Dharmendra Jore: The fault lies everywhere

Some crucial questions remained unanswered in the six-day strike by resident doctors in Maharashtra, either because they were not asked, or when asked, were simply ignored by the people concerned. So discussions revolved largely around measures that needed to be taken to protect doctors on duty from attacks by patients' relatives and well-wishers. This was all in addition to a law legislated some years ago to protect doctors and hospitals.

Strike in session
The Budget Session of the state legislature was underway when the doctors stopped work and their advisers, who wielded a remote control, thought of putting the government on the mat. Such a strategy works wonderfully because no government would want any trouble when the legislative session is on. The protesters raised a collective voice and the apex body of doctors - Indian Medical Association (IMA) -joined in to give credence to the strike.

Everything strike-related went well until the Bombay High Court came down heavily on the doctors, asking them to resume duties, and later threatened contempt proceedings when its directives were ignored on the flimsy ground that directives were not issued in writing. However, by Saturday, all residents had returned to work.

Yet, will only the muscle power that security personnel provide to doctors resolve the issue for both health care professionals and the people who avail of their services at private and government hospitals? The answer is largely negative. The doctors will continue to work in fear of being attacked and patients will continue to suffer and rage. Private hospitals though may not face as many untoward incidents because of resources available to them and the fact that their managements can afford to take stern steps that government hospitals cannot without political approval.

All stakeholders are responsible
Now consider this: Why was Dr Rohan Mamorkar, a doctor at Dhule Civil Hospital, brutally attacked? He is feared to have lost his eyesight. This attack, followed by a few others elsewhere, led these doctors to strike work. Dhule's government facility, the district's main hospital, did not have a neurosurgeon for treating a head injury. Did any striking association or political party ask how many district hospitals don't have super-specialists? Did they ask the government why state facilities lack modern equipment, trained staff and experts?

Some senior doctors who are not attached to government institutions did ask these prickly questions, but resident doctors have to think twice before posing uncomfortable questions to their well-connected senior teachers or heads, who save their skin by keeping political bosses in good humour.

Mumbai's government and BMC hospitals are no different. Nobody would deny that resident doctors work tirelessly and live in inhuman conditions - one has to visit residents' hostel in JJ Hospital and BMC hospitals to experience this; one has to taste the food they eat at odd hours. And then the juniors need to ensure that they don't hurt egos of their seniors who are hardly on the scene anyway. Fortunate residents get good teachers - there are many such noble souls on the campuses, but they are generally victims of in-house politics. Little wonder then that immense work pressure destabilises young residents mentally and they end up suffering when it comes to managing doctor-patient relationships.

Meanwhile, relatives of patients get enraged because of inordinate delays in diagnostic tests because of lack of infrastructure and the ever-increasing number of patients. They are also asked to consult private clinics in the vicinity by paying a sum of money they can ill-afford. Another concern for them happens to be the support staff, which does not even pull out a stretcher to wheel in patients. Courtesy dies a thousand deaths here. So, it's an aggregation of various factors that leads to violence from the care-seekers' end.

Lesson for ministers
Taking into account Girish Mahajan's extraordinary work in the healthcare sector, when he asked CM Devendra Fadnavis for the medical education department in addition to water resources department last July, it was expected that he would overhaul the system, maybe not immediately, but steadily. Meanwhile, Shiv Sena's Dr Deepak Sawant heads another department, public health, which looks after extensive health care jobs in the state. The senior sainik hasn't been able to bring any significant change because the two ruling partners continue to war over political issues, ultimately affecting a larger cause of healthcare. It's time that Sawant, a doctor himself, carved a niche for himself by taking corrective steps.

In summation, Mahajan, if he continues, should ensure that doctors produced every year are only subjected to relatives who are sensitised enough to not devolve into violence. He should start identifying parasites in the system, especially senior professors and officials who believe they can do anything because of the ministers' protection.

Dharmendra Jore is political editor, mid-day. He tweets @dharmendrajore. Send your feedback to mailbag@mid-day.com