Indian Journal of Medical Ethics

LETTERS


Correction

The Q in QPMPA stands not for Quilon but for Qualified. The Qualified Private Medical Practitioners Association now has a web site, http://www.qpmpa.com/

Not an ethical issue

In reference to Geetanjali Gangoli’s report on the National Health Services (1), we should be least concerned about the problems of the NHS other than noting that such a system, like all socialistic systems, cannot survive in a demanding capitalistic environment. To expect the government to provide quality services encompassing the entire gamut of modern medicine at a disproportionate cost compared to the private sector, is absurd.

Concerning the proposal to send patients to India, we need to look at its ethical, legal and economic aspects.

Ethically, I doubt if such a transfer of patients violates any ethical principle. Legal issues may be complex and need careful evaluation. If a malpractice suit is filed while the patient has an adverse reaction during the flight, or in the parent country long after the procedure, it may be difficult to determine errors in practice, and even more to settle claims. Standards of care may vary from country to country and may need more precise definition.

As for the economic aspects, I doubt if patients arriving in India from the UK can exploit our private medical enterprise. It has never happened with patients coming from the Gulf. In fact, the reverse may be true. From past experience, patients coming from the Gulf were exploited systematically starting with taxi drivers at the airport to touts and ward boys at major hospitals. Hospital administrators, doctors, nurses and laboratory services had a hey day with each taking a slice of the Gulf pie.

I have no reason to believe that we have changed in the past decade. The state may have to enact laws to protect foreign patients against exploitation. As far as foreign patients reducing Indian patients’ access to care, these numbers would be so small that the private sector easily accommodates them. They are unlikely to make a dent in our vast medical service.

Jagdish Chinappa, Manipal Hospital, Airport Road, Bangalore, 560 017.

References

  1. Gangoli G: National health services: imminent collapse. Issues in Medical Ethics 2000; VIII (3): 97.