Doctors Push for Central Protection Act as Assaults on Healthcare Workers Surge

 Healthcare workers across India are protesting in response to growing concerns about their safety, poor working conditions, and inadequate support. 

A significant incident that has fueled these protests occurred at the R.G. Kar Medical College and Hospital in Kolkata, where junior doctors faced assaults, sparking outrage. Junior doctors, interns, and nurses often work under extreme pressure, with long hours, insufficient resources, and inadequate security measures. The key demands of the protesters include better protection against violence, improved working conditions, increased staffing, and fairer wages.

A Recap of the Ongoing Situation

Resident doctors across India have gone on strike, demanding stronger laws to protect their safety while on duty. This action was triggered by the tragic rape and murder of a young doctor at R.G. Kar Medical College and Hospital in Kolkata on August 9. The protests erupted after the doctor's body was found in a seminar room of the emergency building where she had been working. Doctors have criticized the hospital administration and State government for attempting to downplay the incident, highlighting the absence of a Central law that safeguards healthcare workers.

On-the-Ground Situation

According to constitutional provisions, health and law and order fall under the jurisdiction of the State, making it the primary responsibility of State governments or Union Territory administrations to address incidents and take necessary actions to prevent violence. The Union government has acknowledged that there is no central record of the number of fatalities among medical professionals resulting from attacks by patients' families.

Violence against healthcare workers in India has a long history. In 1973, Aruna Ramchandra Shanbaug, a junior nurse at King Edward Memorial Hospital in Mumbai, was brutally sexually assaulted by a hospital sweeper. Following the attack, she remained in a vegetative state for over 41 years until her death in 2015.

 Decades later, healthcare workers are still advocating for essential safety measures in hospitals, such as better lighting, enhanced security, and properly monitored security cameras.

Protesters in Delhi highlight the inadequate safety measures in medical colleges, pointing out issues such as poorly lit corridors, unsecured wards, and the significant distances between departments. "There is an urgent need to enhance working and living conditions by installing proper lighting, employing security guards, installing cameras, and ensuring manned walk-throughs between departments, operating rooms, and emergency areas. These straightforward steps could significantly improve safety," say doctors. Dr. Praveen Gupta, principal director and chief of neurology at Fortis Hospital, added, "We have consistently called for a safer work environment. This incident serves as a wake-up call. Junior doctors working night shifts and nurses, regardless of gender, are facing increasing threats to their physical safety, mental well-being, and lives. Concerns about their safety and mental health are growing."

Advocating for immediate systemic reforms to prevent future tragedies, Archana Dhawan Bajaj, a gynaecologist at Nurture Clinic, emphasized the necessity of a Central Protection Act for doctors. "Improving the working conditions of junior doctors across the country is essential," she stated. "While violence against healthcare workers is a global concern, other countries have adopted effective measures to safeguard their medical professionals, providing models for India.

 For instance, the UK's NHS has a zero-tolerance policy on violence, supported by dedicated security teams and a comprehensive reporting system. In the U.S., certain states classify assaults on healthcare workers as felonies, serving as a strong deterrent. Australian hospitals have implemented safety measures such as security personnel, panic buttons, and mandatory de-escalation training. India must urgently introduce a Central Protection Act and implement similar measures to create a safer environment for its healthcare workers," said Dr. Sunita Kapoor, Director at City X Ray & Scan Clinic.

Doctors' Key Demands

The Indian Medical Association (IMA), representing allopathic doctors nationwide, has called for a significant policy shift regarding the recognition and response to violence against doctors in healthcare settings.

 In its demands to the Union government, the IMA has requested that hospital security measures be as stringent as those at airports and that healthcare facilities be designated as safe zones with mandatory security features, including CCTV cameras and security personnel. 

The IMA highlighted the case of a victim who was on a 36-hour duty shift without a safe place to rest, underscoring the need for a complete overhaul of the working and living conditions for resident doctors. IMA National President R.V. Asokan emphasized the need for thorough and timely investigations into such crimes, demanding justice and exemplary punishment for the perpetrators. Additionally, he called for appropriate and dignified compensation for the victim's family.

Central Government's New Provisions

On August 16, the Ministry of Health and Family Welfare issued a directive stating that, in cases of violence against healthcare workers while on duty, the head of the institution must file an institutional FIR within six hours of the incident. This measure was introduced in response to the increasing instances of violence against doctors and other healthcare staff in government hospitals.

2019 Draft Bill

The IMA highlighted that the 25 state legislations have been ineffective in curbing violence nationwide. It emphasized the low number of FIRs and the even fewer convictions related to such cases. The organization urged the immediate enactment of a Central Act to address violence against doctors and healthcare facilities, a demand strongly felt by the medical community in India.

 The IMA recommended that the Draft Bill 2019, which includes amendments from the Epidemic Diseases Amendment Act, 2020, and the Code Grey Protocol from the Kerala Government for preventing violence against healthcare workers, should be issued as an ordinance.

The IMA pointed out that the Central Government has the authority to enact a Central Act, as demonstrated by the Clinical Establishments (Registration and Regulation) Act, 2010, which was passed by Parliament at the request of four states, despite hospitals and dispensaries being under the state list in the Constitution of India. Similarly, during the COVID-19 pandemic, the Epidemic Diseases Amendment Ordinance was issued on April 22, 2020, to amend the Epidemic Diseases Act of 1897. This ordinance was later approved by Parliament as the Epidemic Diseases Amendment Act, 2020, and received the President’s assent on September 28, 2020

The letter mentioned the tragic deaths of four doctors who lost their lives while on duty: Dr. Sethulaxmi in Tuticorin, Tamil Nadu (2012), Dr. Deben Dutta in Teok Tea Estate, Jorhat, Assam (2019), Dr. Vandana Das in Kottarakkara, Kerala (2023), and a trainee doctor at RG Kar Medical College and Hospital, Kolkata (2024). The Indian Medical Association (IMA) emphasized that doctors, by virtue of their professional responsibilities, form a distinct group, and the State has a fundamental obligation to ensure their safety and security. The IMA also highlighted that the "Right to Life" is a basic human right that must be protected.

Meanwhile, the IMA has left it to state resident doctor associations to decide on how to take their regional protests ahead, IMA representatives said.