India’s medical sector saga

Alternative medicine, though desirable, is fraught with malpractices

The New Year saw the covernment backtrack on more occasions than one: the significant being the national anthem and the National Medical Commission Bill.  On the first, the Government stepped back voluntarily and on the second it was pushed. The “push” came close on the heels of the Government’s unrelenting position on the triple talaq Bill that was stuck in the Upper House of Indian Parliament after the Government failed to get the Opposition parties on board. Had the doctors not gone on a strike, the Medical Bill, as it came to be known, could have been part of the slugfest between the Government and all those opposing it in Parliament.

As for the national anthem, it was the Government that told the Court that it was in favor of modification of the earlier order making the playing of national anthem mandatory before the screening of movies. The Court had earlier ruled that all those present in cinema halls must “stand up in respect” while the anthem was being played. This, it said, would instill “committed patriotism and nationalism”.

The order had then created a furore with many alleging that the BJP was trying to impose its own brand of nationalism by forcing the people to carry patriotism on their sleeves. This, they said, was against the basic concept of freedom and did not go down well in a democracy.

The protests, however, fell on deaf ears and the Court order was being followed by all cinema halls even at the cost of inviting ire from some sections of the cinema going crowds. Ofcourse there was a sizeable section that welcomed the move on grounds that every Indian must respect the national anthem and was duty bound to revere it. Many felt that it was an opportunity to “stand united” as a nation. For several others, it was a way to sing the lines along while it was being played and refresh one’s memory of the Indian anthem.

 As the dust settled and people started getting used to the practice of the anthem preceding a movie, the Government took a somersault: a huge one at that.   

In a surprise move, it told the apex court that playing the national anthem should not be made compulsory for now. The Centre, it said, had constituted a 12-member inter-ministerial group to study and suggest possible changes in the Prevention of Insult to National Honour Act for incorporating measures to enhance respect for the national anthem.

The 1971 Act prohibits the desecration of or insult to the country’s national symbols including the national flag, the Constitution and the national anthem.

The inter-ministerial committee, the Court was told,  will take at least six months to study all aspects relating to signing and screening of national anthem and the manner of respect due to it and give recommendations to the Centre.

 During a hearing on a PIL on October 23 last year, the Court had questioned the logic behind the earlier order, saying there is no need for an Indian to "wear his patriotism on his sleeve". It had also said that if a person does not stand up for the national anthem it cannot be assumed that he is "less patriotic".

The Government, had then said, that India was a diverse country and the national anthem needed to be played in cinema halls to bring in uniformity.

With its latest affidavit asking the Court to make the playing of the anthem optional, its earlier contentions have been thrown to the wind. Even while the why and whereof of this is being fiercely debated, the consensus seems to be that the BJP is under fire from the liberals and its aggressive brand of Hindutva, patriotism and nationalism is making it unpopular. There is more criticism than praise and at this point in time when economic woes are staring hard, the Government perhaps decided to go slow on nationalism and hindutva.  

The national anthem propos al and the Government backing it to make its playing mandatory before every movie was seen as imposition and opposed tooth and nail. But the government did not relent and pushed the move with vigour. It is against this backdrop that its recent affidavit asking the Courts to reverse its earlier order is not only being viewed with suspicion but raises more questions that it answers.

Equally, the logic of the Medical Bill has also raised the hackles of the medical fraternity as well as those who  have some understanding of the way health services are handled, rather mishandled, in India.

There was a nation wide stir against the National Medical Commission (NMC) Bill, that seeks to replace the MCI and also proposes allowing practitioners of alternative medicines, such as homoeopathy and ayurveda, practice allopathy after completing a "bridge course".

The Bill which was tabled in Parliament in the recently concluded session, was referred to a parliamentary standing committee following a strike by doctors protesting against its provisions.

One of the objections to the Bill was on grounds that it will promote quackery: a major grouse being about the prospect of “cross-pathy” — a person trained in one stream of medicine practicing another — which is specifically disallowed under the current rules.

The Bill says that the government wants “to enhance the interface between homeopathy, Indian systems of medicine and modern systems of medicine”.

AYUSH practitioners who are required to pass the bridge course to prescribe allopathic medicines do not have to pass the licentiate examination either.

