Corporate hospitals are not providing access to the health records of patients and patients are also not demanding the same. Tragically, corporate hospitals extortion has assumed serious proportions resulting in most unethical and illegal ways of exploitation of vulnerable unhealthy persons, asserts Prof. Madabhushi Sridhar
It is the experience of almost every patient in corporate hospitals that they were treated shabbily and looted heavily. They do not know about their treatment and its purpose thoroughly. Secrecy around health records became breeding ground of corruption and unethical practices. Health care remains no more a profession today. It’s rather a business where a medico invests crores in his medical education and thus expects to collect returns with huge margin.
Fee for medical seat is directly proportional to corruption by the doctors. As the fee for medical education is rising, the loot by private hospitals is also increasing to the same proposition. Spending lakhs and crores on medical seat and same amount ormore again for PG Medical Education seat is creating a logical ground for a doctor and his family to extract to make up the investment and profit. If this quid pro quo is the philosophy of young doctors, totally forgetting and ignoring the Hippocratic Oath and solemn promise made during convocation, the so called health care industry, a beautiful name given to five star hospitals in private sector, runs only on profit motto with all sorts of business tactics.
“Insurance, reimbursement policies of states and welfare schemes like Aarogya Shree are the sources of looting the patients. To facilitate this loot, corporate hospitals are indulging in unnecessary diagnostic tests, undue prolongation of patients stay in ACUs and rooms and most inhuman pretention of treatment of dead-bodies for three or four days, misrepresenting the relatives.”
Insurance, reimbursement policies of states and welfare schemes like Aarogya Shree are the sources of looting the patients. To facilitate this loot, corporate hospitals are indulging in unnecessary diagnostic tests, undue prolongation of patients stay in ACUs and rooms and most inhuman pretention of treatment of dead-bodies for three or four days, misrepresenting the relatives.
Records are forged, necessities are created thus the most honourable profession of doctors have turned into extortion, worse than dacoity. Dacoits do not care any injury or death to victims; their sole aim is taking away money or valuables even bykilling or maiming. Doctors of these treatment shops are no different. Fudging of records by the Dr. Dacoit and their managing directors can go on only when the records are kept secret even from the patients. The secrecy is the manifestation of corrupt corporate hospitals and their inhuman exploitation.
As long as the law does not specifically mandate them to disclose the medical records on day to day basis to the patients or make every medical record electronic which could be shared by the patient, doctors, consultants and kept open to be discussed by experts from anywhere, the dacoit doctors continue their killing loot.
The urgent need to prevent this dacoity is the ‘right of patient to their medical record’. Unfortunately, 90 per cent of doctors are no more representatives of the God, but are organised by the extortionist gangs decently called ‘corporate hospitals’. They advertise with huge hoardings hiring sexy models to attract the gullible patients, both rich and middle class.
One year ago, a post graduate doctor married a lady doctor with huge dowry. He harassed and exploited her financially, physically and mentally. When she consumed killer medicine in high quantum, she was taken to a ‘star hospital’ in Secunderabad. The post graduate doctor conspired with his co-dacoit-doctors and extracted around Rs 25 lakhs from the parents of the lady doctor in the name of treatment, emergency, acute medical care, diagnosis etc. She was almost crippled because of these rogue doctors. They had to spend some more money and time for recovering after getting discharged. The managing directors and expert doctors used to tell beautiful lies in convincing manner, mostly terrorising the parents. They fudged records and forged the diagnosis. They didn’t give medical/health record to conceal their loot. She required information to prove the crime of hospital and domestic violence of her husband, based on which her right to be free from the cruel marriageand right to life could be decided. With looted money, these dacoits in apron hired other set of extortionists robed in black coats.
In some other cases, the patients do not know that they have right to question the detention and treatment, if they were wrongfully considered as mentally sick for the malicious reasons of the others. Thus, medical negligence is another tragedy the Indian patients are suffering from.
“The urgent need to prevent this dacoity is the ‘right of patient to their medical record’. Unfortunately, 90 per cent of doctors are no more representatives of the God, but are organised by the extortionist gangs decently called ‘corporate hospitals’. They advertise with huge hoardings hiring sexy models to attract the gullible patients, both rich and middle class.”
In the context of corporate hospital exploitation, the right of patients to their health records becomes a dire necessity. Basically, the patient has a right to his/her medical record, and that right is rooted in Articles 19 and 21 of Constitution of India. The hospital authorities, whether public or private hospitals, have a duty to provide the same under Right to Information Act, 2005, Consumer Protection Act, 1986, the Medical Council Act, 1956 and world medical ethics read with constitutional rights.
