In the public debate on the Gorakhpur tragedy, several reasons were put forth as to why these deaths occurred. That several factors collectively led to this tragedy is the undeniable truth. Rather than trying to pinpoint who is to be blamed, our focus instead should be preventing further outbreaks in the future.
Dealing with the aftermath of a tragedy is important as also, how we choose to deal with it. And the question that we all should be asking ourselves in this regard is “what can we do to prevent future epidemics” and not “what should have been done and was not done”.
Will we be ready to tackle future epidemics? The answer to this depends on what corrective measures we take today.
A long-term strategy needs to be formulated to deal with such outbreaks. A well-planned surveillance and response system should be in place, which can be mobilized quickly when needed. We need better investment in preparedness.
We have to work together to stop the next outbreak, not only in Gorakhpur, but also any epidemic in the country. Dengue, for example, occurs in epidemic proportions every year.
The Indian Medical Association (IMA) has suggested the following to avoid more incidents like the Gorakhpur tragedy.
· There should be no shortage of staff – doctors, nurses and other supporting staff. Staff deficit affects patient care. Shortage of staff should be supplemented with the services of locum doctors.
· Private doctors can be hired, but only for locum jobs, not as regular doctors.
· The practice of “moonlighting” as is prevalent in the US should be allowed in India.
· There should be a uniform system for Govt. doctors: either practice is allowed or it is not allowed.
· All patients who are denied treatment at government hospitals should be reimbursed for the cost of treatment in the private sector at predefined rates.
· All hospitals should have back up of at least one-week supply of all essential drugs, investigations and oxygen.
· To reduce the cost of treatment, essential drugs and investigations - not non-essential drugs and tests - should constitute the bulk of the expenditure of the allocated budget.
· All payments for health care services should be made either in advance or in time.
· Insurance Regulatory and Development Authority (IRDA) has made it mandatory for all private hospitals to get NABH accreditation. The same should be extended to all government set ups.
· Every death should be audited to find out the probable cause of death and whether it was a preventable death so that future such deaths can be prevented from occurring.
· In any case of negligence, one should differentiate between administrative negligence and medical negligence.
Disclaimer: The views expressed in this write up are entirely my own.
Dr KK Aggarwal