M J Antony: A prescription for private hospitals

OUT OF COURT

With the commercialisation of health care and application of consumer laws to hospitals and doctors, more and more complaints are being lodged in the consumer forums all over the country.

Recently, a Supreme Court judgement asserting that doctors would be criminally liable only if they were "grossly negligent" created some stir and the issue will now be reconsidered by the court.

Last week, the Supreme Court gave a new twist to the question of medical negligence by placing more responsibility on the hospitals in medical negligence cases.

The case of Savita Garg vs National Heart Institute related to the death of the petitioner's husband at the institute in New Delhi. It was alleged that the death was caused by the negligence of the doctors.

The widow moved the National Consumer Disputes Redressal Commission claiming Rs 45 lakh as compensation. The commission rejected the claim "" not the merits of the case "" on a technical point.

It said that the complaint named only the hospital, not the doctors. The petitioner appealed to the Supreme Court. It held that not naming the doctors could not be a ground for dismissing the petition.

While arriving at this conclusion, the Supreme Court looked at the realities of the current situation. It is common experience that when a patient goes to a private hospital, he goes by its reputation and with the hope that proper care will be taken by the authorities.

It is not possible for the patient or his relatives to know which doctor will treat him. It is the hospital that engages the doctors for treatment.

A patient does not know which doctor is the best in the speciality required for his treatment. He leaves this decision to the management of the hospital because of the trust he places in the hospital.

On the other hand, it is the responsibility of the hospital to provide the best services when it charges the patient for the services rendered to him. This is all the more important when private hospitals are run on a purely commercial basis these days.

It is their duty to select the best specialist doctors available. The patient is not required to know the talent available in the field. The present practice is for the private hospitals to have a panel of doctors in various specialities and it is the hospitals that choose the specialist.

Therefore, the patient can be excused if he does not know who treated him and how many doctors were involved in an operation. The traditional doctor-patient relationship is on the wane. The Supreme Court stressed this reality of life while fixing the responsibility on the hospital.

The protection given to consumers of medical service by the consumer forums set up in all districts in the country makes it even more critical for private hospitals to be more responsible.

And the forums are informal in nature and do not insist on the strict fulfilment of the procedural technicalities "" though the lawyers have dragged in much of their paraphernalia into them.

The Supreme Court took a liberal view in favour of the patient. It said: "It is very difficult for the patient to give any detail about which doctor treated him and whether the doctor was negligent or the nursing staff was negligent.

It will be an impossible task and if the claim is to be defeated on that ground it will virtually be frustrating the Consumer Protection Act, leaving the claimant high and dry."

Even if the patient and his relatives undertake a searching enquiry, they may not be successful in pinpointing the negligent people, especially because the hospitals may not co-operate.

The judgement is a pointer to the need for more transparency in private medical care. In an earlier judgement, the court had made it compulsory to give the details of the treatment to the patients. In the present judgement, it carries forward the call for openness in medical services.

Doctors cannot remain faceless and nameless. Considering the deteriorating conditions in medical education, the patient should also be able to know the doctor's qualifications and the institution from which he took his qualifications.