[Answered]What are various malpractices in the medical and healthcare system in India? Discuss its consequences.

Health is considered as the biggest wealth of a human being. Healthcare is a fundamental right under Article 21 of the Indian Constitution. It includes within its ambit the right to health and medical care.

Various malpractices in the medical and healthcare system:

1. Illegal organ trade: Illegal organ trade is the biggest crime going on in the medical There is the sad practice of luring poor and uneducated people to agree to donate organs, kidneys in particular, for which there is no dearth of high paying customers. The arrest of top doctors, of Hiranandani Hospital in Mumbai, in connection with a kidney sale and transplant case is an example of ongoing unethical (and illegal) business practice at India’s big private hospitals.
2. Corruption: Numerous doctors are involved in corrupt practices. For a hefty commission, doctors prescribe more tests than necessary, to be done at preferred in-house or outside labs. Sometimes tests are not even conducted on the samples taken, instead, fake results are given. On a similar theme, doctors prescribe expensive medicines or vaccines when cheaper, quality substitutes are easily available.
3. Unnecessary charges: Private hospitals, with profit-making as their main motive, use a system of incentives and disincentives to push doctors to over-bill using whatever means. Nexus between doctors and pharmaceutical firms are rampant, and that leads to prescription of costly drugs.
4. Quackery: Quacks are although healthcare providers in rural inaccessible areas, but are dangerous to patients as they lack proper training and education. They put a patient’s life in danger. Often quacks pay money to keep their business thriving.

Consequences of various malpractices:

1. Endangers others life: Malpractices like illegal organ trade put the life of donor in danger. It leads to an increase of health Further as these donations occur behind the curtain any death goes unnoticed and the culprit moves freely.
2. Rise in cost of treatment: Corruption, wrong diagnosis, unnecessary tests, costly medicine make healthcare unaffordable. India hosts millions of poor people who do not have enough to pay for food. Further they suffer from malnutrition. Corrupt medical practices make treatment unaffordable for them.
3. Mistrust: When common people learnt about such malpractices they lose their trust in doctors and system. They lose hope of getting treated. Further, this mistrust may lead to attack on innocent doctors if they do not attend patients on risk.
4. Medical education: There is no accountability and transparency in the state medical organisation and institutions. There are no accountability and transparency measures and often this leads to malpractices in medical administration. This is reflected in unnecessary fee rise in medical courses making it unaffordable especially for common people.

Way Forward:

1. Changes in the Medical Council of India:The Medical Council of India (MCI) has had a limited success in checking malpractices and corruption in the medical field. The National Medical Commission Bill seeks to replace A system of standardised treatment protocol (or SOP) may help check some abuses with required changes in MCI.
2. Incentives: Increasing the supply of seats in government medical colleges and capping capitation fees will reduce investment costs for medical students and in turn reduce their incentive to give in to the uncontrolled pursuit of profit in private hospitals, which are often run not by doctors but by MBAs. Lowered debt will reduce the incentives for doctors to cheat.
3. Access to information and transparency: Mandatory video recordings and sharing the recording with patients or their representatives, will make doctors accountable. At present, private hospitals do publish the credentials of top doctors, including their education and past experience. That practice needs to be expanded to include each doctor’s record in treating patients.
4. Disincentives: Aggrieved patients should be encouraged to take their grievances to consumer courts, which are cheaper, faster, and don’t require lawyers for representation.
5. Restructuring medical education: Various committees like Ranjit Roy committee, 2014 has recommended a restructuring of medical education in India. The Supreme Court set up an oversight committee under Justice Lodha who stressed, to bring in transparency and accountability within the MCI and oversee its statutory functioning.

The above measures can check most of the unethical practices but not all of them. For serious infractions, stringent penalties including fines, permanent disbarment, and imprisonment will still be needed.