Recently, one officer of RAW was seeking her own medical records from the hospital. She claimed that she was unnecessarily taken to mental hospital for some reasons and she wanted to prove that she was mentally fit and the detention in the name of treatment was forced on her. She claimed that because she was not sick, the detention there was illegal and if she is really sick then she should be treated but not punished like that. She filed RTI application seeking information such as certified copies of her case, correspondence, reports, commentaries, entries in daily diet, etc. The hospital denied information claiming pendency of an inquiry as aground. In the absence of evidence about that pendency of any inquiry and how that was going to impede inquiry, the Central Information Commission (CIC) rejected it and directed disclosure.
A patient is a consumer as per the definition of ‘consumer’ under Consumer Protection Act 1986 and according to Supreme Court’s landmark judgment in Indian Medical Association vs V.P. Shantha & Ors, the medical services are ‘services’ under that Act which entitles her to seek information. According to Medical Council Act, consumer has a right to be informed about the quality, quantity, potency, purity, standard and price of goods or services, as the case may be, so as to protect the consumer against unfair trade practices. Refusing record could be deficiency and lead to damages for negligence.
In Ozair Husain Vs Union of India [AIR 2003 Delhi 103], the bench of Justice A D Singh and Justice M Mudgal reiterated that consumer has right to information about the product. The Medical Council of India, as per Act of 1956, has imposed an obligation on hospitals to maintain the medical record and provide patient access to it. It says: “Every physician shall maintain the medical records pertaining to his/her indoor patients for a period of three years from the date of commencement of the treatment in a standard proforma laid down by the Medical Council of India. If any request is made for medical records either by the patients/authorised attendant or legal authorities involved, the same may be duly acknowledged and documents shall be issued within the period of 72 hours”.
In Kanaiyalal Ramanlal Trivedi v Dr.Satyanarayan Vishwakarma 1996; 3 CPR 24 (Guj); I (1997) CPJ 332 (Guj); 1998 CCJ 690 (Guj), the hospital and doctor were held guilty of deficiency in service as caserecords were not produced before the court to refute the allegation of a lack of standard care. In case of Dr. Shyam Kumar v Rameshbhai Harmanbhai Kachiya 2002; 1 CPR 320, I (2006) CPJ 16 (NC), the National Commission said that not producing medical records to the patient prevents the complainant from seeking an expert opinion and it is the duty of the person in possession of the medical records to produce it in the court and adverse inference could be drawn for not producing the records.
The UK’s Data Protection Act 1998 gives an individual a right of access to information held about him. The Access to Health Records Act 1990 gives access to a patient’s medical records in non-computerised form, while Data Protection Act 1998 Act gives access to both electronic and nonelectronic records. The 1990 Act is still relevant to be in force related to access to a patient’s medical records after his death. Section 3 of Access to Health Records Act 1990 says that the holder of the record, within a maximum period of 40 days, must give access to the record by allowing the applicant to inspect the record (or an extract) or if the applicant so requires by supplying him with a copy of the record or extract.
Section 2(f) of RTI Act, 2005 by defining ‘information’ has given power to Commission to enforce the right to information provided under any other law. CIC observed that three enactments – RTI Act, Consumer Protection Act and Medical Council Act, provide the appellant a strong and undeniable right to information of his own medical record. The fundamental right to life under Article 21 of Constitution includes right to health as held by the Supreme Court in Consumer Education & Research Centre and Union of India, AIR 1995 SC 992. This right extends to every person.
Another fundamental right of expression as enshrined under Article 19(1) (a) includes right to receive information as per International Conventions including Universal Declaration of Human Rights. Article 21 also extends to cover right to know. Hence, the right of a patient to his/her own information as its foundation in fundamental rights is guaranteed by the Constitution. This right can be enforced by the arms of legislations and forum created by them such as Consumer Protection Forum and Information Commissions.
The right of patient to information to his/her own medical record is not only guaranteed under above three legislations but also rooted in Article 21, right to life which includes right to health and Article 19(1)(a), right to freedom of speech and expression, which includes right to receive information. This right is not limited torecords held by public authorities alone but extends to all hospitals including private or corporate hospitals also to individual doctors.
The Information Commission can enforce the same as per mandate of the Parliament through the definition of information under Section 2(f). It is the legal duty of the hospital to give the health record to patient within 72 hours. If the patient wants to use that record to prove his fitness and question the illegality of his detention, it should be allowed. The contentions can stand only when the evidence convinces the court. Right to seek justice is also a fundamental right.
There is a need to make a law guaranteeing the right to medical records and provide a mechanism with time frame to provide the case sheet and details to the patient as and when they are formed without waiting for demand. At the same time, the record should be secured from invasion by the third party. The new law has to take care of right to medical records by the patients with mental disorder. (Based on my order in Ms Nisha Priya Tripathi v. Institute of Human Behaviour and Allied Sciences, GNCTD on File No.CIC/AD/A/2013/001681- SA on 23.7.2014)
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