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The lives of the poor have no value?

By Mahesh Vijapurkar
January 06, 2010 14:04 IST
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Beware. If you are poor, go to a municipal or government hospital and seek medical help, chances are that anything can be done to you and if it affects your life or livelihood, there is nothing can be done to secure protection even if it is a case of medical negligence.

Because, when you do not pay, you are getting things "not for a consideration" and when that consideration -- fees or charges as the case may be -- is absent, then the victim of even medical negligence has no leg to stand on for such individuals are not 'consumers.'

Therefore, the Maharashtra State Consumer Disputes Redressal Commission has told Sudhakar Shetty that his petition against the KEM Hospital in Mumbai, run by the Municipal Corporation of Greater Mumbai, for medical negligence did not hold water, He had to limp out of the hearing, perhaps shocked.

Amputation

Sudhkar Shetty is one of those who earned about Rs 8,000 per month and comes in the category of the poor, just marginally above the poverty line. He was told that his leg, where the gangrene stemming out of a shoe bite, had spread, needed to be amputated. He shifted out to a private hospital and yet, the leg had to be chopped off.

He alleged medical negligence. But since he was a patient seeking free medical treatment, other reasons, perhaps quite tenable, were actually subsidiary why the case was thrown out.

I am not in agreement with this at all. I am not a lawyer to cite laws and rules and sections and enactments. But on the face of it, this protection afforded to the hospitals in the public domain is ridiculous. Does it mean that the poor should have no defence against the insensitive, callous, uncaring public sector arrangements?

Key issue

It raises the fundamental question: if a patient who walks into a public hospital because he cannot afford the private, is he gambling with his life? We all know how the public hospitals are, where the authorities cannot even keep the premises free of the odious smells of drying urine.

The health segment of the MCGM has, for 2009-2010, budgeted an expenditure of Rs 1,228 crore which is over ten times the receipts and incomes under that head which points to the enormous size of its healthcare system and the number of people who would be using it. It is common knowledge that the rich don't prefer them, the poor do though with some reluctance.

Value of lives

It buttresses the not-so-uncommon feeling amongst the people, especially the disadvantaged, that the poor people's lives have no value and that they are less of human beings. That they count for nothing except as a number in a set of statistics.

Doesn't the civic body which runs the hospital have a duty to perform? It has. If an organisation, in this case, the civic body which is an arm of the state given the regulatory tasks it has been tasked with under the statutes, runs free medical services programme, can it claim that those it serves are not consumers and therefore, have to take a chance when they walk into its portals?

Then what happens to the rights of the people who depend on the public services as in the various government hospitals across the country to the primary health centres. These institutions, because of the protection now afforded as a consequence of this judgement, can play any games they chose to apart from the general apathetic nature of their functioning. If lives and limbs of the unsuspecting and the poor are lost in the bargain, so be it?

Unconscionable

It is unconscionable because in a welfare state -- despite privatisation, liberalisation etc, we have not yet lost that profile -- the people matter and that every individual regardless of whether he is paying for services or not, is a consumer of the state's programmes. If the argument that a free patient has no right is carried forward, it would amount to saying that only those who pay taxes have the rights, and by inference, non-tax-paying public have none. And in this country, hardly anyone pays all the tax dues; most under-report their earnings or fudge their accounts and pay less than they should.

My argument is that even a non-tax paying citizen has equal rights. The taxes collected are meant for use of the people's welfare. They are not collected for deployment for the benefit of only the taxpayer. If Shetty could not pay, I am paying as a taxpayer. From those tax proceeds, the services are run by the state or the civic body. Therefore, to term him not a consumer is laughable.

Equality

This country believes all citizens are alike, entitled to equal rights, and Shetty, cannot be treated as second-class citizen. Had he travelled ticketless on a train, fallen off and had his leg amputated, one can understand that he was a trespasser illegally using the train and not entitled to compensation. Had the train been designed to carry the poor, then he would have a case.

By stretching the argument, a person who is poor to afford legal fees, uses free legal aid as is available in this country, is not entitled for justice.

Likewise, in the state or civic-run medical institutions, which is designed as a tool for performing set duties, cannot escape any responsibility saying he was not a patient paying for the services. He was taken in apparently in the full knowledge that he was to be treated free. So, why this discrimination?

Time we changed this.

Mahesh Vijapurkar is a Thane-based commentator

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