cox Town, Bangalore 560005
  2. Brinda Pancholi
  3. Meena P, Azim Premji University.
  4. Teena Xavier, Karnataka Janarogya Chaluvali (Kalaburgi)
  5. Chethan BV
  6. G. Ravi, Jana Chinthana Kendra
  7. Vishal Kumar, Theatre research scholar
  8. Sumathy Nagendra, Bhumika media
  9. Dr. Sunil Kumar Hebbi
  10. Rajesh Umadevi Srinivas, Sangama
  11. Jayaram, People’s Union for Civil Liberties, Bangalore
  12. Dr. Venkat Pandu
  13. Karthik Ranganathan
  14. Lohith Sharanappa
  15. Safiya, Movement for Justice
  16. Pushpa Achanta, Journalist and trainer
  17. Dr. Sylvia Karpagam, Public health doctor
  18. Dr. Karthik Bittu, Biologist
  19. Nagarjun Kandukuru
  20. Geeta Thatra, Researcher, Jawaharlal Nehru University
  21. Meera Sanghamitra, National Alliance of People’s Movement
  22. Cynthia Stephen, Independent policy researcher and journalist
  23. Siddharth K Joshi
  24. Chetana
  25. Bala Krishnan
  26. S.S.Rajani, Consultant, development sector
  27. Sowjanya B, IT employee
  28. Gee Imaan Semmalar, Sampoorna
  29. Kamayani Bali Mahabal, health and human rights activist
  30.  Rajesh Umadevi Srinivas, Sangama
  31. Nidhin S, IT employee
  32. Guru, Associate director, Basic needs India
  33. Dr. Akhila Vasan, Karnataka Janarogya Chaluvali
  34. Vijayakumar S, Karnataka Janarogya Chaluvali
  35. Vinay K Sreenivasa. Alternative Law Forum
  36. Doddipalya Narasimhamurthy, Swaraj Abhiyan
  37. Dr. Vasu. Karnataka Jana Shakti
  38. Karnataka Janaarogya Chaluvali
  39. Karnataka Janashakti
  40. Karnataka loading and unloading workers union
  41. Safai Karmachari Kavalu samiti
  42. Alternative Law Forum
  43. Slum Janandolana Karnataka
  44. Right to Water Campaign
  45. Karnataka Jana Shakti
  46. Mahila Munnade
  47. Swaraj Sanghatane
  48. Kamayani Bali- Mahabal
  49. Movement for Justice
  50. Swaraj Abhiyan
  51. Sangama, Karnataka Sex Workers’ Union
  52. Garment and Textile Workers’ Union
  53. Karnataka Rajya Raitha Sangha
  54. Janaandolanagala Mahamaitri
  55. Samanathegaagi Janaandolana
  56. Manthan Law
  57. Dalit Sangarsh Samiti (DSS)
  58. Jana Sangram Parishat
  59. Samaana shikshekaagi jandandolana