Defying Rules
- Unstoppable Rampant Private Practices -
- Hueiyen Lanpao Editorial :: January 23, 2009 -

THE HEALTH care facilities in Manipur are in a sorry condition and something drastic ought to be done to retrieve the lost ground. The doctors are drawing 25 per cent of their salary as non-practising allowance every month, and yet the doctors who do not earn four figure income daily through private practices can be counted at one's fingertips.

In the past, attempts to dissuade the doctors from indulging in private practices had miserably failed since the doctors refused to listen to the authority and there was nobody to discipline them. The successive directors of RIMS have issued memoranda asking the doctors not to indulge in this kind of unethical practice as they are drawing the non-practising allowance.

However, no doctor has taken note of the same. Most of the doctors are attached to the mushrooming private clinics and nursing homes. People also know that many other doctors are treating patients at their residences. Most of the doctors charge Rs 200 per patient for a few minutes' diagnosis.

Since patients are treated from morning to night with some hours' break for the mandatory attendance in the offices, the amount earned from this unethical practice must be exceptionally high. It is observed that the kind of diagnosis and medical advice they give to the patients who come to the hospitals are perfunctory, superficial and really suspicious.

Because a silent message is obviously semaphored to the poor patients that if they care for quality diagnosis and advice, they should come to the clinics and doctors' residences. Apart from Rs 200 as fee, a patient has to spend money in hiring taxi, etc. There is so much overcrowding that the patients have to jostle from 4 am onwards to get a token.

There have been grumbling, even reports in a section of press, pointing out that some doctors advise the patients to get testing done in some particular clinics. It transpired that these testing were not necessary at all. A patient has to spend hard earned money in getting these tests done.

There are reports that not much weightage is given on these test reports. And it is a well known fact that doctors do get the lion's share of the fees. Another suspicious practice is that most of the expectant mothers are advised to give birth by caesarean section which costs about Rs 14,000/15,000 at the nursing homes.

Even women who had delivered through normal course were thus advised. When this kind of suspicious advice was hotly discussed among professionals, some doctors had tried to defend themselves by incoherently saying that most of the "educated women prefer to give birth by caesarean section". But money does not grow on trees and many families can ill-afford Rs 10,000 plus medicine and other unavoidable expenses.

In the past, patients in Manipur used to go to Dibrugarh Medical College and other distant locations. Patients from Manipur go to other states for treatment despite some reputed private hospitals and nursing homes catering to local patients. Apart from the prohibitive expenses, proper diagnosis has been a problem and far from satisfactory. Because a patient or the attendant must narrate the entire medical history either in English or Hindi.

Taking advantage of the language barrier and other factors, some of the patients had been exploited. There was report recently on how a youth was robbed of his kidney during a major surgery in New Delhi. In a few months' time, he died of complications and the crestfallen father merely preserves the medical records including X-ray which establish that his son's kidney was normal and it was not necessary to remove it. There must be many unreported cases of such organ stealing.

There is no dearth of specialists in Manipur. In other words, there is no need for the patients to go to other places for better treatment. It is another story if the family members take a terminally ill person to New Delhi or Guwahati just for the psychological comfort.

Taking all these factors into consideration, the medicare system in Manipur needs to be reoriented to instil a confidence among the patients so that they elect to stay inside Manipur for treatment. They are in a position to get quality medicare by spending nominally. There is already fund for free testings, medicine and other assistance for the BPL people.

Patients from other NE states have been coming to Imphal for treatment while many others from Manipur are going out, which is ironical. The first step is to ban any form of private practice since doctors are drawing non-practising allowance. In such an eventuality, the doctors will have to sit in the hospitals for treating the patients.

It is somewhat surprising that the Health Minister and others have not paid proper attention to this public interest issue. Time is overdue to transform the lame duck medicare system into something spectacular.