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| Sunday, 22 September 2002 |
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Features |  |
| News Business Features Editorial
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In part II of our series on Medical Negligence, we talk to families of victims of medical mishaps and to various medical bodies for their views The issue - MEDICAL NEGLIGENCE - is passionate and emotional. The losers - the patient or his/her family - will never ever become winners. When a patient dies it is just another death to the hospital. But to the family it is a total loss. And to children, if the patient is the mother or father, it is the whole world lost. It was the very first day she breast fed her bouncy baby boy. It was also the last day she embraced him so warmly. Meenu (not her real name) died on that misty morning at the age of 23, one day after her life long dream - a baby boy - became a reality. Meenu was too young to become a mother and too young to leave this world. This is a true story where one of my best friends took her last breath due a wrong injection being administered by a skilled and experienced gynaecologist. "She always thought her doctor was a 'GOD', because she trusted so much in them. Can God take my daughter's life so early", cried Meenu's mother, at her funeral. She died at a semi private hospital, to which they paid over rupees two lakhs as bills after her death. Though this happened three years ago, her family can't forget her. "Why did the doctor make such a mistake", still the question echoes in her mother's mind. This tragedy of errors never became a newspaper headline, as the family did not want to fight with the 'GODS' that Meenu trusted so much. But, at the end of the day, the question still remains unanswered. Who would shoulder the responsibility of these innocent victims, who left the world for no fault of theirs but due to negligent or inappropriate treatment given by qualified people who have taken an oath to care and protect their lives? A legal battle against those errant doctors and other medical staffers would never become a serious issue in Sri Lanka since most of the victims are not in a position to resort to legal action against them, especially due to lack of knowledge about how and where to lodge a complaint. In most cases, it would only be a silent cry or 'karma'. The patients interviewed at the Outdoor Patients Department (OPD) of the Colombo National Hospital requested the government to introduce the proposed 'Patients' Charter' in which the patients have the right to receive proper medical facilities and claim damages from the Ministry of Health, in case of medical negligence. "The Patient's Charter is a distant dream and when something goes wrong we have to suffer silently", said J. M. Chandradasa from Piliyandala. "It is not an easy task for us to have legal battles with medical staffers, since we do not have sound financial backing. We travel once a month from very distant parts of the country, because we do not have the means to consult specialists in private hospitals and to get the medicine", said P.D. Gunawathi from Avissawella. "We can't fight with them, but need someone's help when we lose our relatives due to medical negligence", she said. "Yes, a no fault system of compensation should be established for the benefit of these victims", said Prof. Ravindra Fernando, Head of the Department of Forensic Medicine and Toxicology, Faculty of Medicine, University of Colombo. Private Health Sector, tip of the iceberg Dr. Amal Harsha de Silva, Director, Private Health Sector Development said that there are 160 private hospitals and nursing homes, 800 general practitioners, over 5,000 pharmacies, 400 private laboratories, five private ambulance services and six private nursing homes functioning in the country. "This is the tip of the iceberg. There may be lots of cases where patients think the damage occurred due to a wrongful act by a medical officer. But when investigating the matter there is no truth in such allegations", he said. According to Dr. de Silva, a patient who neglects his or her own life for a prolonged period expects the medical officer to correct the illness soon when he or she falls ill. "It is wrong to burden the medical officer. People should pay more attention to their lives", said, adding that with competition, most of the private hospitals provide better and satisfactory heath care service. However Dr. de Silva received over 20 complaints against private hospitals and some of them against leading hospitals in Colombo, he said. Ministry of Health : Committee talking on medical mishaps The Ministry of Health and Nutrition has appointed a committee comprising 10 officials to look into any alleged wrong action by any medical staffer. Dr. Nihal Jayatilake, Additional Secretary ( Medical Services) said that the victims of any medical negligence could direct their complaints to these officials to take immediate action or to direct the relevant authorities for further investigations. While private health care institutions are mushrooming in the country, doubt looms about their qualitative service. Some serious complaints against some leading private hospitals were lodged last year. However, Health Minister P. Dayaratne assured that the Private Health Care Institution Bill will be presented soon before Parliament to keep a sharp eye on irregularities of the private health care services in the country. Under the new Bill the Health Ministry is vested with the authority to monitor the functioning of all private hospitals for which it is essential to have a well trained and experienced medical staff. Private hospitals without qualified staff will not be allowed to function in future under the new regulations. Quack factor According to Dr. Padeniya there are over 40,000 quacks practising medicine in the country. " The Ministry should take a serious note on this to avoid medical negligence", he said. Whatever said and done, still the patient or the kith and kin of the victims are unaware that the particular incident happened due to mis-diagnosis or mis-treatment or where to lodge such a complaint against medical officers or the hospitals. Most of them are without proper legal backgrounds, it is just a distant dream to get compensation for their losses. Considering the number of alleged incidents on medical negligence reported in newspapers, which is alarming, now is the time to introduce some measures to safeguard patients who are always on the losing side of this tug-of-war." Some legislative changes and policy decisions should be introduced to provide optimum health care service with limited resources", said Dr. Padeniya. GMOA : no resources The Government Medical Officer's Association (GMOA), which always fights for the rights of government doctors, is of the view that the negligent doctors should be punished for true reasons, but not for negligence which occurred due to lack of resources in government hospitals. Dr. Anurudha Padeniya, Secretary of the GMOA said that when there was an incident of medical error, the whole blame would be directed towards the doctors, whether they were responsible or not. " This is unfair and even the World Bank and the World Health Organisation appreciated our health achievements had been achieved with limited resources. Sri Lanka is a country which spends one of the lowest (1.5 %) from the GDP on health and it is lower than the WHO's recommended rate (3.5 %)", he pointed out. According to him the main litigation against doctors is the lack of recorded documents on investigation results. " This is a lapse on our part, which happens mainly due to insufficient time spent to record all documents within a short time. Most doctors do the necessary treatment but will not record them. But, when there is a court case against a doctor, the court will query about the ideal treatment given to the patient. In such instances, when there are no documents to prove that the 'best' treatment was given to the patient, the medical officer will be in trouble", he added. "But if we record each and every detail we have to attend only to three or four patients daily", Dr. Padeniya said. |
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