The doctors today decided to put off their protest after reaching an agreement with the government on Tuesday. The major demand of the private hospitals to exempt them from the provisions of the bill has been accepted by the Ashok Gehlot led Government.
Let us see what happened that led this doctors to protest.
Thousands of doctors took to the street in Rajasthan hitting healthcare services across the state after the Right to Health Bill was passed in the state assembly on March 21.
Indian Medical Association (IMA), the private hospitals, the Nursing Homes Association, and the United Private Clinics and Hospitals Association (UPCHAR) have come forward in the support of Rajasthan’s Doctors
According to the Doctors the bill is one-sided and unreasonable on the other hand the government is emphasising the bill’s significance in ensuring that health is seen as a right.
What is Right to health bill?
- The recently passed Right to Health Bill states that every resident of Rajasthan will be able to avail Outpatient Department (OPD), In-Patient Department (IPD) and emergency services without prepayment at any public health institution, health care establishment and designated health care centres. In case the patient does not even after discharge , the hospital can ask the government for reimbursement of the expenses.
- To ensure the right to health and maintain public health certain obligations have been set up by the bill on the government.The Bill also provides a medium for resolving complaints against denial of services and contravention of rights.
- Certain Health Authorities will be set up at the state and district level. These bodies will ensure and formulate, implement, monitor, and develop mechanisms for quality healthcare and management of public health emergencies.
- A web portal and helpline centre will be set up to file complaints.The concerned officer will have 24 hours to respond to the complaint.The District Health Authority shall take proper action and upload the action taken report on the web portal within 30 days. If the District Health Authority does not resolve the issue within 30 days, the complaint will be forwarded to the State Health Authority.
- In a Medico – legal case where the police clearance is required , no private hospital can deny treatment to any patient. All patients will be entitled to healthcare services including consultation,medicines, diagnostics, emergency transport, and procedure. This provision will be subject to conditions specified in rules that are yet to be formulated.
Why are doctors protesting ?
- The doctors have said that they have a objection with the provision of the bill which provides free emergency healthcare , according to Dr Vijay Kapoor, Secretary of Private Hospitals and Nursing Home Society.
- Doctors argues that the Bill violates provisions of the Minimum Wages Act under which a private worker can’t be forced to work for free.
- Though the bill clearly states that the hospitals can seek reimbursement from the government, the doctors have shown concerns that government has not clarified how and when these finances will be transferred to the hospitals. The Bill does not specify if the state will repay private clinical establishments for providing such free services. This will violate Article 19(1)(g) of the Constitution, which guarantees the right to practice any profession or carry on any occupation, trade or business.
- IMA chairman Dr Sharad Kumar Agarwal, was of the view that the government spends aroundRs. 20,000-40,000 to run each bed in their hospitals. Who is going to provide that kind of amount. The act does not mention who will and when will pay us. Doctors are ready to support government but we cannot take the entire responsibility,
- In 2018-19, in Rajasthan, the total expenditure on health was Rs 29,905 crore. Of this, 43.7% was spent by the government (both state and centre) and 44.9% was paid from out-of-pocket expenditure by individuals (average expenditure of Rs 1,745 per person).
- Providing free healthcare and emergency services would mean that a significant proportion of the cost incurred by individuals will be funded. This means that the state will have to increase the budgetary allocation on health. In 2022-23, Rajasthan allocated 7.4% of its overall budget on health, which is higher than the average of 6% across all states. As per report by National Health Systems Resource Centre, Ministry of Health and Family Welfare, 2022.
- Moreover , since 2021-22, people in Rajasthan have already been provided with insurance coverage under the Mukhyamantri Chiranjeevi Swasthya Bima Yojana. Under this scheme, eligible families receive an annual health insurance worth Rs 10 lakh and accidental coverage worth five lakh rupees.
- Doctors are also showing agitation because no doctors were consulted before passing the legislation. In addition , hospitals have to provide emergency service but they have not defined what an emergency is. It could range from a heart attack to a delivery to a child with stomach ache in the middle of the night. It will increase administrative challenges in hospitals in determining what is and is not an emergency.
- Advocate Ashok Agarwal, who has been fighting cases to ensure access to healthcare in Delhi and is a part of the committee monitoring the private hospitals said citing previous judgements of the Supreme that makes it mandatory for all medical practitioners to provide emergency care, without worrying about fees. So why are the doctors protesting.
- He also added that the Bill will also ensure that those people who are not able to get access to healthcare— such as people with rare diseases for which treatments are extremely costly will become the responsibility of the state.The state then will not be able deny them treatment because it will be their right, the Bill was a great step, something no state or central government has been able to do so far.
Written by -Vaishnavi goel, 6th semester, Punjab school of law , Punjabi University, Patiala
