A Bill of Rights needed for dealing with doctors


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Category: Health Care Date: 30 Jul 00

In the 15th century, priests in the Catholic Church were perceived as direct intermediaries between you and God, vested with knowledge and power that could make for you, the difference between heaven and hell.


As history tells us, in any such situation of supremacy, corruption sets in. In those days it took the form of indulgences, where you were forgiven your sins if you made a suitable contribution to the church. As we all know, this triggered the reformation, with its demands for accountability and purification of the church.


My recent experience, and subsequent interviews with many people, suggest the modern equivalent of this high altar for man, has been replaced by medical practitioners operating in private institutions.


We need to nail a charter on the doors of the new high priests.


We, the people demand the following:


1. Speak to us...

Part of the service we expect to receive, without begging, following an examination, is a clear presentation of the facts and possible options.

Medical practitioners in this country have made an art of obfuscation - to patient and family. They operate as if they are demi-gods, answering to no one, and become thunderous if anyone dares question them regarding the patientís health or treatment.


And because they hold either your life or that of those dear to you in their undoubtedly skilled hands, there is the tiniest bit of implicit threat: You annoy me and you could be messing with your health now or in future.


Even more than the money is the arrogance and autocratic contempt with which they deal with patients. As if to say: ďI have the power of God in me. The power to save your life. If you donít listen then you will have to live with the consequences.Ē Their sense of mysterious omniscience is tied in with the fees, because you donít know what youíre paying for. You have no idea of what you are dealing with, so itís difficult and expensive to start again with yet another doctor.


2. Transparency in fees

Private medical centres are an administrative and systems mess. If you think private organisations are any less of an administrative nightmare than Government institutions, then think again.


Private organisations are run by virtually ad hoc cadres of doctors whose word is law. They have not set up clear systems in-between. This aura of mystery and confusion ensures you pay through your nose eyes and ears by the time your relative or your procedure is up.


Every diaper, every glass of water, every aspirin is accounted for, and the price of water, diaper and eggs is a hundred times higher than it could be in the starriest of star-studded five-star hotels around you.


3. Donít milk us

Donít milk us because you think weíve chosen private care over public. Medical practitioners working in private institutions would rather boil their heads than refer you to doctors or Government institutions you can afford.

They use the worst sort of weapons and guilt trips to keep you forking out because of their financial links to private institutions. They hold you hostage with your love for your family and the precious gift of life. They operate like a glorified protection racket by trying to make you feel morally bound to give them huge sums of money.


4. Try to keep appointments...

...or donít call them that. Call them vague approximations. It is almost a point of honour for medical practitioners to make appointments with patients or the family of patients and turn up six hours late. They wear lateness like a badge of privilege and proof of their elevated status.


5. Supervise and regulate

Create an independent body to supervise and regulate private medical practitioners, and this does not mean that everybody on the Board should be doctors. Create ratings for doctors, and efficiency scales for private institutions. A body that would regulate fees according to services. A body that would give some recourse to people who are dissatisfied with the service they have received.



Medical practitioners operate with absolutely no checks and balances. There is meant to be a medical association, but it is so dead and decomposed that it doesnít even deserve a formal funeral.


6. Small claims court

Create a special small claims court to deal with medical complaints. Our current absurd backlog of cases, and archaic legal system which, like a monster of the deep, swallows the very justice it is meant to dispense with expensive legal fees and delays, works in the favour of medical practitioners, adds to their sense of omniscience.


So nobody sues, because they are afraid this is a small country and they may need that doctor some time in their lives for themselves or their loved ones. I havenít heard of even one successful case of malpractice here. And in crunch time, individual practitioners are cowards. No one is willing to stand up publicly against a corrupt or incompetent colleague. What kind of sick brotherhood is that?


7. Ensure practitioners collaborate

Put in systems to ensure medical practitioners collaborate, pass on records, share information, so the patient is put firmly where he or she belongs: in the centre, in sharp focus. Right now, the patient is out of focus, and merely incidental to all kinds of doctor-to-doctor politics. I would go so far as to say some would rather let their patients die rather than go to a colleague for information or advice.


8. Honour genuine service

Honour practitioners who genuinely serve the infirm, combining excellence with compassion, who exercise their power responsibly. Hold them up as examples to the fraternity. My call to rehaul the system couldnít have taken place without yardstick medical practitioners who have for me, created an ideal.


I have been privileged to come across a few, such as Dr Allan Patrick, Dr Maria Bartholomew, Dr Michael Telemaque, Dr Rasheed Adams, Dr Everard Girod, Dr Kayum Ali. There are tiny pockets of them everywhere - people who breathe soul into their vocation, who never forget why they wanted to become doctors in the first place; people who genuinely use their knowledge to save lives, make sick people well, with humility and at times when they can afford it without remuneration. They obviously love what they do, and it shows. They take pleasure in using their power to uplift the wretched, the ill, the people without hope, and help them gain a new lease on life, get well again. Their hope and care for their patients only vanish when there is no longer any life left. But they are too few, too few, far too few.


9. Demands of the charter

These are the demands of the charter we need to nail on the doors of every private practitioner, because we no longer trust that they act in the patientsí best interests, although we are not questioning their skills.


I am calling on the Minister of Health to investigate the manner in which private practices are run, to ensure checks and balances are put in place in privately-run medical institutions. Health is not a luxury, it is a necessity.

People go for private care because they donít want to take any chances, and are willing and able to pay for what they think is the best health care. They expect to pay more, but they donít expect to be utterly exploited. But they are.


If you think Government-funded health care is in a mess, try the private sector. Unless you give them a blank cheque and carte blanche to do what they want with you. Empower yourself! Write to the Minister of Health, write to the Prime Minister, write in to the newspapers, speak out on talk show programmes on radio and television.


Send in your health nightmare stories to Ira Mathur in care of the Guardian or e-mail me. You, the people of this country, those who use public and private health care institutions, have the real scoop on the matter. Join a chorus of voices and then, maybe, there will be change - a much-needed reformation.


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All Articles Copyright Ira Mathur