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Do Doctors Need
PROTECTION?

                  JDA
IS THIS OUR FATE??

     POLITICIANS
     HOOLIGANS
     LAW
     MEDIA
     SO CALLED SOCIALISTS
     DOCTORS’ COMMUNITY
     PATIENTS
• What are the triggers to such violence and
  what are the underlying conditions that give
  rise to these patient-provider conflicts?
• What are the structural and organizational
  factors that contribute to these conditions?
• What steps have been taken to reduce the
  current hostility towards the public health
  delivery system and
• what needs to be done?
Who is responsible?
•   Doctors?
•   Para medicos/Nurses?
•   Hospital administration?
•   Patients attenders?
•   Limited resources?
•   Law?
Triggers
• Sudden death.
• Denial of admission.
• Delay in providing care.
• Absence of equipments and drugs.
• Negligence by staff.
• Junior doctors communicating about death to
  patient.
• Limited understanding about disease.
Causes
•   Shortage of drugs and other supplies.
•   Malfunctioning of equipments.
•   Shortage of personnel.
•   Resident doctors: Working and living
    condition, meager stipend.
STRATEGY
• Proper training for improving communication with
  patients and their relatives.
• Role of senior staff
• Role of Liaison officer.
• Increase number of staff.
• Planned duty roaster and hours.
• Establish functioning Public Relation Office (PRO).
• Shortages and planning issues to be addressed.
• LAW
INCIDENTS

  A WELL
  KNOWN
  POLITICIAN
  WAS TREATED
  & DIED IN A BIG
  HOSPITAL IN
  MAHARASHTRA
INCIDENTS
• POLITICAL PARTY activists reduced to rubble
  the 200-bed Sunitidevi Singhania
  Hospital in Thane
• A POPULAR LEADER treated for a fractured
  leg expired
INCIDENTS
• In three hours of mayhem, they torched the
  building and smashed ambulances, medical
  equipments and everything in sight. Patients,
  doctors and nurses were sent scurrying for
  cover.
• A six-month-old child with a respiratory
  problem and a 65-year-old man suffering from
  a kidney ailment died after their life-support
  machines were wrecked.
INCIDENTS-PROTESTS
• Bihar hospital doctors on three-day token strike, march
  04, 2012 against the alleged assault on a civil surgeon
• Tamil nadu doctors strike work over killing of a doctor,
  january 4, 2012 (the doctors demand punishment of
  culprit at the earliest and police protection to all
  hospitals.)
• A pg student attacked and furniture broken in icu in
  medical college hospital, Thiruvananthpuram in sept
  2011. Assaulter arrested. The indian medical association,
  thiruvananthapuram, observed september 5 as a black
  day in protest against the assault on doctors
INCIDENTS-PROTEST
• Mehsana-june 2011-assault on a doctor-200
  doctors on strike
• Unjha-assault on a private practitioner
• Nagpur-march 1st 2012-stones pelted on a private
  practitioner
• Similar incidents in chennai
• In Patna, the junior doctors of PMCH had gone on a
  lightning strike on Tuesday night after supporters of
  a slain RJD leader Pappu Khan clashed with them
  over alleged delay in conducting post-mortem
• Gaya-dec 30 2011-500 private practitioners on
  strike after a series of assaults
• Calcutta med coll-nov 2011-strike by doctors
• Jabalpur,MP,-march 2008-strike by IMA
  jabalpur unit
• Safdarjang hospital, ND-June 2008
IMPLIMENTATION??
             AWARENESS???
• Maharashtra doctors on strike, demand
  security, march 25, 2011
• Sion hospital , Mumbai–jan 2011-200 doctors
  were on strike-BMC employed private security
  guards
• July 2011- Bhabha hospital, Mumbai-assault
  on 2 paediatricians in ICU
EXISTING
 LAWS
LANDMARK
• Thousands of Doctors went on strike in Government
  Hospitals across Andhra Pradesh, from
  2 December to 18 December 2007.

• OPD services were hit as doctors went on strike after a
  legislator of a political party allegedly manhandled medical
  staffs at Hyderabad's Niloufer children's hospital.

