Corruption in Indian Medicine
Or Overenthusiasm of the Marketing Department
Corruption in Indian medicine is back on the front pages. One would think that there has been an abrupt spurt in corrupt practices or a major scandal. Nothing of that sort has happened. However, there have been some interesting developments for the focus to shift back to what is really a very old affliction. This is an update on recent happenings as the entrepreneurial spirit of the new India plays out in healthcare.
Sanjay Nagral
July 19, 2014, EPW
An Australian physician, David Berger, after volunteering for a year in a hospital in the Himalayas, wrote a scathing piece in the prestigious journal, BMJ (formerly the British Medical Journal) in May detailing the corrupt practices he experienced.1 Berger perhaps had the advantage of seeing the problem with the clarity that only an outsider can. While his article had eloquent descriptions of corrupt practices well known to anyone who engages with healthcare in India, he made some critical points worth noting. The first was to establish a linkage between India’s highly privatised healthcare model, the liberalised economy and the booming private medical college industry. The second was that corrupt practices, including the payment of commissions and cuts, severely undermine the doctor-patient relationship in India, as a result of which patients now fear going to doctors. Finally, in a strange twist, he called upon the international medical community to take on this corruption because, as he put it, “If prompt reform is not forthcoming from within the country, then the spotlight needs to turn global.” He suggested that one tangible way of doing this was by “the medical licensing authorities of the United Kingdom, the US, Canada, Australia, and New Zealand” (countries where a large number of Indian medical graduates migrate) withdrawing recognition “from all suspect private Indian medical colleges, sending a signal that there is no longer such a thing as ‘local corruption.’”
This was soon followed by an editorial in the BMJ co-authored by Samiran Nundy, a senior surgeon in Delhi.2 The authors, after lamenting the corruption described by Berger, analysed the drivers of this and remedial measures in some depth. They suggested that good governance, transparency, and zero tolerance must form the basis of an anti-corruption strategy. However, they hastened to add that these policies may be ineffective if healthcare professionals are not assured of a decent salary and fair opportunities for professional growth. They admitted that this is a difficult task in a corrupt society and that the answers may lie outside the world of medicine. They ended with an announcement and a call to join the BMJ in a campaign against corruption in Indian healthcare.
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