By Ranga Kalansooriya –
Dear Dr Rajitha,
You had been a fire-brand in the frontline of politics for the past two decades and now your dreams may have come true, but not ours. You got a big mess to clear up. The crucial sector that you are now responsible of needs total clean up, irrespective of their professional status. May be in that case yours, too, may be still a dream. As citizens, or rather as patients, we are totally fed up and loss confidence of the health sector – whether it is state or private.
The story of the status of the state run hospitals is nothing new. We know it is an ailing sector. But how come the private sector too becomes an ailing sector with serious concerns. The accusations are not only on the private hospitals, but on their practitioners as well. Let me tell you some stories first.
My wife and I were waiting for a doctor at a channeling section of a Colombo leading private hospital recently and accidently happened to observe the conduct of another doctor who has already begun consultation in an adjoining room. With the noticeable rapid frequency of patience in-and-out of the consultation room, we decided to monitor the time per patient. This particular doctor who deals with an extremely important organ of the body finished 20 patients in less than 30 minutes. Imagine..! Less than two minutes per patient, many of them carrying MRI and various other types of medical reports. What a genius this particular doctor should be.
The story does not end there. After seeing the patients the doctor commenced entertaining some medical reps and more time were spent with them than with the patients. It was barely 4.30 in the evening. While this was happening a father clad in a national dress along with his daughter who looked like the patient hurried towards this particular room. I assume their number has already passed with this particular doctor, not due to their fault but the doctor has finished the patients early as it was a marathon run. The nurse informed the doctor about the arrival of this patient. “I have finished seeing the patients here, ask them to come to the other (she named another private hospital in Colombo city) hospital at 7.” The poor father and the daughter who had come all the way from Anuradhapura had no clue about the other hospital. They reached us for help.
This poor farmer surely had to purchase another appointment to see this doctor at the other hospital. Nevertheless, the doctor spent another 15 minutes with the medical reps after returning that poor farmer – who certainly would have contributed to the free education of this particular doctor – to the next destination of consultations.
I am not sure whether there is a minimum timeframe that a doctor should spend with a patient according to their Code of Conduct – or who determines this matter. Last week I took my father-in-law to see a doctor and we managed to meet him after almost three hours of waiting. The time of the appointment mentioned in the receipt was 4.36 pm and when I raised the issue with this particular doctor, he was professional enough to accept it and contacted the hospital management as to how this timing issue comes on to the appointment receipt. He was shocked to realize that the time allocated per patient by the hospital was only three minutes – where he demanded at least 10 minutes.
On another occasion I was visiting one of my friends who was operated at another private hospital. All of a sudden a face peeped through the door and yelled “You are OK now isn’t it? Don’t worry, everything is OK, ha,” and vanished. I asked my friend who it was – Oh God..! It was the doctor, and that was his style of daily visit. A thumping amount would appear on the bill for doctor’s (such) visits, though.
A couple of years ago we admitted one monasterial Buddhist monk to the national hospital with some breathing issues. A particular doctor was trying to market a highly expensive breathing machine to the monk that will be fixed to his body lifetime. Some of the monk’s Dayakas who happened to be doctors themselves suspected this move and discouraged the attempt. “Don’t worry, the monk has rich Dayakas” claimed to be the comment from the suspected culprit.
I am sure the readers would also have many such stories to share, but who would dare to make your own guardian upset by protesting against this conduct. But I think the situation has exceeded its own limits now and it is high time that we should not keep our mouths shut. Give a good service to the amount you charge us, we should be able to tell our own doctors.
On the other hand it is a pertinent question to ask whether the doctors follow their Code of Conduct to the letter. I have my serious doubts. There could be a few, in fact we know some of them who are totally opposite to the caliber that we are talking about here, but they are the tiny minority. There are some good doctors that would not fit into this category of ‘mafia,’ who maintain a good relationship with their patients by providing a service that goes beyond the value of money. In the state sector, we frequently hear stories of historic operations under dying circumstances to save lives of the poor with utmost dedication. They are not forgotten here at all.
Recently there were media reports on a court case where Sri Jayawardenepura hospital administration has taken action against a doctor after a series of demises of four patients one after the other due to negligence. Could it only be the wrong doing of the particular doctor? How on earth the administration waited until the loss of the fourth life, as it was not just one or two. Where is the Medical Council? Why not GMOA take a stand on such professional issues of their members without confining themselves to petty issues of trade union matters?
Where is the morality? Where are the values? Please do not forget we are talking about one of the supreme and highly respected profession in our societies.
Do we have to go to Geneva to talk about crimes against humanity? I don’t think so, just go to a private hospital in Colombo, you can see plenty.
Look at the recent historic judgment against Lanka Hospital for forcibly keeping a dead body of a patient for not paying the dues. How come a sector with humanity, kindness, empathy and compassion conduct such an inhumane act? As the judge correctly pointed out, where is the respect to the dead body? Where is the respect for humanity? Also hats off to the Narahenpita Police that took the matter to courts seeking justice for the deceased. Remember, another private hospital detained an under-age girl until the bill of her critically ill mother was paid? Aren’t these incidents provide clear case studies on crime against humanity? Apart from the decisions of the court, what kind of measures that we can expect from your ministry on such errant private hospitals, Hon Minister?
I am aware of a body where these private hospitals are being monitored or regulated probably that comes under your purview. But is it yet another dead body? Do we hear of its actions on these massive acts of violations of fundamental rights of the patients by these private hospitals and their practitioners?
I think we need a better monitoring system to regulate these private doctors and hospitals. When we say system to regulate, that should include a sound system to entertain and inquire public complaints. One simple example – Just visit any canteen or restaurant of any leading private hospital in Colombo and look for healthy food – or at least a cup of tea without sugar. That does not exist there. The place that should maintain high health standards would sell the most unhealthy food that includes machine-produced tea or coffee with the maximum amount of sugar. Who monitors them?
Probably the proposed Right to Information Bill could include these sectors as well, as in the case of Pakistan where private institutions that provides services to the public are also bound by this particular law. Though they are running a private business, it enjoys tax concessions and such benefits at the expense of poor tax payers.
The crux of the matter here is that the health sector in Sri Lanka – whether public or private – is yet to become a patient centric system. We are still in the colonial conservative mindset of doctors centric health sector. Thus, we never question them and they run their own systems as they wish. Doctors are God-send to us, actually that is how it should be but they should know how to maintain that respect. Though money is the most sought after element in all these incidents, by far the most valuable currency in this game will be trust. Respect will be a value addition.
Thus Mr. Minister, please act on behalf of poor patients as they are suffering in both private and public health sectors.