• Doctors demanded that a non-bailable case be registered
  against the person

• Doctors wanted the Government to pass an ordinance to
  ensure security at Government Hospitals.
PREVENTION OF VIOLENCE AND
   DAMAGE TO PROPERTY ACT 2008
• (a) Registered Medical Practitioners, working in
  Medicare Institutions
• (including those having provisional Registration;
• (b) Registered nurse;
• (c) Medical students;
• (d) Nursing students;
• (e) Practical workers employed and working in
  Medicare Service Institutions.
• Any act of violence against Medicare service
   person or damage to property in a Medicare
   service Institution is prohibited.
• Any Offender who commits any act in
   contravention, shall be punished with
   imprisonment for a period of Three years and
   with fine, which may extend to
  fifty thousand rupees.
• Any offence committed under Section , shall be
   cognizable
• In addition to the punishment specified in
  section the offender recovery of loss for the
  damage Caused to the property shall be
  liable to a penalty of twice the amount of
  purchase price of medical equipment
  damaged and loss caused to the property as
  determined by the Court trying the offender.
• If the offender has not paid the penal amount
  under sub-section (1),the said sum shall be
  recovered under the provisions of the Andhra
  Pradesh Recovery Act, 1864 as if it were an
  arrears of land revenue due from him.
• The provisions of this Ordinance shall be in
  addition to and not in derogation of the
  provisions of any other law, for the time begin
  in force.
IMPACT
                                      TREND
                  25

                  20
No of incidents




                  15

                  10

                  5

                  0
                       2007   2008   2009   2010   2011
                                     Year

                                                          Stats from IMA
SIMILAR ACTS THAT FOLLOWED

• Delhi medicare service personnel and
  medicare institutions-Act 2008
• Prevention of violence and damage to
  property act 2008-Haryana
• Rajasthan medicare service personnel and
  medicare service institutions-prevention of
  violence act 2008
• Prevention of violence and damage to prope rty
  Act 2009-orissa
• Prevention of violence and damage to property
  act 2009-maharashtra
• Prevention of violence and damage to property
  act 2009-chattisgarh
• Prevention of violence and damage to property
  act 2008-Tamilnadu
• Karnataka prevention of violence and damage
  act-2009
IN PROCESS
Kerala healthcare service persons and
  heaalthcare service institutions{prevention of
  violence and damage to property}bill,2011

Similar Scenario in bihar..clinical establishment
  act 2007 exists but it doesn’t cover the
  protection of doctors-matter is in process
Is it justifiable to respond to a SLAP

        or
    Do we have to wait till one
    of us gets KILLED???

