In
the 15th century, priests in the Catholic Church were perceived as direct
intermediaries between you and God, vested with knowledge and power that
could make for you, the difference between heaven and hell.
As
history tells us, in any such situation of supremacy, corruption sets in.
In those days it took the form of indulgences, where you were forgiven
your sins if you made a suitable contribution to the church. As we all
know, this triggered the reformation, with its demands for accountability
and purification of the church.
My
recent experience, and subsequent interviews with many people, suggest the
modern equivalent of this high altar for man, has been replaced by medical
practitioners operating in private institutions.
We
need to nail a charter on the doors of the new high priests.
We,
the people demand the following:
1.
Speak to us...
Part
of the service we expect to receive, without begging, following an
examination, is a clear presentation of the facts and possible options.
Medical
practitioners in this country have made an art of obfuscation - to patient
and family. They operate as if they are demi-gods, answering to no one,
and become thunderous if anyone dares question them regarding the
patient’s health or treatment.
And
because they hold either your life or that of those dear to you in their
undoubtedly skilled hands, there is the tiniest bit of implicit threat:
You annoy me and you could be messing with your health now or in future.
Even
more than the money is the arrogance and autocratic contempt with which
they deal with patients. As if to say: “I have the power of God in me.
The power to save your life. If you don’t listen then you will have to
live with the consequences.” Their sense of mysterious omniscience is
tied in with the fees, because you don’t know what you’re paying for.
You have no idea of what you are dealing with, so it’s difficult and
expensive to start again with yet another doctor.
2.
Transparency in fees
Private
medical centres are an administrative and systems mess. If you think
private organisations are any less of an administrative nightmare than
Government institutions, then think again.
Private
organisations are run by virtually ad hoc cadres of doctors whose word is
law. They have not set up clear systems in-between. This aura of mystery
and confusion ensures you pay through your nose eyes and ears by the time
your relative or your procedure is up.
Every
diaper, every glass of water, every aspirin is accounted for, and the
price of water, diaper and eggs is a hundred times higher than it could be
in the starriest of star-studded five-star hotels around you.
3.
Don’t milk us
Don’t
milk us because you think we’ve chosen private care over public. Medical
practitioners working in private institutions would rather boil their
heads than refer you to doctors or Government institutions you can afford.
They
use the worst sort of weapons and guilt trips to keep you forking out
because of their financial links to private institutions. They hold you
hostage with your love for your family and the precious gift of life. They
operate like a glorified protection racket by trying to make you feel
morally bound to give them huge sums of money.
4.
Try to keep appointments...
...or
don’t call them that. Call them vague approximations. It is almost a
point of honour for medical practitioners to make appointments with
patients or the family of patients and turn up six hours late. They wear
lateness like a badge of privilege and proof of their elevated status.
5.
Supervise and regulate
Create
an independent body to supervise and regulate private medical
practitioners, and this does not mean that everybody on the Board should
be doctors. Create ratings for doctors, and efficiency scales for private
institutions. A body that would regulate fees according to services. A
body that would give some recourse to people who are dissatisfied with the
service they have received.
Medical
practitioners operate with absolutely no checks and balances. There is
meant to be a medical association, but it is so dead and decomposed that
it doesn’t even deserve a formal funeral.
6.
Small claims court
Create
a special small claims court to deal with medical complaints. Our current
absurd backlog of cases, and archaic legal system which, like a monster of
the deep, swallows the very justice it is meant to dispense with expensive
legal fees and delays, works in the favour of medical practitioners, adds
to their sense of omniscience.
So
nobody sues, because they are afraid this is a small country and they may
need that doctor some time in their lives for themselves or their loved
ones. I haven’t heard of even one successful case of malpractice here.
And in crunch time, individual practitioners are cowards. No one is
willing to stand up publicly against a corrupt or incompetent colleague.
What kind of sick brotherhood is that?
7.
Ensure practitioners collaborate
Put
in systems to ensure medical practitioners collaborate, pass on records,
share information, so the patient is put firmly where he or she belongs:
in the centre, in sharp focus. Right now, the patient is out of focus, and
merely incidental to all kinds of doctor-to-doctor politics. I would go so
far as to say some would rather let their patients die rather than go to a
colleague for information or advice.
8.
Honour genuine service
Honour
practitioners who genuinely serve the infirm, combining excellence with
compassion, who exercise their power responsibly. Hold them up as examples
to the fraternity. My call to rehaul the system couldn’t have taken
place without yardstick medical practitioners who have for me, created an
ideal.
I
have been privileged to come across a few, such as Dr Allan Patrick, Dr
Maria Bartholomew, Dr Michael Telemaque, Dr Rasheed Adams, Dr Everard
Girod, Dr Kayum Ali. There are tiny pockets of them everywhere - people
who breathe soul into their vocation, who never forget why they wanted to
become doctors in the first place; people who genuinely use their
knowledge to save lives, make sick people well, with humility and at times
when they can afford it without remuneration. They obviously love what
they do, and it shows. They take pleasure in using their power to uplift
the wretched, the ill, the people without hope, and help them gain a new
lease on life, get well again. Their hope and care for their patients only
vanish when there is no longer any life left. But they are too few, too
few, far too few.
9.
Demands of the charter
These
are the demands of the charter we need to nail on the doors of every
private practitioner, because we no longer trust that they act in the
patients’ best interests, although we are not questioning their skills.
I
am calling on the Minister of Health to investigate the manner in which
private practices are run, to ensure checks and balances are put in place
in privately-run medical institutions. Health is not a luxury, it is a
necessity.
People
go for private care because they don’t want to take any chances, and are
willing and able to pay for what they think is the best health care. They
expect to pay more, but they don’t expect to be utterly exploited. But
they are.
If
you think Government-funded health care is in a mess, try the private
sector. Unless you give them a blank cheque and carte blanche to do what
they want with you. Empower yourself! Write to the Minister of Health,
write to the Prime Minister, write in to the newspapers, speak out on talk
show programmes on radio and television.
Send
in your health nightmare stories to Ira Mathur in care of the Guardian or
e-mail me. You, the people of this country, those who use public and
private health care institutions, have the real scoop on the matter. Join
a chorus of voices and then, maybe, there will be change - a much-needed
reformation.
