 Second
Opinion
Mob rule and striking docs: wrong prescription for disease
A nerve centre of the country's health services in the North Central
Province, the Polonnaruwa Hospital is in the news again. Two strikes within
a short period of time have crippled its services causing immense hardship
to patients in the region.
The second dispute is a sequel to the first when doctors kept away from
work after they were assaulted by a mob which ran amok after a patient
treated at the hospital died- after being transferred to a different hospital!
Negligence in the care of that patient was alleged but there was political
involvement as well. And, even if negligence did occur, mob rule and damaging
the property of doctors is not the remedy.
The incidents which occurred in Polonnaruwa are deplorable in that context
because it is similar to crucifying a High Court Judge when his verdict
is overturned by the Court of Appeal!
We see this trend- that of trying to seek vengeance from doctors- as
emanating from the government reaction to the recent prolonged strike launched
by the GMOA protesting the handing over of the health services to provincial
administrations. On that occasion, the government stage-managed protests
against doctors- the 'janathaawa', they were called- and the state media
was used and abused to denigrate the medical profession in no uncertain
terms. Even the President herself made certain comments regarding the profession.
The message to the people was: you may abuse the doctors; we shall look
the other way. That message, it appears has now filtered down to the masses.
It is not that the medical profession is absolutely innocent. A section
of it is guilty of lowering ethical standards and chasing after financial
rewards alone. But we believe that still a vast, overwhelming majority
of doctors render a silent service under trying conditions.
The government often remind us that doctors are abusing privileges gained
through the free education system. But that is hardly a tenable argument
because most doctors see over 50 to 100 patients a day, when the accepted
norm in other countries is to treat less than ten patients a day! There
is also a new cry for litigation in instances of medical negligence. Medical
negligence is a veritable industry in other countries. There is every reason
to support litigation against doctors who fail in their duty because such
checks and balances are a necessary evil. But it must be viewed in the
Sri Lankan context before brashly assuming it to be the panacea for all
ills. We say so because- as mentioned earlier- local doctors see hundreds
of patients daily. Threaten them with the possibility of medical negligence
and they would automatically seek refuge in the practice of trying to provide
ideal care- seeing only a handful of patients a day and ordering all the
possible investigations before pronouncing a diagnosis. Such an eventuality
will only cause a collapse of the health care system in the country because
it will be a virtual 'work to rule' by the doctors. This is not to say
that because of this the people and the government should swallow any bitter
pill prescribed by the medical profession. It should not be so. What is
needed is a rational and pragmatic re-appraisal of the present system where
checks and balances against medical misdemeanours can be introduced without
hurting the interests of both doctors and patients.
Certainly, verbal sabre-rattling against the doctors and thuggery of
the Polonnaruwa variety are not the best solutions. Maybe a medical insurance
scheme for patients and a malpractice insurance scheme for doctors can
be introduced with the state playing an active role. Countries where such
schemes have been successful can be studied and lessons can be learnt from
their experience.
That would be a reasonable way to deal with the issue. But sadly, what
we see now is a scramble for litigation. That will not solve the question
of medical negligence nor will it ensure better health care for the poor
patient who cannot afford treatment from the private sector.
Alas, fools- and some lawyers- have rushed in where others have feared
to tread!
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