Unethical practice, corruption and scandalous revelations in medical treatment are prevalent in all the states of India
The deterioration in medical facilities and services in Jammu and Kashmir should be a concern to all Kashmiris and even more so for those of us in the medical community. Clearly, the Jammu and Kashmir has been unable or unwilling to provide an adequate and functioning health system, even at a very minimum level. The result is what we have at present, a health system that continually fails the vast majority of the citizens of Jammu and Kashmir.
Given the political upheaval of the past 30 years, it would be a mistake to presume that solutions that have worked in other parts of the country will necessarily work in Jammu and Kashmir. Quite obviously, we have to develop long term projects, particularly in remote war-torn areas alongside communities and health service providers.
The focus should be to help women, children and men – who in many cases are the only earning members of their families – to achieve better health and well-being. Our priority needs to be those people and communities most affected by conflict and political instability. These are the ones who are unable to access routine health care and are dying prematurely through ill-health and disease.
Jammu and Kashmir Health and Medical Education Department (JKHMED) is in fresh process to attract global investment into health care setup, including health and wellness tourism. It is eyeing on an initial investment of Rs 1,000-2,000 crore in private sector for establishment of hospitals, medical and allied educational infrastructure. It is also trying to establish Jammu and Kashmir as a destination of choice for private healthcare services providers, besides promoting medical tourism.
But it is failing in providing both a necessary and important step in the road towards self-sufficiency for the provision of health care in Jammu and Kashmir; although the present health care setup may be one aspect of this. Obviously, it includes recent Covid-19 pandemic.
Our people should take their health into their own hands and we should join them in achieving this. We should ensure that every intervention in the lives of our people develops the strength and well-being of their families and communities, as well as their ability to look after their own health, education, employment, training, language, culture and economy.
We have to develop better communication between patients and health professionals. This has been a much-neglected problem not only in Jammu and Kashmir but elsewhere in the world. Much has been achieved in this regard in the leading industrialised nations; consequently, it is no longer possible for us to ignore this vital aspect of the doctor-patient relationship.
However, it is also true that such vital training needs to be provided by the state, especially when poor communication in public services including health is not the exception, but the rule, as in our state. Patients have to tolerate bad manners, foul language and in some extreme cases, physical violence.
Access to adequate and proper health facilities should be a most urgent imperative of our society. A measure of accountability amongst health professionals would be beneficial as it would clearly result in a more efficient health service. These changes need to be implemented so as to facilitate the provision of first-rate health services to all, whether they reside.
And irrespective of whether the provision of health services is through a dispensary, primary health centre, district hospital, city hospital or institution and now in newly thought private sector.
Increasingly, these deficiencies highlight the need to improve and develop the curriculum for medical education and training which should include ‘ethics and human rights.’
Unethical practice, corruption and scandalous revelations in medical treatment are prevalent in all the states of India and that is why medical bodies and institutions should include ‘ethics and human rights’ in their teaching of doctors and medical students.
The medical profession is entrusted with defending the welfare of patients and we need to study more closely the mechanism which will support the average doctor in detecting and resisting the influences which encourage him or her to take the first step down the slippery slope into the abyss of negligence and unethical practice.
Because human rights violations affect the health of the people, we call upon all medical colleges to advocate for the inclusion of human rights education in the medical curriculum and for doctors awareness of ‘ethical code’, especially those relating to vulnerable patient groups which include our people in rural areas and we should be educating common people of their rights.
These goals are a basic and most fundamental necessity in our difficult transition to a just and civil society. I would suggest the medical fraternity both within the state and outside the state to join together discussing in greater detail, proposals for good governance of the health sector in Jammu and Kashmir.
Mr. Atal Dulloo may be the lead from the government in consultation with the health and medical education secretary of state to organise this venture keeping in mind that the private sector at present will be a great failure in Jammu and Kashmir as it has no viable economy except money which the government propose to get funded from World Bank without any returns.
Author is retired consultant orthopaedic surgeon