Crisis In Critical Care
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14 April 2010
Despite SC Ruling, Accident Victims Are Often Refused Treatment
Less than 20% of critically injured patients in Kolkata receive treatment within an hour of sustaining injury, considered the most crucial period in such cases. Nearly a half are refused treatment and forced to shift elsewhere, losing valuable time and risking death. This, despite a Supreme Court ruling and a state health department circular that prohibits hospitals from refusing seriously injured or ill patients.
Peerless Hospital, that allegedly refused to admit a 13–year–old girl injured in an accident on E M Bypass, is apparently not the only one guilty of turning away critical patients. There are several other private facilities that routinely flout the norm and ask for a deposit before admitting critical patients.
A month back, a hospital had allegedly refused a train accident victim, who had to be shifted to a private hospital on E M Bypass but didn’t survive. Another private hospital had refused to treat a bleeding patient till his family produced money.
The health department claimed their hands were tied by the law. “Unfortunately, the Clinical Establishments Act doesn’t allow us to either monitor or penalize erring private hospitals. We are in the process of moving a bill to set up a monitoring system that will help curb this inhuman practice,” said Aniruddha Kar, director, health services.
Police, however, claim that refusals have dropped following the health department directive. “We advise all ambulances to carry a copy of the Supreme Court order and show it to the hospital authorities if necessary. The police has made it clear that no critical patient can be turned away or forced to pay before treatment has commenced. Even though it is difficult, we do keep a vigil on hospitals that has a record of refusals,” said DC (traffic) Dilip Banerjee.
Following the health department directive, several private hospitals had laid down a norm. Under it, critical patients were to be taken in immediately and resuscitated, irrespective of the availability of beds and without asking for payment. If the patient recovered enough to be shifted, an option was to be given to the family to either get him admitted or move him to another hospital. “Most have stuck to the practice, but refusals still happen. Hospitals still ask for payment even before the patient has been taken in or attended to. Many are still forced to move to government hospitals and die on the way,” said Arijit Bose, an expert in critical care.
Ruby Hospital, that had come under the scanner for allegedly refusing injured patients several years ago, was among the first to set up a trauma care unit. A five–member team, including a critical care consultant, neuro–surgeon and orthopaedic surgeon, are on duty round the clock. The hospital claims it has never refused a patient in the last six years. “We don’t ask for money till the patient is out of danger. In many cases, we end up losing money, as the patients’ families can’t afford to foot the bill or even pay for diagnostic tests. But we are ready to bear the loss on humanitarian grounds. Also, we can’t flout the health department directive,” said the CEO, S B Purakayastha.
AMRI, Salt Lake is another institution that has often been accused of refusal. The hospital authorities, however, claimed it has made amends. “Nearly 40% of our patients fall in the critical category and there has been no complaint,” said T S Kukreja, director.
Apollo Gleneagles, too, has a dedicated trauma care team comprising more than 30 doctors. This includes orthopaedics, reconstructive surgeons, emergency physicians and neurosurgeons. “Hospitals with emergency units can’t refuse trauma victims. We have augmented our trauma care facilities over the years. Following the norms, we never ask for payment before the patient has been resuscitated,” said Rupali Basu, the CEO.
Even as the situation is improving, experts said that the facilities on offer are insufficient, considering the number of accidents that happen in Kolkata. “Barring a few private and government hospitals, trauma care facilities are nonexistent. Patients’ families are still armtwisted for money,” said Bose.