Jaipur: Kota-based Dr Neelam Khandelwal, five days into her hunger strike, was firm on carrying on her protest against the Rajasthan government’s Right To Health (RTH) Bill. Many doctors like her are on hunger strike to demand rollback of the Bill, which was passed on 21 March.
“We are not a bunch of uneducated people. We understand the Bill and its implications. It will destroy the healthcare system. Doctors will migrate to other states,” Dr Khandelwal asserted Saturday at Jaipur Medical Association’s premises, which is now a battleground for these agitating doctors.
The 40-year-old said she would end her hunger strike only when the government has agreed to the doctors’ demand.
Ever since the government tabled the Bill — which gives people the right to free emergency treatment at government hospitals and privately-run establishments — in September 2022, there has been resistance from the private hospitals.
Barring emergency cases, medical services remain suspended since Thursday at private hospitals across Rajasthan, which are no longer admitting new OPD patients.
In their fight, the doctors have even involved their kids to draw the people’s attention. The association had planned a protest Sunday in which children would chant slogans such as ‘My father is a doctor, he is not a lootera’.
The doctors further have been actively countering various narratives about the Bill on social media, including WhatsApp, by posting emotional appeals.
In a ‘Maha rally’ planned on 4 April in Jaipur, every doctor is expected to bring seven to eight people with them. “More than a lakh people will rally in the state capital,” Dr Sunil Kumar Garssa, one of the association representatives, said.
Doctors believe the government will accede to their demands. But, the Rajasthan government is firm about not budging. “Let me clarify: There will be no rollback. The Bill was passed without opposition from any side. We have incorporated all the demands that the IMA (Indian Medical Association) and opposition leaders proposed,” Health minister Parsadi Lal Meena told ThePrint.
“We haven’t taken away any rights from anybody. Instead, we have provided the right to health to the people of Rajasthan. We are the only state to do so. What’s wrong with that? We are fully prepared to deal with the protests.”
To address the concerns of doctors, the government had formed a standing committee comprising Health minister Parsadi Lal Meena, opposition leader Rajendra Singh Rathore, senior officers and the representatives of private hospitals.
The committee held its first meeting on 23 January and five more have taken place, so far. “We got a list of demands from the IMA doctors and we incorporated their suggestion,” Meena, also the chairperson of the committee, said.
Maha rally & suspension of medical services
As doctors out on the roads were met with lathi charge in Jaipur at the end of March, the strike gained momentum, drawing solidarity and support from allied associations, including Vyapari Mandal and chemist unions.
Rathore, the deputy leader of opposition, called the Bill “vague”. “The Bill is not for the public. It was brought so that Gehlot can get back his ground. So, that is why he brings social security acts at times, and, sometimes, debt relief acts for farmers,” the BJP leader claimed.
Even as former deputy chief minister Sachin Pilot met agitating doctors Thursday and urged the government to listen to them, the two sides are yet to find common ground.
In fact, the agitating doctors have taken strong objection to the messages, including a tweet posted on 22 March, of the Congress and its leaders, who have been in congratulatory mode after the Bill was passed.
राजस्थानवासियों को बधाई 💐
आपका प्रदेश देश का पहला राज्य है, जहां 'राइट टू हेल्थ' बिल पास हो गया है।
कांग्रेस सरकार राज्य के हर व्यक्ति को इलाज की गारंटी दे रही है, अब कोई भी अस्पताल इलाज से मना नहीं कर सकेगा।
इसके साथ ही इमरजेंसी में भी निजी अस्पताल Free इलाज करेंगे।
— Congress (@INCIndia) March 22, 2023
Also Read: Why Rajasthan Right to Health Bill has become flashpoint between doctors & civil society groups
Free market vs socialism
Dr Khandelwal and many like her believe that the government’s intention of bringing the Bill is not just to provide free healthcare service but also to reap political dividends in an election year.
“The message that has gone to the public is that every private hospital will treat them free of cost. People have the right to food too, but can they go to any five-star hotel and demand food on an emergency basis, free of cost? No. We have created an ecosystem of private hospitals with our blood and sweat,” said Dr Omendra Ratnu, a doctor for the past 25 years.
According to these doctors, private hospitals are already roped in for the government’s two schemes: Rajasthan Government Health Scheme (RGHS) and Chiranjeevi Yojana. Any further additional responsibilities will be the last nail in the coffin for private hospitals, they claim.
“They have not revised the packages for RGHS and Chiranjeevi. Why should we be forced to sign up for a third one? In a free economy, the prices are dependent on demand and supply. The government does not decide the prices. The prices are a contract between us and the patients,” Dr Ratnu said, calling it a fight between socialism and the free market.
Changes in revised bill
On its part, the Rajasthan government has made changes in the revised Bill introduced and passed in March to address issues raised by the doctors. ThePrint has the copy of both the original and revised Bills.
While the reimbursement of emergency treatment wasn’t clear in the earlier Bill, the revised one says the government will foot these bills if patients are unable to pay for the services. Similarly, the revised Bill has included the rights, the duties and the responsibility of patients as well as healthcare employees, and this will be defined through rules later.
Unlike the previous Bill which did not have the provision of a grievance redressal system at the level of hospital, the revised one mentions that any grievance will be first taken up by hospitals and that they will get three days to address them.
If a complainant is still not satisfied, then he/she can approach authorities at the level of district and state. For such cases, the revised Bill mentions two authorities at state level and one at district level. It says two IMA doctors will be a part of state level authority.
The most contested section that barred doctors from taking legal recourse in a civil court against decisions affecting them under the new rules was done away with, the government asserted.
Concerns remain
Broadly, in the revised Bill, agitating doctors have flagged clauses and sub clauses including 3(c), (d), (s) and 4(h) as ‘objectionable’.
While 3(c) deals with immediate response to cases of emergencies, 3(d) pertains to the rights of citizens to avail free healthcare services from facilities including private hospitals, and 3(s) deals with first aid and transportation for patients. Under Clause 4(h), nobody can be directly or indirectly denied government funded healthcare services at public healthcare institutions and designated health care establishments.
Agitating doctors are worried about financial losses and also dread humiliation in the hands of authorities.
“You (government) have already sent a message to the public that you were trying to introduce this Bill but the private doctors protested. Blame us, and now rollback. We will rebuild our relationship with the patients,” said a member of United Private Clinics and Hospitals Association of Rajasthan (UPCHAR), which represents over 1,000 private hospitals.
But sources in the Rajasthan government told ThePrint that they are confident that if one-two hospitals are penalised, the protest will lose steam.
“That is the worry. This Bill is penalising us. Article 19 of the Constitution gives me a right to earn livelihood through proper means, but the government is denying that by asking to provide service free of cost,” Dr Ratnu said. “There is a consumer court, civil court and Rajasthan medical council to regulate us. You have brought a fourth one (Bill) to penalise us?”
(Edited by Tony Rai)
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