Time and again, sensationalism seems to cure the health sector of its ill health. Fake drug scandals, hepatitis C epidemic, and children dying in scores in hospitals are just a few examples of how effectively the health sector is being managed. Let us not talk about the tortuous queues, lack of beds, poor sanitation, missing lifesaving drugs, corruption and the scarcity of manpower plaguing our hospitals. With the so called sting operation by a known bigoted news channel, who even accuses the state chief minister of being a separatist, the government suddenly woke up from a deliberate slumber. In a civilised and accountable society, before making allegations of kickbacks on anyone, the news channel would consult their lawyers to check that they have enough proof for what they are about to allege. But ironically, here the government takes the word of the prejudiced news channel and remove the director of the institution from his post without any due process. Surely this is done to create a rhetoric of providing healthcare to people when in actual sense, it hardly matters, as nothing changes for a common man who has to wander from door to door to get any help.
I am not supporting private practice by those doctors who claim a non-practising allowance and it is clearly in breach of their contract. However, when the subject is debated on moral grounds, do we really want to agree that it is in public interest to keep hundreds of sick people waiting on your doorstep and refuse to help them. I am not trying to say all these doctors are doing it out of goodwill or charity and many may be indulging in wrong practices. More pertinently why do so many people have to beeline the private premises of a doctor at odd hours? If the government thinks banning private practice is good for the masses, then where are the alternatives? Who would redirect these people to right place at the right time so that they get some relief? There are more questions here than solutions. This brings us back to the basic question. Do we have adequate doctors and hospitals, and if not, are we utilising the available manpower to the maximum of their capacity and capability? Suspending few doctors or removing SKIMS director hardly makes life easy for someone who needs help here and now.
Time and again, local media and journalists report the failings of health sector, falling on deaf ears. The bottom line is providing safe, accessible, and timely healthcare is not a priority for the government or the bureaucracy. The people who are supposed to manage our hospitals hardly use them. From health minister to any Babu in the secretariat, a posh private hospital in Delhi is closer than SMHS or SKIMS, paid by the state exchequer and duly referred by the Directorate of health services. This could be for as simple as a fatty liver or a migraine. If they or their loved ones do come to local hospitals by any chance, the nepotism and VVIP culture makes sure they are received on a red carpet. This means directors need to more worried about attending the phone calls of their bosses, arrange private rooms, bypass queues, refer them to outside of the state, than look after the departments they are supposed to manage. Why do we think then SKIMS can be run smoothly or director health services will be confident to stay in his job, if he doesn’t agree with a Babu or attend to their undue demands. The policy of appeasement is more important that the lack of health policy in the state, which none of the health ministers or health secretaries think is of any importance.
The institutions of repute like SKIMS ought to be independent if they have to develop and provide services effectively. By keeping them hostage to the external influence of people who do not know ABC of healthcare or who don’t bother to know, simply means such institutions are doomed. If the director of SKIMS is powerless, on the mercy of a lay minister or indifferent commissioner, always in need to please people to stay in his job, why are we expecting our institutions to become centres of excellence? I am not suggesting there should be no accountability but surely there should be no political interference. External independent bodies should audit standards of care, corruption and overall performance. Nowhere in the world, have top institutions excelled when governments and bureaucrats try to micromanage them for paltry gains of power and nepotism.
Let us not forget that doctors and other health professionals work in incredibly difficult and adverse circumstances in the valley. They are often beaten, abused and humiliated. With the ongoing conflict, they have provided services when rest of the populace is trying to keep safe. There are not many incentives for them to be around, but they make sure lives are saved, putting their own lives at risk time and again. Sadly the administration has created a narrative around the failure of the health sector in the valley, which squarely blames an average doctor for all its shortcomings. For a common man, a doctor is the face of a health institution. If there are no medicines available, people do not blame the administration but the sole doctor on duty in a remote area and at times manhandle him. The local politician once elected does the same and never takes responsibility for the health sector in his constituency. The most they do is to call the BMO, order them rudely to do this and that, if they have to please a yes-man. This whole scandal is a vicious cycle which only makes sure that health sector becomes a failure no matter what the frontline staff does or doesn’t do. Again, when have people sought better health care from their representatives? Do we ever hear that there was a protest rally to secure better health facilities? The answer is simply, No.
The issue of private practice by doctors working in the Medical Colleges and SKIMS is often used by the politicians to divert the attention from the real issues. Many people believe that banning private practice of such doctors will improve the state of institutions they work for. I am not sure if it is based on mere speculation or some real scientific evidence. Probably if they are fully dedicated to their jobs, it may enhance the academic and research capabilities of such institutions. However, looking at the state of the healthcare, doctor-patient ratio, hospital infrastructure, and the systemic failure of health provision, it is fairly evident that there are more patients in need of help than the government health sector can provide. Hence we see people beelining the private premises of doctors after travelling hundreds of miles to have few minutes with a doctor. This is an issue of supply and demand and simply banning private practice without providing a real alternative to common people is not going to work.
The best government can do is to come up with a sensible health policy keeping in view the resources, manpower, and demand on health infrastructure. Allowing the health institutions to function and develop without undue political interference will be a good start. Protecting doctors from ill-tempered revenue officials or homicidal police officers when they are working in harsh conditions is not a big ask. The kneejerk reaction to please a bigoted news channel would not save lives but shatter the already low morale of health professionals to rock bottom. I am not suggesting that all doctors are honest and some don’t indulge in malpractice. Such doctors need to be made accountable by lawful means than by acting like a dictatorship. The new director SKIMS will not come with a magic wand that the attached director didn’t possess. Finally, the government needs to be serious to sort out the mess in health provision than just acting up to shut up a rude malicious news channel.
