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???