Promoting the fight against medical malpractice

INVESTMENT in public services has not kept pace with the health needs of India's growing population. This has resulted in the quality of medical services being poor. The dismal performance of government hospitals has encouraged the growth of private medical institutions, but these are profit-motivated and far too many of them indulge in cutting corners and unethical medical practices.

Medical practitioners in private practice are now accountable to the public under the Consumer Protection Act (COPRA), 1986, which came into force in 1988. The act recognises a consumer's right to safety, information, choice, redressal, consumer education and to be heard. There is a strong consumer movement to extend COPRA to cover public medical services.

The inclusion of medical services under COPRA has evoked scathing criticism from the medical profession, which argues doctors will have to practice "defensive medicine" while treating patients, including undertaking multiple consultations. Doctors will also be forced to insure themselves heavily against malpractice suits.

But Dr Arun Bal, who heads the Association for Consumer Action on Safety and Health, says, "If doctors and hospitals can treat their work like a business, patients are justified in acting like consumers."

Other legislation beneficial to patients is the Indian Medical Councils Act, which lists a code of ethics under Section 20 (a). Any violation can be forwarded to the state medical council for action.

Patients seeking redress can do so at the district, state and national levels. District forums may be approached when the loss incurred is below Rs 1 lakh; the state commission, for compensation upto Rs 10 lakh and to appeal the district forum ruling, and the national commission, for compensation exceeding Rs 10 lakhs.

Consumer courts, which dispense with lawyers and court fees, are a forum for speedy redressal of medical grievances. In addition, several non-profit, voluntary consumer groups have begun filing cases of medical negligence and are also available for advice, support and to guide the petitioner through the appellate process. For instance, the Consumer Action Group in Madras provides a list of the vital documents needed to reinforce a medical complaint. The documents include nursing notes, medication records and the duty doctor's daily orders.