New Dog, Old Tricks

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Either there has been a dramatic improvement in the situation, or the silence over mortality at a supposedly-speciality hospital in Srinagar is as conveniently complicit as the then gradually building-up clamour on a grave and complex issue made trivial by some opportunistic exposition. Several other unsavoury aspects of the valley’s government-run healthcare system coming to the fore momentarily and then disappearing from discourse can only be another manifestation of the deeply entrenched nature of the problem which prevails over all remedies – particularly the usually-employed cosmetic troubleshooting. It is therefore in context of the overall scene that  side-effects, a term usually associated with prescription drugs, can safely be applied in Kashmir to illness itself. For, no sooner does a healthy person here transition into patient-hood than he or she suffers leaden feet – a problem research could show to be universal in the Valley. Far from being a prospect of relief and comfort, the thought of visiting hospitals and private clinics for treatment comes with the sickening foreknowledge of heavy expense beyond the capacity of honest monthly earnings. But then there is no questioning the wisdom of healers who reel off a long series of investigations and a longer one of medication, often, as patients mostly complain, after the most cursory examination and reflection. Clinicians – there are justifiable reservations for using this word for Kashmir’s medical practitioners who have neither the time nor the inclination in their overcrowded waiting-rooms and multiple practices to use clinical skill – bank purely on technology where a scrupulous application of the trained mind’s deductive powers could have sufficed. The need to eliminate ‘diagnostic error,’ an argument often proffered to defend what essentially is professional malpractice, has been turned, for the patient, into ‘diagnostic terror.’ For, what can the poor fellow, with life at stake, do, except cower under the doctor’s learned gaze, and beg, borrow or steal to fund his CAT Scans, MRIs and bronchoscopies – blood chemistry, X-Ray, and even ultra-sonography now being passe in the new era where a doctor advising anything less would not be worth the paper his medical degree is printed on.  

Unbeknown to the government, which has been an enthusiastic advocate of the policy, a public-private partnership in health care is already a reality, perhaps a harder reality that the government could ever hope to achieve. For, the public pays for the sophisticated, and in many cases state-of-the-art, diagnostic equipment in state-run hospitals and for the supposedly trained manpower to operate it, and the profits go to private health care enterprises. It is a mystery how high-end diagnostic facilities in allegedly organised hospitals remain stubbornly out of order, but private clinics with  same or similar machinery run like clockwork – often manned by personnel also on government payroll. Allegations abound. Not just that highly-qualified and highly-paid physicians and surgeons are half-hearted in their official duties with more than half a mind dwelling on their private practices, but also that members of the so-called noble profession do not deem it beneath themselves to be hand-in-glove with private diagnostic clinics and pharmaceutical companies for hefty commissions. This mutually-beneficial arrangement cannot run if diagnostic facilities in state-run hospitals are kept in order and functioning reliably on a regular basis.

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