The Hans India: National: Tuesday, June 12, 2018.
Thousands of
medical records of hundreds of patients stocked in the hospitals would not
serve any purpose, unless institution wanted for research. Such records will
occupy huge space and need to be removed at some point of time. Instead, the
medical information if shared with the patient, it would help the patient or
his relatives to understand the problem he was suffering from and the experts
or neutral persons to verify the process of treatment, when necessary. Like the
immovable property transfer is recorded by registration for verification, the
treatment is also recorded for the same purpose.
The hospital
can retain records for research into trends and responses to their treatment. But
how many hospitals are doing it. Sharing of the information with patients will
not affect their research anyway. Or, they can digitise the records and can
refer when patient comes again with any health problem. Are they doing it?
The patient
is the owner of the information generated for him at his instance and on his
payment. The body fluids of the person
are tested and analysed, thus the source material of diagnostic test is the
body of the patient. That has to be the property of the patient. Rightly, the
diagnostic centers share the information without any objection. Soft copies are
made accessible with a password based on the bill of payment. Except patient,
doctor, well-wisher, researcher or examiner, no person has any right to seek that
information.
A patient who
is suffering from the disease also suffers the pain of treatment, paying for
the same. Then why not he own that information and how could it be denied to
him? A doctor uses his education and experience to understand the diagnostic
reports and applies that knowledge to the body’s constitutional problems to
decide treatment. If there is no such patient, the doctor would never find a
chance to think about the treatment. It is the patient who undergoes the
treatment, suffers consequences and derives the benefits on payment of adequate
consideration prescribed by the hospital authorities, along with side effects
and risk. How could the hospital own such information and refuse to give to the
real owner?
Even a rich
patient stands weak against the expert doctor and medical institution. The state has to come to rescue of weak with
law and regulations. Medical information empowers him. The health department of
the state has to develop mechanisms and systems to make hospitals and also doctors
to provide the certified copies of treatment within 72 hours of treatment from
time to time, without waiting for the completion of treatment or till disease
is cured. Release of records daily will prevent manipulations and tampering of
records and to conceal mistreatments or wrongs of negligence.
Right to
information regarding medical records touches upon the right to life, besides
seriously impairing the right to autonomy or to exercise his choice. Denial of medical records could amount to
denial of right to life.
Private
hospitals
Around 20
hospitals in Delhi secured government land from Delhi Development Authority on
condition that they would treat a particular percentage of patients below the
poverty line free. One citizen wanted the information about regulatory check
and licensing of private hospitals and nursing homes in Delhi. List of members
of the committee constituted for recovery of unjust enrichment as directed by
Delhi High Court in Civil Writ 2866/2002; complete address of the committee and
all its members; date from which Committee start functioning etc.
In the past
DDA and Land & Development Office of Government of India had allotted land
to the registered societies and trust on concessional rates (predetermined and
zonal variant rates) for establishment of hospitals and also stipulated the
conditions that they would provide certain percentage of beds in the hospitals
free for the poor/indigent category patients. Similarly, in the OPD, it was
stipulated that free treatment has to be provided to the patients belonging to
the indigent category. These hospitals came into functional stages during
different times and had the conditions varying from 10% of free beds in the IPD
to 70% IPD beds in some of the cases, however in most of the cases it was 25%
free IPD beds.
Due to lack
of proper guidelines for providing free treatment, and also there being no
proper criteria of eligibility as who would be considered poor, and what
constitutes the free ships on the free beds, and also due to unwillingness on
the part of some private hospitals, it was not being implemented in a proper
way, despite the government doing its best efforts. The government constituted
different committees in the past in order to find out a solution to the
problems being encountered by the private hospitals while giving free treatment
and also the problems being faced by the government.
A high-power
committee under the chairmanship of Justice AS Qureshi was also constituted in
the year 2000 and the recommendations made by the said committee regarding the
conditions that there should be 10% free beds in the IPD and 25% of the
patients in the OPD should be provided free treatment. It was also recommended
that the conditions should be uniform and applicable to all the allottees with
or without having conditions and the free treatment should be totally free.
Delhi government found these recommendations reasonable and accepted the same
and intimated the concerned land allotting agencies, to solve this whole gamut
of problems.
A lawyers
group filed a PIL writ petition (WP(C) No. 2866/2002 High Court of Delhi has
pronounced the final judgment on 22.3.2007) pointed out the acceptance of
report of Justice Qureshi Committee with regard to the recommendations that 10
% of total beds in the IPD should be free for poor and 25% of patients in the
OPD should obtain free treatment. The court had considered files of 20 such
private hospital allottees and directed that all other hospitals to strictly
comply with the terms of free treatment to indigent /poor persons of Delhi i.e
25% OPD and 10% IPD patients completely free of charges in all respects.
Therefore, the government hospitals should refer the poor patients to the
private hospitals where the requisite facilities are available.
The
Commission held: This Judgment of Delhi High Court, the Recommendations, the
Committee Report would constitute the law time being in force, which provided
the right to information to all persons by prescribing duty of maintenance of
records, referral desk, sending reports
about treatment etc,
as per section
2(f) of the
Right to Information
Act, 2005.
Then CIC
directed the regulatory, to collect the information and furnish the same.
Exercising its powers under Section 19(8)(a) Commission required all the private hospitals/nursing homes to
furnish the information through the public
authority, i.e., the respondent authority and if not, the Commission
will exercise the powers under Section
18(3) to summon the heads of those hospitals and nursing homes with documents/files/ records which
they are supposed to maintain about the
free treatment to EWS sections and payment of money fixed by the committee as unjust enrichment. (Mr. Rakesh Kumar Gupta
vs GNCTD on 31 December, 2014 and 21.1.2015, CIC/SA/C/2014/000223)
It is the
duty of the state and its regulatory to implement the terms of agreement signed
by the private hospitals who were given land at concession rates as they would
constitute the public authorities under RTI Act, because of this substantial
and indirect funding by state.
Apart from
the above, the state health regulatory has a duty to furnish all the
information about their health schemes, welfare measures, services,
developmental activities and the policy related details to the citizens.