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Indian doctors not accountable, says consumer report

BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7261.588 (Published 09 September 2000) Cite this as: BMJ 2000;321:588
  1. Ganapati Mudur
  1. New Delhi

    A consumer advocacy group in India has said that patients claiming damages for medical negligence are often unable to prove their allegations because doctors are unwilling to testify against other doctors.

    “The complainants cannot muster evidence to prove negligence beyond doubt,” said the Voluntary Organisation in Interest of Consumer Education in New Delhi after a survey conducted in three cities.

    The survey examined grievance redress mechanisms in 81 large hospitals and small clinics and studied 86 cases of alleged medical negligence filed in consumer courts in three large Indian cities—Delhi, Hyderabad and Lucknow.

    The cases included allegations of medical negligence that led to death, permanent physical injury, or multiple operations. In one case, for example, a woman had claimed that the doctor had performed cataract surgery on the wrong eye.

    The study, supported by the Indian health ministry and the World Bank, showed that more than half the hospitals surveyed did not have mechanisms to manage complaints from patients or their relatives.

    Patients usually turned to consumer courts only after trying to resolve their grievances with their doctors or hospitals, according to the study, which will be published later this month.

    The Indian Supreme Court ruled in 1995 that doctors could be sued in India's consumer courts, which are intended to offer a speedy alternative to civil courts.

    The Indian Medical Association had unsuccessfully campaigned against the inclusion of medical services under the consumer protection act on the grounds that medical services could not be equated with other consumer transactions.

    Although the court had also ordered a penalty of 10000 rupees (£150; $225) on those who file frivolous or false cases against doctors, members of the Indian Medical Association have said they do not consider this to be a significant deterrent.

    “But patients are clearly at a disadvantage because of lack of on-the-record testimony by doctors and also lack of relevant medical documents,” said Bejon Misra, lead investigator in the survey and adviser with the Voluntary Organisation in Interest of Consumer Education.

    The Central Consumer Protection Council has periodically urged the Indian health ministry to make it mandatory for all hospitals to provide medical records to patients. “Our survey shows this is not happening,” Mr Misra said.

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