Violence against healthcare workers
in India has become a significant and growing concern.
Reports indicate that incidents of aggression and physical
assault are increasingly frequent, particularly in public healthcare settings.
This violence can range from verbal abuse to physical assaults,
often perpetrated by patients’ relatives or other individuals frustrated by the
healthcare system.
Key
Points of Concern:
·
Increasing
Frequency: The number of violent incidents reported across India,
particularly in public healthcare facilities, is rising. These incidents often
involve doctors, nurses, and other healthcare professionals being assaulted by
patients or their relatives.
·
Vulnerable
Groups: Young and female healthcare professionals are
disproportionately affected by these violent incidents. Female staff, in
particular, are often targeted due to perceived vulnerability.
·
Public
Healthcare Settings: Violence is notably more prevalent
in public healthcare facilities, where resource constraints, overcrowding, and
long wait times can exacerbate tensions. Patients and their families,
frustrated by these conditions, often lash out at healthcare workers.
·
Impact
on Healthcare Services: The fear of violence
can lead to a significant drop in morale among healthcare workers, affecting
their ability to provide quality care. It may also deter new professionals from
entering the field, exacerbating the existing shortages of healthcare workers.
Underlying Causes
·
Overburdened
Healthcare System: India’s public healthcare system
is often under-resourced and overburdened, leading to delays and
dissatisfaction among patients.
·
Lack
of Security Measures: Many healthcare facilities lack
adequate security measures to protect their staff from such incidents.
·
Communication
Gaps: Poor communication between healthcare workers and
patients’ families can escalate tensions, leading to misunderstandings and
violent outbursts.
Legislation
addressing violence against healthcare workers in India
State-Level Legislation (2008 Onwards)
·
The Maharashtra Medicare Service Persons and Medicare
Service Institutions (Prevention of Violence and Damage or Loss to Property)
Act, 2010 was one of the early laws that set a precedent for
other states.
·
Similar laws were enacted in states like Andhra Pradesh,
Karnataka, and Tamil Nadu around the same period.
·
Kerala Healthcare Service Persons and Healthcare Service
Institutions (Prevention of Violence and Damage to Property) Amendment Act of
2023 is also an example.
·
These state laws typically included provisions for penalties and
imprisonment for those who commit violence against healthcare workers or cause
damage to medical facilities. However, the enforcement of these laws was often
criticized as being weak and inconsistent.
state level acts should be strengthened as follows:
National-Level Legislation (2020 onwards)
THE
EPIDEMIC DISEASES (AMENDMENT) ACT, 2020
·
The COVID-19 pandemic highlighted the need for stronger
protection for healthcare workers.
·
In response to the rising number of violent incidents against
health professionals, particularly during the early days of the pandemic, the
Indian government introduced an ordinance that later became the Epidemic
Diseases (Amendment) Act, 2020.
Key
Features:
· Stringent Penalties: The amendment made acts of violence against healthcare service personnel a cognizable and non-bailable offence. The penalties were significantly increased, with imprisonment ranging from 6 months to 7 years, depending on the severity of the offence.
·
Compensation: Provisions
were made for compensation to healthcare workers who suffered injuries, as well
as for damages to property, such as clinics or ambulances.
·
Time-Bound
Investigation: The law mandated that investigations into such offences be
completed within 30 days, and trials should be conducted expeditiously, ideally
within a year.
PREVENTION
OF VIOLENCE AGAINST HEALTHCARE PROFESSIONALS AND CLINICAL ESTABLISHMENTS BILL,
2022
·
The Prevention of Violence Against
Healthcare Professionals and Clinical Establishments Bill, 2022 is
a legislative proposal aimed at addressing the increasing incidents of violence
against healthcare professionals in India.
·
The Bill was introduced in response to the rising concerns
during the COVID-19 pandemic, where numerous instances of violence against
doctors, nurses, and other healthcare workers were reported.
Key
Provisions of the Bill:
·
Definition
of Violence: The Bill broadly defines violence as any act that causes harm,
injury, or damage to healthcare professionals or property at clinical
establishments. This includes physical violence, verbal abuse, and damage to
hospital property.
·
Protection
for Healthcare Professionals:
·
The Bill extends protection to a wide range of healthcare
professionals, including doctors, nurses, paramedics, and support staff working
in public and private healthcare facilities.
