Doctors are seen as saviours, but who is saving them? In 2023, a study by the Indian Medical Association, Kerala, on 2400 doctors revealed that 66% of doctors experienced violence, and 90% faced verbal abuse. 

This paints a disturbing picture of what it's like to be a healthcare professional in India today. After the shocking Kolkata rape and murder case of a trainee doctor, the need for stronger protection for doctors has become ever more urgent. Medical professionals are now demanding a Central law to protect healthcare workers.

In this blog, we will understand why doctors and medical professionals are demanding a central protection law, how such a law could make their work environment safer and the role of the Supreme Court in safeguarding doctors from unnecessary harassment. 

Examples of Violence in Healthcare

Violence against doctors stems from multiple factors, including patients' expectations, high out-of-pocket expenditures, poor communication between doctors and patients, and a lack of faith in the judiciary. Inadequate hospital security also contributes, while inadequate hospital security fails to prevent such incidents.

There are a few offences which Medical practitioners in India often face: 

A. Harassment: Common forms of harassment include- telephonic threats, intimidation and oral/verbal abuse. This can lead to physical harm, mental trauma, and loss of reputation.

B. Physical Violence: The outcome of a dispute is not always limited to verbal abuse and often leads to actual violence in the form of-  physical but non-injurious assault, physical assault, vandalism and arson. 

C. Criminal Charges: Indian Doctors face criminal charges for medical malpractice, fraud, or other offences. Criminal charges can result in fines, imprisonment, or suspension of medical licenses.

D. Medical Negligence: Often accused of medical negligence, even in cases where due care and standard procedures were followed, which leads to legal action and compensation claims. 

Demand for Central Legislation for Doctor Safety

After the recent incident of the Kolkata Doctor Rape and Murder Case, there is a growing demand for Central Protection Act for Doctors to protect not only doctors but all medical professionals.

A Central law with a specific classification of attacks on healthcare workers as non-bailable offences with strict penalties in order to reduce the incidents of violence. 

What is the Central Protection Act for Doctors?

The 'Prevention of Violence Against Healthcare Professionals and Clinical Establishments Bill, 2022', also known as the 'Central Protection Act for Doctors' was introduced in the Lok Sabha in the year 2022. 

This proposed legislation focused on defining violence, prohibiting such acts, and establishing penalties for offenders. Also, makes it mandatory to report the incidents and includes provisions for public sensitisation and grievance redressal in a systematic manner.

Key Provisions of the proposed Central Protection Act for Doctors

Under the Prevention of Violence Against Healthcare Professionals and Clinical Establishments Bill, 2022, include:

• Definition of Violence: Any act causing harm, injury, or intimidation to healthcare professionals while performing their duties, as well as damage to property or reputation.

• Prohibition of Violence: Prohibits violence against healthcare professionals and clinical establishments, including targeted violence based on caste, gender, religion, language, or place of birth.

• Cognizability and Penalties: Offences under this Act are cognizable and non-bailable, meaning they can be arrested without a warrant and are subject to trial by a Judicial Magistrate of the First Class.

• Mandatory Reporting: The Act mandates the reporting of violence and establishes a panel to investigate such cases.

• Public Sensitisation: It emphasizes the need to inform the public about the constraints faced by healthcare professionals and promote understanding.

• Grievance Redressal Mechanism: Establishing a mechanism to address grievances and reduce long waiting periods in healthcare settings.

• Curriculum Changes: Suggests incorporating cognitive, psychomotor, and empathic skills into medical education to help reduce conflicts between healthcare providers and patients.

Who qualifies as a 'Healthcare Professional' under the proposed law?

Under the Prevention of Violence Against Healthcare Professionals and Clinical Establishments Bill, 2022, the term healthcare professional includes:

• Registered Medical Practitioners: Individuals with recognized medical qualifications under the National Medical Commission Act, 2019.

• Mental Health Professionals: Defined under the Mental Healthcare Act, 2017.

• Dental Professionals: Registered dentists, dental hygienists, and dental mechanics as per the Dentist's Act, 1948.

• Nursing Professionals: Registered nurses, midwives, auxiliary nurse-midwives, and health visitors under the Indian Nursing Council Act, 1947.

• Allied Health Professionals: Occupational therapists, speech therapists, nutritionists, pharmacists, and para-medical staff.

• Medical and Nursing Students: Students in any recognized system of medicine.

• Support Staff: Individuals who interact with patients' families, such as social workers, bereavement counsellors, and Arogya Mitra under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY Scheme).