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Protection for doctors

  • 2. IS THIS OUR FATE?? POLITICIANS HOOLIGANS LAW MEDIA SO CALLED SOCIALISTS DOCTORS’ COMMUNITY PATIENTS
  • 3. • What are the triggers to such violence and what are the underlying conditions that give rise to these patient-provider conflicts? • What are the structural and organizational factors that contribute to these conditions? • What steps have been taken to reduce the current hostility towards the public health delivery system and • what needs to be done?
  • 4. Who is responsible? • Doctors? • Para medicos/Nurses? • Hospital administration? • Patients attenders? • Limited resources? • Law?
  • 5. Triggers • Sudden death. • Denial of admission. • Delay in providing care. • Absence of equipments and drugs. • Negligence by staff. • Junior doctors communicating about death to patient. • Limited understanding about disease.
  • 6. Causes • Shortage of drugs and other supplies. • Malfunctioning of equipments. • Shortage of personnel. • Resident doctors: Working and living condition, meager stipend.
  • 7. STRATEGY • Proper training for improving communication with patients and their relatives. • Role of senior staff • Role of Liaison officer. • Increase number of staff. • Planned duty roaster and hours. • Establish functioning Public Relation Office (PRO). • Shortages and planning issues to be addressed. • LAW
  • 8. INCIDENTS A WELL KNOWN POLITICIAN WAS TREATED & DIED IN A BIG HOSPITAL IN MAHARASHTRA
  • 9. INCIDENTS • POLITICAL PARTY activists reduced to rubble the 200-bed Sunitidevi Singhania Hospital in Thane • A POPULAR LEADER treated for a fractured leg expired
  • 10. INCIDENTS • In three hours of mayhem, they torched the building and smashed ambulances, medical equipments and everything in sight. Patients, doctors and nurses were sent scurrying for cover. • A six-month-old child with a respiratory problem and a 65-year-old man suffering from a kidney ailment died after their life-support machines were wrecked.
  • 11.
  • 12. INCIDENTS-PROTESTS • Bihar hospital doctors on three-day token strike, march 04, 2012 against the alleged assault on a civil surgeon • Tamil nadu doctors strike work over killing of a doctor, january 4, 2012 (the doctors demand punishment of culprit at the earliest and police protection to all hospitals.) • A pg student attacked and furniture broken in icu in medical college hospital, Thiruvananthpuram in sept 2011. Assaulter arrested. The indian medical association, thiruvananthapuram, observed september 5 as a black day in protest against the assault on doctors
  • 13. INCIDENTS-PROTEST • Mehsana-june 2011-assault on a doctor-200 doctors on strike • Unjha-assault on a private practitioner • Nagpur-march 1st 2012-stones pelted on a private practitioner • Similar incidents in chennai • In Patna, the junior doctors of PMCH had gone on a lightning strike on Tuesday night after supporters of a slain RJD leader Pappu Khan clashed with them over alleged delay in conducting post-mortem
  • 14. • Gaya-dec 30 2011-500 private practitioners on strike after a series of assaults • Calcutta med coll-nov 2011-strike by doctors • Jabalpur,MP,-march 2008-strike by IMA jabalpur unit • Safdarjang hospital, ND-June 2008
  • 15. IMPLIMENTATION?? AWARENESS??? • Maharashtra doctors on strike, demand security, march 25, 2011 • Sion hospital , Mumbai–jan 2011-200 doctors were on strike-BMC employed private security guards • July 2011- Bhabha hospital, Mumbai-assault on 2 paediatricians in ICU
  • 17. LANDMARK • Thousands of Doctors went on strike in Government Hospitals across Andhra Pradesh, from 2 December to 18 December 2007. • OPD services were hit as doctors went on strike after a legislator of a political party allegedly manhandled medical staffs at Hyderabad's Niloufer children's hospital. • Doctors demanded that a non-bailable case be registered against the person • Doctors wanted the Government to pass an ordinance to ensure security at Government Hospitals.
  • 18. PREVENTION OF VIOLENCE AND DAMAGE TO PROPERTY ACT 2008 • (a) Registered Medical Practitioners, working in Medicare Institutions • (including those having provisional Registration; • (b) Registered nurse; • (c) Medical students; • (d) Nursing students; • (e) Practical workers employed and working in Medicare Service Institutions.
  • 19. • Any act of violence against Medicare service person or damage to property in a Medicare service Institution is prohibited. • Any Offender who commits any act in contravention, shall be punished with imprisonment for a period of Three years and with fine, which may extend to fifty thousand rupees. • Any offence committed under Section , shall be cognizable
  • 20. • In addition to the punishment specified in section the offender recovery of loss for the damage Caused to the property shall be liable to a penalty of twice the amount of purchase price of medical equipment damaged and loss caused to the property as determined by the Court trying the offender.
  • 21. • If the offender has not paid the penal amount under sub-section (1),the said sum shall be recovered under the provisions of the Andhra Pradesh Recovery Act, 1864 as if it were an arrears of land revenue due from him. • The provisions of this Ordinance shall be in addition to and not in derogation of the provisions of any other law, for the time begin in force.
  • 22. IMPACT TREND 25 20 No of incidents 15 10 5 0 2007 2008 2009 2010 2011 Year Stats from IMA
  • 23. SIMILAR ACTS THAT FOLLOWED • Delhi medicare service personnel and medicare institutions-Act 2008 • Prevention of violence and damage to property act 2008-Haryana • Rajasthan medicare service personnel and medicare service institutions-prevention of violence act 2008
  • 24. • Prevention of violence and damage to prope rty Act 2009-orissa • Prevention of violence and damage to property act 2009-maharashtra • Prevention of violence and damage to property act 2009-chattisgarh • Prevention of violence and damage to property act 2008-Tamilnadu • Karnataka prevention of violence and damage act-2009
  • 25. IN PROCESS Kerala healthcare service persons and heaalthcare service institutions{prevention of violence and damage to property}bill,2011 Similar Scenario in bihar..clinical establishment act 2007 exists but it doesn’t cover the protection of doctors-matter is in process
  • 26. Is it justifiable to respond to a SLAP or Do we have to wait till one of us gets KILLED???