Thursday, October 6, 2022

Nagaland Legislative Assembly discuss issue of medical negligence and malpractices


Legislators on Thursday deliberated on the issue of medical negligence and malpractices and called for an end to these, during the discussion on matters of urgent public importance pertaining to the issue on the last day of the 12th session of the 13th Nagaland legislative Assembly.
Initiating the discussion, NPF Legislative Party (NPFLP) leader Kuzholuzo (Azo) Neinu raised concern over cases of medical negligence and malpractices and proposed that Nagaland Medical Negligence Bill be passed by Nagaland Legislative Assembly (NLA) and also to restore trust and respect of public in the profession and also ensure the best possible healthcare delivery in the State.
While pointing out that sections 88 to 92 of Indian Penal Code (IPC) protected doctors from criminal liability on the premise that a doctor always acted in good faith for the well-being of his patient, Azo said a Bill on medical negligence be passed by NLA to provide the best possible healthcare delivery in the State.
He also said besides types of medical negligence like misdiagnosis, delayed diagnosis, failure to diagnose, surgical error, wrong site surgery, unintentional laceration or perforation, unnecessary surgery, negligent anaesthesia preparation, childbirth injuries, drug prescription errors, etc. , the healthcare industry has come to be regarded as a profiteering business in recent years.
Owing to this, he said many private hospitals have sprung up without adhering to infrastructural specifications and safety norms which can be termed as infrastructural negligence. He also said that government and private hospitals in Nagaland operated without necessary medical equipment which have greatly hampered healthcare delivery system and compelled many patients to seek treatment outside. To make matters worse, he alleged that the Health & Family Welfare (H&FW) Department had messed up in posting of doctors. He cited an instance of how a doctor with specialisation in anaesthesia had been posted to a hospital where there was no surgeon.
He also alleged that most government doctors were involved in private practise but drawing Non-Practising Allowance (NPA). He said there has been numerous complaints from patients that they receive better treatment and care in private healthcare centres.
On food safety, Azo said though the government had appointed health inspectors and food inspectors, there was hardly any report of these officials checking food items.
Also taking part in the discussion, Forest & Environment minister YM Yollow recalled how his illness had been wrongly diagnosed and would not have survived had chief minister Neiphiu Rio not intervened and evacuated him outside the State. He said not all were fortunate and therefore requested the government to focus on all district hospitals by providing better facilities.
Yallow also disclosed that the State government was spending more than Rs 8 crore on Non Practising Allowance (NPA) for government doctors but many of them still practised in private.
Yollow said though ICUs were sanctioned in all district hospitals during Covid-19 pandemic, yet there was shortage of manpower to manage them.
He also mentioned some CHCs and PHCs were without any doctors and therefore he stressed that the H&FW department should work on transfer and posting to ensure that no lives were lost due to the absence of medical practitioners.
He said owing to poor medical facilities in other districts, many people on retirement preferred to settle down either in Kohima or Dimapur where proper medical facilities were available.
On his part, Urban and Municipal Affairs adviser Dr Neikiesalie Nicky Kire clarified that not all deaths were due to negligence. He also said that some doctors do not want to be posted to the H&FW directorate but want to continue serving in hospitals.
He urged the doctors to keep themselves updated and not just remain content with what they knew.
He also mentioned that Prime Minister Narendra Modi’s announcement on enhancing retirement age of governments doctors to 62 years should be looked into. He said when other States could implement it, there was no reason why Nagaland could not.
NPF legislator Dr Ngangshi also took part in the discussion and reminded the importance of medical ethics. He remarked that streamlining the system in order to check doctors withdrawing NPA and practising in private, would need a strong political will and hoped that it will be done by the government.
Dr Chumben Murry observed that there were serious concerns over the increasing number of litigations for medical negligence, which could be due to increasing awareness among healthcare recipients.
He stressed putting more efforts on spreading awareness on legal avenues and on improving doctor-patient relationship to enable a more rational approach towards the problem.
Thus, rather than the proposal for a Medical Negligence Bill, Dr. Murry called for strengthening rules and regulations of Medical Council and penal laws dealing with medical negligence so that disposal of cases could be fast-tracked.
He alleged that many cases of medical negligence went unaddressed as the already distressed patient did not want to go through the hassle of prolonged medico-legal battle or they were not properly aware to take informed decisions. Therefore, he said bodies like consumer forums and legal awareness cells should take up awareness campaigns on dealing with medical negligence.
In his response, H&FW minister S Pangnyu Phom said doctors regulated their conduct though a Code of Ethics enforced by self-regulatory body Nagaland Medical Council (NMC). He said the council, on receiving complaints against its members from public, including patients and their relatives, was expected to conduct enquiries, he added.
Depending on the seriousness of the complaints, Phom said the Council had the power to reprimand a medical practitioner or suspend or remove his name from its register. There were also other legal options available to aggrieved patients, including filing a case for civil negligence where the patient could seek compensation for the injury caused due to negligence. He said case could also be filed for criminal negligence where the doctor showed a gross absence of skill or care, besides filing a case for damages as a consumer of services under Consumer Protection Act, 1986.
He cited an instance where a case was considered by Gauhati High Court Kohima Bench in 2020 about denial of medical services to a person living with HIV after getting to know the status of her being HIV positive. NMC had conducted an inquiry and the lapses in communication between the medical practitioner and the patient were established. Due to this, he said the court had awarded Rs 40,000 as compensation to the patient with half the amount to be deducted from the doctor’s salary.
Phom emphasised that patient safety should be the cornerstone of standard operating procedures, protocols and processes put in place in a hospital, adding that these could be ensured by the H&FW Department along with NMA and other stakeholders.