Healthcare services were hit in Rajasthan on Monday as thousands of doctors protested against the Right to Health Bill, which was passed by the Congress led state government in the State Assembly last week.
The Indian Medical Association, country's biggest physician association, has also announced its support to the doctors.
Doctors have called the bill draconian but the Congress party led state government maintains that the latest version of the legislation addressed most of their concerns.
The protesters argue that the Bill harms doctors and hospitals instead of benefitting patients.
A contentious section in the bill mandates hospitals, both public and private, to provide emergency treatment to a patient without prepayment, when required.
Sharad Kumar Agarwal, the national president of the Indian Medical Association (IMA), also participated in a protest in Rajasthan.
He emphasised that citizens deserve the right to healthcare, but it is the responsibility of the government to provide it.
However, as the state governments are unable to fulfil this responsibility, doctors are being burdened with the task, he added.
Agarwal asserted that while doctors are willing to support the government, they cannot shoulder the entire responsibility themselves.
He pointed out the exorbitant cost of running each hospital bed and questioned who would provide the funds necessary for it.
"We are ready to support the government but we cannot shoulder the entire responsibility. The government spends around Rs 20,000 to Rs 40,000 to run each bed in their hospitals. Who will provide us with this money? The Act does not say who will pay these expenses. We urge the government to take back this draconian Bill," Agarwal was quoted by Indian Express as saying.
The Act reportedly does mention that hospitals will be reimbursed by the government, but protestors critique the lack of clarity on when and how these funds will be provided.
Others claimed the redressal mechanisms mentioned in the Bill will not let doctors work in peace. Moreover, there is still some confusion among a section of doctors, who are citing the old Bill that was sent to the Select Committee.
Some argue that the bill's redressal mechanisms will hinder doctors' work while confusion remains among some doctors, who are citing the old Bill that was sent to the Select Committee.
Amit Yadav, former president of Jaipur Association of Resident Doctors, identified several issues present within the legislation.
"One, when they say hospitals have to provide emergency service, they have not defined what an emergency is. It could range from a heart attack to a delivery to a child coming in with stomach ache in the middle of the night. It will increase bureaucratic challenges in hospitals — determining what is and is not an emergency," Yadav was quoted as saying in the IE report.
Secondly, the bill lacks clarification on reimbursement from the government, according to Yadav.
"And third, it does not say who should treat what. If I run an eye clinic, I cannot treat a heart attack case," Yadav added.
However, the bill, as finally passed in the State Assembly, reportedly defines emergency in detail, along with adding, "... and any other emergency decided by the State Health Authority".
The state government reportedly said that more clarification will be provided when the rules for the bill are drafted.
Yadav suggested that having local politicians and government-nominated members in the district authority responsible for handling patients' complaints may lead to corruption.
To avoid this, there should be a single state-level redressal authority with doctors as members, according to Yadav.
Yadav believed that politicians or IAS officers may not have the adequate knowledge to make informed decisions on medical procedures.
Responding to this concern, the government reportedly said that two IMA members have replaced two nominated government members in State and District Health Authorities to address the issue.
Despite doctors' protests, advocates for improved health access view the Bill as a positive move forward.
Jan Swasthya Abhiyan's national co-convener, Abhay Shukla, dismissed the demand to withdraw the Bill over the emergency treatment clause, likening it to a careless baby-and-bathwater situation.
Shukla was part of the drafting crew during the bill's initial phase.
Shukla explained that most of the bill focuses on holding government healthcare systems accountable. By making health a right, similar to MGNREGA's work rights, people can demand it from the government and draw attention to the system's gaps, according to Shukla.
He highlighted that the provision for emergency care in all hospitals makes up only a small fraction - 5 per cent - of the total bill. He also noted that private hospitals have a responsibility towards the people, given that their doctors' education and hospital lands are often subsidized by taxpayers, among other things.
The government is not mandating free treatment, but rather establishing mechanisms for reimbursement that will be clarified in the upcoming rules, according to Shukla.
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