Saturday, April 11, 2009

Privatization of medical education showing its ugly face

Privatization of medical education showing its ugly face

Posted : Wednesday, April 01, 2009 By : MUKESH YADAV
Mushrooming of private medical colleges in India and acute shortage of medical faculty along with huge profit motive on the part of private management leads to ruin quality of medical education in India. Recently Hon’ble M.P. High Court (Jabalpur Bench) came to rescue operation by giving direction to MCI in its order dated December 19TH 2008, in a PIL (Arvind Kumar Mishra Vs. Union of India & Ors. in WP No. 10263/2008).
The Hon’ble HC Observed:
“……..The petitioner has alleged in this writ petition that the private Medical and Dental Colleges in the State of Madhya Pradesh do not have the required faculty members on their permanent rolls. We direct that the Medical Council of India, the respondent No.1 and the Dental Council of India, the respondent No. 3 will carry out the inspection of all the private medical and dental Colleges in the State of Madhya Pradesh and report this Court whether the teaching staff has been permanently employed by the private Medical and Dental Colleges in the State of Madhya Pradesh, or such teaching staff has only been shown in the rolls of these Colleges for purposes of permission or recognition. Court has given directions for the inspection to be carried out by the MCI and report be submitted by 05.01.2009”.
To verify the teaching faculty, residents and clinical material - Pursuant to order of Hon'ble M.P. High Court MCI conducted Inspection on 2nd January, 2009, of four private medical colleges viz.: People’s College of Medical Sciences & Research, Bhanpur, Bhopal, Index Medical College Hospital & Research Centre, Indore, Sri Aurobindo Institute of Medical Sciences, Indore, Ruxmaniben Deepchand Gardi Medical College, Ujjain.
To the utter surprise for all of us the shortage of teaching faculty was 61.2% (i.e. 79 out of 129) and that of Residents were 65% (i.e. 49 out of 76) at Index Medical College Hospital & Research Centre, Indore.
Clinical material was grossly inadequate as reported by the MCI inspectors. On the day of Inspection: O.P.D. attendance was 129 in place of average 800 per day and Bed occupancy was 26.7% as against 80% as per MCI norms Minimum Requirements.
Other interesting observations of MCI Inspectors were:
On actual verification and as per ward census, bed occupancy was found to be 26.7% on the day of inspection.
There were no patients in casualty, Paediatrics ICU & NICU on the day of inspection.
There was no delivery/LSCS on the day of inspection.
The admission/discharge registers were found to be incomplete.
There were no entries in Surgery admission register after 29.12.2008, in Ortho register after 30.12.08, in Peadiatrics register after 2.1.09 and the Medicine registers were not available.
In most of the wards, approximately 50% of the admissions were done on the day of inspection.
In all major departments, patients who were admitted did not warrant hospitalization.
In most of the case sheets, there were no OPD slips, no IPD registration number and history sheets were not written. Only treatment notes were found to be written.
Fake faculty:
It was found that the 4 doctors presented as Tutors in Pharmacology were not doctors. However, they signed the declaration certificate that they were working full time in Index hospital. On questioning, they also certified that they are not doctors. However, the Dean did not submit the declaration forms and refused to countersign on the aforesaid declaration certificate. It was signed by the other two Inspectors who were also present at the time of head count. Their names are: Mr. Jeetendra Tiwari, Mr.Pradeep Solanki, Mr.Om Prakash Prajapati, Mr.Sandeep Thakur.
Dr.Kolpe Dayanand Vasant Rao, had presented himself as Asstt. Prof., Forensic Medicine. However, on questioning, he failed to give satisfactory reply pertaining to his qualifications. On further questioning, he admitted that he is not a doctor who had signed the declaration form and was countersigned by the Dean and three Inspectors. Thus he has submitted a false declaration form with relevant enclosures which is countersigned by the Dean.
Recently, The Tribune, a leading news paper from Punjab in its editorial dated March 7, 2009 has reported “the shocking revelation that some Punjab government doctors have been engaging in scandalous moonlighting in private medical institutes deserves severe condemnation. A Tribune investigation lists half-a-dozen government doctors simultaneously figuring on the rolls of private medical colleges in southern India which they have been visiting for monetary benefit during mandatory head count inspections by the Medical Council of India, an apex body entrusted with maintaining uniform standards of medical education in the country”.
The Editorial further added that “the figure of six doctors is more likely to be suggestive of many more doctors engaged in a similar exercise from just not only Punjab but perhaps from other states as well. This corruption by manipulation and moonlighting is the latest by government doctors, many of whom are since long known to engage in unethical activities of private practice and of taking commissions from private diagnostic laboratories and private clinics for referrals”.
Regarding the stand of MCI it mentioned that “Even more strange is the display of indifference by the MCI, which has ruled out any action saying that they accept at face value a written list of doctors submitted by the medical colleges who are privy to the racket. The MCI seems to overlook the fact that only last year they had threatened to de-recognise the three government medical colleges in Punjab partly because of similar manipulation of manpower after 23 faculty members from Amritsar and Fardikot were detected of being posted to the Government Rajindra Hospital in Patiala on the date of inspection and then reverted to their parent institutions when they faced similar inspection a month later”.
If timely actions by all concerned authorities including common man and parents of students studying in these medical colleges are not taken right to quality of heath care in India may be a distant dream for all of us. Many cases related to infrastructural deficiencies are pending in the various high courts of the country and even in the Apex Court of India, waiting for their fate of fighting for a right cause till date.
We have only hope from the higher judiciary, to come forward for these public sprit health rights activist to protect most cherished fundamental right i.e. Right to life and quality of health care. Media one of the important pillars of democracy can also play its much awaited leading role in exposing these illegal and unethical practices on the part of doctors and private management.

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