An AYUSH practitioner is defined as a person who is a practitioner of homoeopathy or of Indian medicine. There will be a national register of the AYUSH practitioners who have qualified the bridge course.

Section 49(4) says that a “specific bridge course may be introduced for the practitioners of homeopathy and of Indian systems of medicine to enable them to prescribe such modern medicines”.

This surely will open the flood gates of backdoor entry in a profession that is already under fire. Private hospitals fleece patients; and surgeries even when not needed are the order of the day. Government hospitals are overflowing with patients and many, even the poor, have to turn to private practitioners. Here it is a free for all with patients at the mercy of doctors whose brief is to “earn first and treat later”.

There are cases galore where a large number of tests, more unnecessary than necessary, are conducted to make a fast buck. Labs and imaging centres are flourishing and there is  a clear nexus between private hospitals and these centres who survive on tests that doctors prescribed.

As if this is not enough, one now has non medical practitioners prescribing expensive tests. This is where the Government needs to bring in checks and balances and as a first step prohibit non medical practitioners from prescribing tests.

In fact, a pre-requisite for carrying out any test must be a prescription from a MBBS doctor and no one else. As things stand, even dieticians who are making a quick buck by suggesting weight loss techniques, often unscientific and untested, recommend lists of tests including Vitamin D deficiency and allergy tests that may not be necessary.

The Government must bring in a law and make it imperative for every clinic be is a homeopath’s, Ayurveda or weight loss to have a qualified MBBS doctor attached to it before any prescription be it for tests or supplements can be honoured. There should be a penal clause against clinics functioning without a fully qualified medical practitioner.

Alternative medicine, though desirable, is fraught with malpractices and however much the Government may want to make it part of the mainstream it must be conversant with the dangers of the proposed bridge course that will only add to the rampant misuse of a profession. There can be no compromise to quality and qualification and the Government must tighten its noose against non medical practitioners, prohibit their practice rather than encourage mediocrity through a short term leap like a bridge course. Were that to happen it would be a sad day and the death of the Indian doctor.

The writer is a senior Indian journalist, political commentator and columnist of The Independent. She can be reached at: ([email protected])

 

