The incident that lead to the license cancellation of the Max Hospital in Shalimar Bagh is a typical case of medical errors that are found across the world. Newborn twins—one stillborn and one alive—were different cases that should have been treated differently. The failure of following protocols resulted in a situation where both the babies were declared dead. Allegedly, the discharge orders were given without consulting the pediatrician – another break in the protocol.
The Delhi government acted hurriedly, and in my opinion, a bit recklessly in suspending the license of the hospital the next morning. The day when the license was canceled, the hospital was not able to treat the patients anymore and had to refuse any walk-in patients. All in-house patients were given the option to continue in another Max facility or to switch to another hospital.
In my opinion, the decision is reckless as, on a monthly basis, Max Hospital at Shalimar Bagh treats over 14,500 patients in the OPD, attends to over 1,700 emergency patients and treats an additional 3,000 in the inpatient wards. Post the recent cancellation order, not only did they have to turn down the OPD but also the emergency patients. According to an internal source in Max—who wishes to be unnamed—critical planned procedures, including 241 dialysis procedures for kidney treatment, 171 chemotherapies for cancer and 63 surgeries had to be canceled, rescheduled or transferred. This would have put the patients further at risk.
The hospital to patient ratio in India is an alarming figure. There are many peculiar cases like the one of a neurology patient registered with AIIMS in Delhi named Anjali Kumari, who in 2013 was asked to come back in 2020 if she wanted to get her treatment done from there. This is not a unique case. The situation is very similar in most Government run hospitals as well as those run by the ESIC. As a result, many people prefer going to the private hospitals.
If the government was providing state-of-the-art medical facilities with the adequate number of beds, there perhaps would have been no need for private players to provide healthcare. But the situation is what it is.
In 1998, when I was in Manipal, my colleagues and I had a debate on the Consumer Protection Act and its applicability to the healthcare sector. Dr. Sripathy Rao, who was heading the Cardio-Thoracic Department, called this move to favor the rich, as only private establishments were under the preview of this act. The Government-run hospitals were protected from the Consumer Protection Act and had institutions like AIIMS been put under the preview of the act, then we might have seen AIIMS shut down the long time ago.
India currently has a poor bed-to-patient ratio. As per the World Bank’s assessment, India in 2011 had 0.7 beds per 1000 people. To give a comparative perspective, Sri Lanka has a ratio of 3.1 beds to 1000 people. The private sector can massively improve this ratio. However, incidents like the one that happened at Max Hospital at Shamilar Bagh, will lead to a negative popular opinion towards the private healthcare sector.
I am not saying that Max Hospitals should escape punishment. I feel they have issues and those who did not abide by the protocols need to be brought to task. But canceling the license of the hospital is probably a step in the wrong direction and may put many patients at risk. I believe the hospital should have been allowed to complete the pre-scheduled surgeries, tackle critical cases on priority and be given some time to sort its protocols out. The cancellation, if inevitable, should have been done in a phased manner by canceling the OPDs first and then reducing the in-house admissions and eventually the emergency services should have been suspended.
This knee-jerk reaction to a breakdown in protocols of one hospital is not a good step and sends the negative indication to all others who would look to get into the healthcare sector. At best, I think this is the political statement of a party that symbolizes the common man, who looks to find a corporate scapegoat for all things wrong with the healthcare sector in India. I think that if the government is looking to make amends, then it is probably better for them to regulate their own healthcare set up for a start.
This Post Has 2 Comments
One thing that is certainly missing today is the trust the medical system and the doctors enjoyed even 20 years ago. Perhaps lack of awareness was one reason why doctors enjoyed this. But another view point is the room for compromise of ethics. We see that happening at times even without the knowledge of the practitioner. Negligence is another matter altogether and can be an ongoing debate.
Good point on the situation with trust. I think the quality of care providers earlier was much higher, and the disease patterns more simplex. The combination of substandard education along with the proliferation of disease patterns has created the current mess we have today. The way out is to develop and establish protocols using technology and making sure there is adherence.