May 25, 2020
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Doc, We’re In Trouble

Healthcare, India’s great failure, has formed fearful, ugly scabs. This is an unflinching look.

Doc, We’re In Trouble
Healers Or Predators? Healthcare Corruption In India
By Samiran Nundy , Keshav Desiraju and Sanjay Nagral
OUP | Pages: 657 | Rs. 750

The one kind of blind faith that beats every possible type of unquestioned loyalty is what an ordinary patient reposes in her or his medical practitioner. That faith is terribly eroded in contemporary India. What started as capitation fees to gain admission to medical colleges expanded into the egregious Vyapam scandal in Madhya Pradesh—more than 50 people have died unnatural deaths in the state in recent years, but almost all those res­ponsible for corruption in admitting aspiring doctors to so-called educational institutions have got away. The taint has reached the highest echelons of the country’s judiciary and the top regulatory authority, the Medical Council of India, remains embroiled in controversies.

If India’s pathetic track record in providing healthcare to the bulk of its population was not bad enough, what has compounded the situation is the privatisation and commodification of what should predominantly be government-subsidised public services (as it is, even in advanced capitalist countries).

The reality today is that there is widespread corruption in everyday medical practices, an unholy nexus between doctors and pharmaceutical companies with the connivance of regulatory bodies, and poor judicial and legislative res­ponses to healthcare corruption.

Examples of outstanding work performed by dedicated professionals provide some room for optimism in an overall ecosystem that is extremely bleak.

This collection of 41 essays and res­earch findings, edited by two eminent medical consultants and a former Union hea­lth secretary, documents not only how the country’s rulers have mis­erably failed in allocating adequate res­ources for healthcare, but also high­­lights how horribly the poor have to suffer. Private caregivers don’t budge without the promise of steep payments; quality medicines at affordable prices are hard to come by even as spurious drugs are readily churned out by manufacturers and supplied by distributors of medicines; and laws that govern clinical establishments which exist in theory are largely not implemented.

To use the words of Nobel laureate Amartya Sen, who has written the fore­word to this “splendid, if depressing, book”, what has contributed greatly to the dismal picture of healthcare—over and above the reasons already cited—has been “the extensive triumph of ava­rice over public duties and professi­onal behaviour”. Adding to the criminal neglect of primary healthcare is the undue emphasis on later-stage inter­v­en­tions, as there is more money to be made than in simple preventive care and elementary outpatient attention.

It is not as if there are no instances of healthcare being provided efficiently to the underprivileged. There are many instances of successful healthcare int­erventions in the section titled “Bea­cons of Hope”. These examples of outstanding work performed by dedicated professionals provide some room for optimism in an overall ecosystem that is extremely bleak.

Thus, in the midst of gloom, the book provides space to alternative narrati­ves which, while representing a minority, shows what can be ach­­i­­eved even with limited resources. These stories of struggle and achievement provide lessons that are yet to be learnt by those in power and authority. Healers or Predators is a must-read for all concerned about the future health of Indians.

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