The healthcare and medical issues grabbed the headlines of the newspapers recently after 7-day doctors’ strike in West Bengal, which spilled over to become a nationwide doctors’ strike.
Doctor’s Strike: Is this the First Time?
No, 2019 doctors’ strike in India is not the first one. Since independence, many such doctors’ strikes have taken place in India. Here are some of the recent ones:
– In October 2009, around 2,000 resident doctors went on an indefinite strike in Jammu with the demand of better pay and stipend.
– In May 2010, around 300 doctors in Rajasthan’s Jaipur went on a 2-day strike demanding arrest of the accused after a patient’s family members assaulted a doctor.
– In September 2010, a 3-days strike was called by resident doctors/medical-teachers/students after an allegation of police brutality following the confrontation between doctors and relatives of patients. The strike was called off after a deal between the Rajasthan state authorities and doctors.
– In December 2011, more than 6,500 doctors from all 6 medical colleges in Rajasthan resigned with the demand for pay parity with the doctors of the central government hospitals. The strike went on for 11 days and was lifted after the state government lifted the Rajasthan Essential Services Maintenance Act (RESMA) and released all agitating doctors who were jailed.
– Nationwide IMA-approved doctors’ strike took place in June 2012 after certain amendments were proposed in an act related to the clinical establishment as well as private practice.
– In June 2013, doctors in Uttarakhand’s Pithoragarh district went on a strike after relatives of a deceased teenage boy roughed up some hospital staff. The extreme shortage of doctors (especially after regular hours) was the reason for the medical negligence.
– In June 2015, around 2,000 resident doctors in twenty hospitals (including central government and municipal hospitals) in Delhi went on a 2-day strike alleging lack of adequate protection for them along with other demands.
– In January 2017, around 2,000 doctors from all over Himachal Pradesh went on an indefinite period strike following the death of a fellow doctor in Una district.
– In March 2017, thousands of doctors in Maharashtra went on a mass strike after 3 medics were assaulted by around 15 people following the death of a woman. The doctors demanded to ramp up security in the wards and hospital premises.
– In October 2017, around 2,000 resident doctors of AIIMS (All India Institute of Medical Sciences) went on a 3-day hunger strike against improper implementation of the recommendations done in the 7th pay commission.
– Doctors across Rajasthan went on a week long strike in November 2017 demanding salary discrepancy correction, grade pay benefit of Rs. 10,000, an increase in safety inside hospitals, service condition improvement, housing facility, and many more.
– During the November 2017 doctors’ strike in Rajasthan, the government accepted all the 33 demands of the doctors. However, 12 doctors were transferred following the strike. Following this, the doctors started protesting since December 1, demanding the reinstatement of the transferred doctors. The doctors went on a strike from December 18.
– In April 2018, junior doctors of premier hospitals (including AIIMS) went on an indefinite strike after a senior doctor slapped a junior doctor.
– West Bengal witnessed a 7-day strike followed by a 1-day pan-India strike by the doctors in June 2019 after some intern doctors were beaten up by a deceased patient’s relatives in NRS hospital alleging medical negligence.
Doctors’ Strike in India 2019: What Really Happened?
The protest started after some intern doctors in Kolkata’s renowned Nil Ratan Sircar Medical College and Hospital (NRSMCH) were beaten up by two truck-loads of relatives of a deceased patient on June 10, 2019, injuring two intern doctors Paribaha Mukhopadhyay (admitted to ICU after serious injuries on the skull) and Yash Tekwani.
While the deceased patient’s relatives accused the intern doctors of medical negligence, high-handedness by the junior doctors, and refusal to hand over the dead body, the doctors demanded their safety from the administration.
7-Day Doctors’ Strike in West Bengal: Timeline
1. The 7-day long protest/strike started on June 11, 2019, when over 50 intern doctors refused to offer medical services and went on to lock the NRSMCH gates after alleging police inaction.
2. The following day (June 12, 2019), the agitation spilled over to other government hospitals across the state, adversely affecting the medical services across West Bengal.
3. As mediation failed, the Chief Minister of West Bengal Mamata Banerjee issued an ultimatum on June 13. NRSMCH’s Principal Professor Saibal Mukherjee and medical superintendent Professor Sourav Chatterjee stepped down.
4. More than 700 doctors resigned en masse on June 14 in Kolkata and Darjeeling. In Maharashtra, 4,500 resident doctors didn’t work from 8 am to 5 pm. Doctors in Nizam’s Institute of Medical Sciences in Hyderabad staged a protest.
5. On June 15, 15 hospitals in Delhi staged a protest. The West Bengal government was given a 48-hour ultimatum by the AIIMS Resident Doctors’ Association. 246 more doctors resigned from government hospitals across West Bengal. The WB CM Mamata Banerjee met senior doctors and invited junior doctors for ending the impasse. However, the junior doctors declined the offer and asked for an apology.
6. On June 16, doctors decided to withdraw non-essential medical services for 24 hours from Monday (6 am).
7. Around 8,00,000 doctors across India went on a strike on June 17. The same day, the junior doctors met Mamata Banerjee (in the presence of media) with a 10-point plan. They decided to call off the 7-day strike after she agreed to all the points.
Why Problem Keeps Surfacing Again and Again since Independence?
The problem keeps surfacing because no one has addressed the main issue of the shortage of adequate health infrastructure, doctors, equipment, and drugs in public hospitals. These shortages spark off the patient-doctor conflict every time and the doctors respond with a strike.
The health infrastructure, as well as the number of doctors across India, is woefully inadequate (for a population of more than 1.3 billion). Instead of the prescribed 1 doctor for every 1,000 people, there is 1 doctor for every 11,000 people in India.
Paras Healthcare’s managing director Dharminder Nagar has rightly summarized the public healthcare problems of India:
“Saddled with a meagre healthcare budget, public hospitals present a dismal picture where overcrowding, long waiting time and the need for multiple visits for investigations and consultations frustrate patients on a daily basis… The healthcare system in India is bedeviled by the paucity of resources. Doctors work in extreme conditions ranging from overcrowded out-patient departments, inadequate staff, medicines, and infrastructure. A limited number of doctors, nurses and medical staff have to cater to a large number of patients.”
Health experts say the trust deficit between patients and doctors has become a matter of grave concern. The recent case of West Bengal is not an isolated incident. IMA has found out that 75% of the doctors complain about verbal abuse by the relatives of patients. In 12% of the cases, the doctors suffered physical violence. Some of the additional reasons for this mistrust among patients towards doctors are:
– Errors by doctors, medical staff, and hospitals
– Corruption among doctors
– The proliferation of private clinics as well as the emergence of corporate hospitals, leading to the growing perception that the doctors are working with the ill intention to fleece patients
These are the reasons why the patient-doctor conflict keeps repeating and the doctors respond with a strike.
Union health minister Harsh Vardhan has asked the Indian states to formulate adequate legislation for protecting the doctors. However, it will hardly be able to contain the problems because they are dealing it as a law and order problem. The problem lies in the inadequacy of India’s health infrastructure. Until and unless the budgetary allocation of union and state governments towards healthcare system increases, health infrastructure becomes better, and the shortfall of doctors goes away, the problem of patient-doctor conflict and doctors’ strike will keep surfacing time and again.