Indias medical sector saga

Alternative medicine, though desirable, is fraught with malpractices

The New Year saw the covernment backtrack on more occasions than one: the significant being the national anthem and the National Medical Commission Bill. On the first, the Government stepped back voluntarily and on the second it was pushed. The push came close on the heels of the Governments unrelenting position on the triple talaq Bill that was stuck in the Upper House of Indian Parliament after the Government failed to get the Opposition parties on board. Had the doctors not gone on a strike, the Medical Bill, as it came to be known, could have been part of the slugfest between the Government and all those opposing it in Parliament. As for the national anthem, it was the Government that told the Court that it was in favor of modification of the earlier order making the playing of national anthem mandatory before the screening of movies. The Court had earlier ruled that all those present in cinema halls must stand up in respect while the anthem was being played. This, it said, would instill committed patriotism and nationalism. The order had then created a furore with many alleging that the BJP was trying to impose its own brand of nationalism by forcing the people to carry patriotism on their sleeves. This, they said, was against the basic concept of freedom and did not go down well in a democracy. The protests, however, fell on deaf ears and the Court order was being followed by all cinema halls even at the cost of inviting ire from some sections of the cinema going crowds. Ofcourse there was a sizeable section that welcomed the move on grounds that every Indian must respect the national anthem and was duty bound to revere it. Many felt that it was an opportunity to stand united as a nation. For several others, it was a way to sing the lines along while it was being played and refresh ones memory of the Indian anthem. As the dust settled and people started getting used to the practice of the anthem preceding a movie, the Government took a somersault: a huge one at that. In a surprise move, it told the apex court that playing the national anthem should not be made compulsory for now. The Centre, it said, had constituted a 12-member inter-ministerial group to study and suggest possible changes in the Prevention of Insult to National Honour Act for incorporating measures to enhance respect for the national anthem. The 1971 Act prohibits the desecration of or insult to the countrys national symbols including the national flag, the Constitution and the national anthem. The inter-ministerial committee, the Court was told, will take at least six months to study all aspects relating to signing and screening of national anthem and the manner of respect due to it and give recommendations to the Centre. During a hearing on a PIL on October 23 last year, the Court had questioned the logic behind the earlier order, saying there is no need for an Indian to wear his patriotism on his sleeve. It had also said that if a person does not stand up for the national anthem it cannot be assumed that he is less patriotic. The Government, had then said, that India was a diverse country and the national anthem needed to be played in cinema halls to bring in uniformity. With its latest affidavit asking the Court to make the playing of the anthem optional, its earlier contentions have been thrown to the wind. Even while the why and whereof of this is being fiercely debated, the consensus seems to be that the BJP is under fire from the liberals and its aggressive brand of Hindutva, patriotism and nationalism is making it unpopular. There is more criticism than praise and at this point in time when economic woes are staring hard, the Government perhaps decided to go slow on nationalism and hindutva. The national anthem propos al and the Government backing it to make its playing mandatory before every movie was seen as imposition and opposed tooth and nail. But the government did not relent and pushed the move with vigour. It is against this backdrop that its recent affidavit asking the Courts to reverse its earlier order is not only being viewed with suspicion but raises more questions that it answers. Equally, the logic of the Medical Bill has also raised the hackles of the medical fraternity as well as those who have some understanding of the way health services are handled, rather mishandled, in India. There was a nation wide stir against the National Medical Commission (NMC) Bill, that seeks to replace the MCI and also proposes allowing practitioners of alternative medicines, such as homoeopathy and ayurveda, practice allopathy after completing a bridge course. The Bill which was tabled in Parliament in the recently concluded session, was referred to a parliamentary standing committee following a strike by doctors protesting against its provisions. One of the objections to the Bill was on grounds that it will promote quackery: a major grouse being about the prospect of cross-pathy a person trained in one stream of medicine practicing another which is specifically disallowed under the current rules. The Bill says that the government wants to enhance the interface between homeopathy, Indian systems of medicine and modern systems of medicine. AYUSH practitioners who are required to pass the bridge course to prescribe allopathic medicines do not have to pass the licentiate examination either. An AYUSH practitioner is defined as a person who is a practitioner of homoeopathy or of Indian medicine. There will be a national register of the AYUSH practitioners who have qualified the bridge course. Section 49(4) says that a specific bridge course may be introduced for the practitioners of homeopathy and of Indian systems of medicine to enable them to prescribe such modern medicines. This surely will open the flood gates of backdoor entry in a profession that is already under fire. Private hospitals fleece patients; and surgeries even when not needed are the order of the day. Government hospitals are overflowing with patients and many, even the poor, have to turn to private practitioners. Here it is a free for all with patients at the mercy of doctors whose brief is to earn first and treat later. There are cases galore where a large number of tests, more unnecessary than necessary, are conducted to make a fast buck. Labs and imaging centres are flourishing and there is a clear nexus between private hospitals and these centres who survive on tests that doctors prescribed. As if this is not enough, one now has non medical practitioners prescribing expensive tests. This is where the Government needs to bring in checks and balances and as a first step prohibit non medical practitioners from prescribing tests. In fact, a pre-requisite for carrying out any test must be a prescription from a MBBS doctor and no one else. As things stand, even dieticians who are making a quick buck by suggesting weight loss techniques, often unscientific and untested, recommend lists of tests including Vitamin D deficiency and allergy tests that may not be necessary. The Government must bring in a law and make it imperative for every clinic be is a homeopaths, Ayurveda or weight loss to have a qualified MBBS doctor attached to it before any prescription be it for tests or supplements can be honoured. There should be a penal clause against clinics functioning without a fully qualified medical practitioner. Alternative medicine, though desirable, is fraught with malpractices and however much the Government may want to make it part of the mainstream it must be conversant with the dangers of the proposed bridge course that will only add to the rampant misuse of a profession. There can be no compromise to quality and qualification and the Government must tighten its noose against non medical practitioners, prohibit their practice rather than encourage mediocrity through a short term leap like a bridge course. Were that to happen it would be a sad day and the death of the Indian doctor. The writer is a senior Indian journalist, political commentator and columnist of The Independent. She can be reached at: ([email protected])