 How far has the proposed Central Protection Act for Doctors progressed?

• Despite the introduction of the Prevention of Violence Against Healthcare Professionals and Clinical Establishments Bill, nearly 2 years back in 2022, the legislation has not yet been enacted.

• According to media reports from February 2023, then Union Health Minister Dr. Mansukh Mandaviya informed the Rajya Sabha that while a draft of the Healthcare Services Personnel and Clinical Establishments (Prohibition of Violence and Damage to Property) Bill, 2019 was prepared and circulated for consultations, it was decided not to pursue separate legislation. Instead, the Epidemic Diseases (Amendment) Ordinance 2020 was enacted on 22 April 2020 to address the issue.

• Under the existing Epidemic Diseases (Amendment) Act, acts of violence or damage to property are punishable with imprisonment ranging from 3 months to 5 years and fines between ₹ 50,000 and ₹ 2,00,000. In cases causing grievous hurt, imprisonment ranges from six months to seven years, with fines between ₹ 1,00,000 and ₹ 5,00,000. Offenders are also liable to pay compensation to victims and twice the fair market value for damage to property.

Steps taken by the Supreme Court for Doctor's safety

Violence against healthcare workers is a global issue, and the Supreme Court of India has made attempts to protect doctors through its Judgments.

Indian Medical Association v. VP Shantha (1996)

The Supreme Court held that doctors cannot be held liable for medical negligence in cases where they have followed accepted medical practice. This is a landmark judgment protecting doctors from false accusations, as they can not be held liable unless it is proved that they deviated from the standard medical practice.

Jacob Mathew v. State of Punjab (2005) 

This landmark Supreme Court judgment laid down guidelines to be followed before launching a prosecution against medical practitioners for negligence in India. It clearly stated that doctors need to be protected from frivolous or unjust prosecution.

Constitution of National Task Force

The Supreme Court constituted a 10-member National Task Force (NTF) of senior medical professionals to create comprehensive safety protocols for healthcare workers across India. The reason for creating such a force was the rape and murder of a trainee doctor at RG Kar Medical College and Hospital in Kolkata, which has created a huge uproar for widespread protests among the medical fraternity demanding enhanced safety measures.

 Why National Task Force? 

The NTF has the critical responsibility of devising an action plan to ensure the safety and well-being of medical professionals. It is constituted to focus on preventing gender-based violence and creating safe working conditions for interns, resident doctors, and non-resident doctors.

The Court identified the following areas : 

• Restricting the number of non-patient visitors.

• Managing crowd control effectively.

• Enhancing security in emergency rooms and other critical areas.

• Implementing baggage screening to prevent the entry of arms.

• Providing restrooms and gender-neutral spaces for medical staff.

•  Introducing biometric and facial recognition systems.

• Improving lighting and installing CCTV in all hospital areas.

• Arranging transport for medical professionals between 10 pm and 6 am.

• Conducting workshops on handling grief and crisis situations.

• Performing quarterly audits of institutional safety measures.

• Establishing a police force commensurate with hospital footfall.

• Applying the Prevention of Sexual Harassment (POSH) Act to medical establishments, ensuring the constitution of an Internal Complaints Committee (ICC).

•  Setting up an emergency helpline for medical professionals.

The NTF can categorize its action plans under two heads -

(1) Preventing violence, including gender-based violence against medical professionals.

 (2) Providing an enforceable national protocol for dignified and safe working conditions for interns, residents, senior residents, doctors, nurses and all medical professionals.

New Rule of Medical Negligence

Earlier in Indian Penal Code 1860, there was no specification for registered medical practitioners. Section 304A of the IPC, which talked about "Causing death by negligence", included medical negligence and a common punishment of imprisonment of 2 years/fine, or both were there.

The new criminal law covers "Causing Death by Negligence" under Section 106 of Bhartiya Nyaya Sanhita, 2023, which provides for a severe punishment of 5 years and a fine. However, doctors are provided with a lesser punishment of 2 years imprisonment and a fine for medical negligence.

Conclusion

Doctors dedicate their lives to saving others, but they often face threats and violence. The push for a Central Protection Law is about ensuring their safety at work. While some states have laws in place, a unified law across India could provide stronger protection. The need for such a law is clear, especially after recent incidents. It's not just about passing a law—it's about making sure it's enforced so doctors can do their job without fear. Protecting our doctors is crucial for a healthy society.