·
It also covers medical students and other trainees working in
healthcare institutions.
·
Penalties
and Punishments:
·
The Bill proposes stringent penalties for those found guilty of
committing violence against healthcare workers. This includes imprisonment
ranging from 6 months to 5 years and a fine of up to ₹5 lakh.
·
In cases of grievous harm, the imprisonment term could extend up
to 10 years, with a higher fine.
·
Compensation
for Damage: The Bill mandates that individuals responsible for causing
damage to property in clinical establishments should compensate for the damage.
The compensation amount would be twice the market value of the damaged
property.
·
Time-bound
Investigation: The Bill stipulates that investigations into violence against
healthcare professionals must be completed within a fixed time frame, ensuring swift
justice.
·
Bailable
and Non-bailable Offenses: Offenses under this Bill
are categorized as cognizable and non-bailable, indicating the seriousness of
the crime and ensuring that offenders are not easily granted bail.
Rationale
Behind the Bill:
·
The Bill was introduced to address the vulnerabilities faced by
healthcare professionals, particularly during public health emergencies like
pandemics.
·
It seeks to create a safer working environment for healthcare
workers, ensuring they can perform their duties without fear of violence or
retribution.
The then Union Health Minister, Dr Mansukh Mandaviya, informed
the Rajya Sabha that while a draft of the Healthcare Services Personnel and
Clinical Establishments (Prohibition of Violence and Damage to Property) Bill was
prepared and circulated for consultations, it was decided not to pursue
separate legislation.
Instead of giving a nod to the protection bill, the Epidemic
Diseases (Amendment) Ordinance, 2020 was promulgated to address the issue.
Continued Challenges
·
Enforcement
Issues: Despite these legislative measures, violence against
healthcare workers continues to be a significant problem in India. Many
healthcare professionals have pointed out that the implementation and
enforcement of these laws remain a challenge.
·
Ongoing
Advocacy: Various healthcare associations and unions continue to
advocate for better implementation of the existing laws, the establishment of
dedicated helplines for health workers, and the need for a more robust legal
framework that includes provisions for the mental health and well-being of
health professionals.
In news
August
2024: Union Health Ministry has directed that the Head of Institution
will be responsible for filing an Institutional FIR within a maximum of six
hours in case of violence against doctors.
·
Director General of Health Services Atul Goel has written a
letter to the heads of the central government hospitals and medical colleges in
this regard.
·
The direction came in the wake of the recent incident of the
murder of a doctor in Kolkata and a protest by the resident doctors over the
issue.
·
In his letter, he said that recently it has been observed that
violence has become common against doctors and other healthcare staff in
Government Hospitals.
·
Several Health workers suffer physical violence during their
duty.
·
Many are threatened or exposed to verbal aggression. Most of
this violence is done by either the patient or the patient’s attendants.
Way forward
Preventing Violence against
healthcare workers is of utmost importance and requires
multi-pronged action.
·
Enhanced
Security: There is a pressing need for better security measures in
healthcare facilities, including the presence of trained security personnel and
surveillance systems.
·
Improved
Communication: Healthcare workers need better training in communication
skills to handle difficult situations and de-escalate potential conflicts.
·
Public
Awareness Campaigns: Educating the public about the
pressures faced by healthcare workers and the importance of mutual respect
could help reduce the incidence of violence.
Conclusion
The persistence of violence against healthcare workers poses a
serious threat to the sustainability of the healthcare system in India. Addressing
this issue requires a concerted effort from the government, healthcare
institutions, and the public.
In recent years, there have been calls for a more comprehensive
national law that would offer uniform protection to healthcare workers across
India, rather than relying on state-specific laws or amendments to existing
legislation.
The evolution of these laws reflects the growing recognition of
the importance of safeguarding those on the front lines of public health, but
it also highlights ongoing challenges in ensuring these protections are
effectively implemented across the country.
Alongside legislative measures, there have been efforts to increase public awareness about the importance of respecting healthcare workers, especially during crises like pandemics.
Q.
What is the Central Protection Act for doctors?
Ans: The proposed Healthcare Services Personnel and Clinical
Establishments (Prohibition of Violence and Damage to Property) Bill, 2022, was
intended to protect healthcare professionals and medical facilities. It was
drafted and circulated for feedback five years ago but has since been stalled.
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