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Doctors have often faced violence at the hands of those they heal. Kerala has now decided to bring out an ordinance to amend the Kerala Healthcare Act after a doctor was murdered while on duty.

Doctors have often faced violence at the hands of those they heal. Kerala has now decided to bring out an ordinance to amend the Kerala Healthcare Act after a doctor was murdered while on duty

At a high-level meeting on May 11, Kerala Chief Minister Pinarayi Vijayan decided to bring out an ordinance to make amendments to the Kerala Healthcare Service Persons and Healthcare Service Institutions (Prevention of Violence and Damage to Property) Act, 2012. 

This was after the dastardly murder of Dr Vandana Das, a house surgeon while she was on duty at a government hospital in Kottarakkara. The accused was a drug addict who had been taken to the hospital for treatment by the police.

At the meeting, it is decided to set up police outposts in medical colleges, district and general hospitals and women and children hospitals in the state. Healthcare institutions are to be graded into three divisions and police outposts would be erected based on it. All hospitals should conduct a security audit every month. Security audits should also be held in hospitals every six months by the health and police departments under the supervision of district collectors. Public announcement systems and CCTVs should be installed in hospitals and the footage monitored.

The CM also directed the health department to consider if two casualty medical officers can be put on duty in the emergency wings in hospitals during night shift and overcrowding in hospitals be controlled strictly. He further directed that special security arrangements be ensured in hospitals when criminals or police detainees with a violent nature are brought for medical examination.

Meanwhile, doctors in the state have intensified their agitations, seeking justice for Dr Das. The functioning of many hospitals was largely hit across the state due to the agitation.

The Kerala High Court has, in the past, passed many orders saying that any attack, minor or major, on any doctor, healthcare professional, nurse or such other, should be taken cognizance of by the police within a one hour period. It had also said that citizens be made aware of the consequences of attacking such personnel through all methods, including the media.

 “The shocking incident may erode faith in the system, particularly for the young students and house surgeons; and it is our duty now to ensure that this does not happen,” Pinarayi reportedly said.

On May 10, a bench of Justices Devan Ramachandram and Kauser Edappagath ordered:

(a) The CCTV visuals of the rooms/places of occurrence of the incident that led to the unfortunate death of Vandana Das be preserved; and the Superintendent of Taluk Hospital, Kottarakkara, shall personally ensure it.

(b) Judicial First Class Magistrate-I, Kottarakkara, to henceforth visit the Taluk Hospital, Kottarakkara, and conduct an inspection of the scene of incident and report to the Court by May 11.

(c) Every order that has passed in this case, as also the provisions of the Act, shall apply in full force and warrant to every intern, house surgeon, postgraduate student and other persons engaged in the health science education, without any reservation; and all our orders shall be implemented in letter and spirit.

On May 11, the Court observed that protocols will have to be immediately evolved as to the manner in which doctors, healthcare professionals, students, interns, house surgeons and such others are to be protected because, otherwise, faith in the system will surely erode.

The Court, therefore, directed the State Police Chief (SPC) to evolve sufficient and effective protocols with respect to the manner in which persons in custody are to be presented in hospitals and before medical professionals as part of the criminal justice system or such other and “as the Bench have already said in our earlier order, it would be apposite to reflect upon the protocols that are applicable in the case of the production of accused before a learned Magistrate. We must, however, say that even the protocols with respect to learned Magistrates are extremely lacking and it is only a matter of providential grace that we have yet to come across a situation where such an officer is attacked. The Police will have to certainly pull up their socks on a war-footing”.

Of course, lack of protocols can never be given as a reason to justify another crime. The bench, therefore, directed that, for the time being, every protocol applicable for production of an accused in custody of the police before a magistrate shall apply in the case of production of such persons in hospitals, before doctors or healthcare professionals.

As for the security in various hospitals, particularly those in the government sector, the High Court said it had no doubt that it was the fundamental duty of the SPC to ensure it. There was also mention whether members of the State Industrial Security Force can be deployed for such purposes. The Bench reminded the SPC that it was the fundamental obligation of the police force to ensure that hospitals and the personnel who man them are adequately and sufficiently protected on a day-to-day basis.

In 2021, a petition was filed in the Supreme Court seeking directions to the centre and authorities concerned to prevent attacks on doctors and healthcare workers by relatives of patients and others and to ensure adequate security at hospitals and medical centres across the country. The petition highlighted 28 incidents of violent attacks on doctors or healthcare workers since 2017. The plea said that there was no substantial central law for protecting medical professionals, etc.

The Delhi Medical Association, with over 15,000 members from the medical fraternity, cited the recent attacks on doctors and healthcare workers in West Bengal, Uttar Pradesh, Telangana, Punjab, Kerala, Karnataka, Jharkhand, Assam and Arunachal Pradesh to argue that the existing laws punishing assaulters of doctors and healthcare workers had not proved to be an effective deterrent.

In 2019, a case was registered against a 17-year-old boy and his friend for allegedly assaulting a doctor at a hospital in Maharashtra after his father died during treatment.

The Indian Medical Association has reported that 75% of doctors face verbal or physical abuse in hospital premises. Unrestricted public access to all areas in government hospitals with lack of security, surveillance and mob-preventing-drills increases the risk of violence. The point of delivery of emergency services was the most common place of violence and verbal abuse experienced by doctors. 

This sad state of affairs towards those who heal is a reflection of a larger malaise in society. 

—By Shivam Sharma and India Legal Bureau

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