Violence Against Healthcare Workers in India

Syllabus: GS2/Governance

Context

• Violence against healthcare workers is a disturbingly common occurrence in India.

About

• Statistics reveal a pattern of increasing aggression, particularly in public healthcare facilities. 
• These incidents highlight the harsh reality that violence is more prevalent in public health facilities and disproportionately affects younger and female professionals.

What kind of Violence is faced by Healthcare Professionals?

• According to a 2016 paper in the National Medical Journal of India, 75% of the violence against doctors is verbal, including intimidation and threats.
• Workplace violence is mostly directed at junior doctors and residents. 
• Studies also show that female medical professionals, with lesser years of experience, are objectively more at risk of being on the receiving end of both physical and verbal workplace violence.
• The violence also happens more often in high-stake settings, such as in the emergency wing and intensive care units.

What are the Reasons for the Violence?

• The perpetrators of violence are family members or relatives of the patient in 82.2% of cases, as per a paper published in PLoS ONE in 2020. 
• Often, patients or their relatives turn to violence because the healthcare system hasn’t met their expectations.
• Some perpetrators become violent over concerns of the patient’s condition, such as actual or perceived deterioration of their condition or doubts about the wrong treatment being administered. 
• Some others become violent due to issues such as high payment dues and protracted waiting times. Doctors aren’t responsible for either. 

Impact of Violence

• Psychological Impact: Being on the receiving end of verbal or physical violence has an immense psychological impact. 
  • Some studies have reported symptoms of post-traumatic stress disorder, anxiety, and depression in doctors who have faced violence from patients or their kin.
• Effect Rural Healthcare: India has a skewed doctor-patient ratio, doctors often decide to operate in resource-abundant settings for their own security. This in turn affects rural healthcare.
• Effect of Quality of Healthcare: After experiencing violence, doctors wish to stop offering emergency services, refer patients sooner to more specialists, and over-investigate symptoms and prescribe more tests. 

Present Scenario of Legal Protection to Healthcare Professionals

• No central law existed to safeguard healthcare workers nationwide. 
• As of 2020, 19 States had implemented their statutes, each with varying provisions. Other States and Union Territories had no laws at all.
  • This lack of uniformity meant protection is inconsistent. 
  • Among States, Kerala and Karnataka now provide their healthcare workers with the most robust legal protections in India. 
• Challenges in enacting a Central law: A central law has not been enacted because public health is a State subject, and VAHCW is primarily a public health-related issue. 
• While the concurrent list allows for a central law, the central government has not prioritised this issue, leaving it to the States to manage.

Way Ahead

• Strengthen the System: To eliminate this ‘threat’, we must spend more money to strengthen the system from the grassroots level, such as reducing long waiting periods for treatment. 
  • The availability and accessibility of medicines, tests, and financial aid for those in need will greatly reduce their stress, instead of leaving them to hold their physicians responsible for it.
• Policy and Institutional Measures: Installing CCTV cameras and metal detectors at hospital entrances to deter relatives from carrying weapons are workable, but they are currently easier to realise in private settings and not at public facilities.
  • Ensuring that there are counselors to help patients and relatives in times of high emotional distress can eliminate any miscommunication regarding a patient’s condition and treatment. 
  • In addition, a robust security system and not allowing more than a few relatives by a patient’s bedside may also be important.
• After the West Bengal incident, the Central Government has declared that it will form a high-level committee to review the 2019 bill tabled in parliament for making the Central Act for protection of healthcare workers.
• Until a central law becomes a reality, these State-level reforms represent a significant step forward in safeguarding those who dedicate their lives to caring for others.

Source: TH