Editor in Chief Dr KK Aggarwal, Padma Shri Awardee

Dated: 16th July, 2019

Health ministry issues Advisory to all States/UTs over assault on doctors

Answer of the Minister of State in the Ministry of Health and Family Welfare (Shri Ashwini Kumar Choubey) Question No. 3253 for 12.07.2019 regarding "Assaults on Doctors".

“(a) & (b): Yes, incidents of strike by doctors because of alleged assault on doctors on duty in various parts of the Country have come to the notice of the Government.

As per Constitutional provisions, ‘Health’ and ‘Law & Order’ are State subjects. Therefore, the concerned State/UT Government are required to take measures to prevent such incidents under the appropriate legal framework applicable in the respective State/UT. Details of such cases is not maintained centrally.

(c): As per the information received from IMA, IMA had appealed for withdrawal of non essential services on 17th June, 2019 from 6:00 AM to 6:00 AM next day, as a token protest. The emergency services and critical services were unaffected.

(d) to (f): Union Ministry of Health & Family Welfare has issued an advisory to all States/UTs to consider immediate measures for inculcating an effective sense of security among the doctors on duty, as under:

i.Security of sensitive hospitals to be managed by a designated and trained force,

ii.Installation of CCTV cameras and round the clock Quick Reaction Teams with effective communication/security gadgets particularly at Casualty, Emergency and areas having high footfalls, iii. Well-equipped centralized control room for monitoring and quick response,

iii.Entry restriction for undesirable persons,

iv.Institutional FIR against assaulters,

v.Display of legislation protecting doctors in every hospital and police station,

vi.Appointment of Nodal Officer to monitor medical negligence,

vii.Expeditious filling up of vacant posts of doctors and para medical staff in hospitals/Primary Health Centres to avoid excessive burden/pressure on doctors and to maintain global doctor-patient ratio,

viii.Better infrastructural facilities and medical equipment and provision of extra monetary incentive for the doctors and para medical staff serving in hard/remote areas as compared to major and metro cities with better career prospects, etc.

Government has constituted a Committee to examine various aspects of a uniform legislative framework to address the issue of assault on clinical establishments and doctors on duty.”

The above answer is in response to the Unstarred Question No. 3253 admitted by the Lok Sabha for 12.07.2019 regarding "Assaults on Doctors" raised by 10 MPs: Prasun Banerjee; Shri Khagen Murmu; Shri Bhartruhari Mahtab; Shri Vinod Kumar Sonkar; Shri Syed Imtiaz Jaleel; Shri Rahul Ramesh Shewale; Dr. Sukanta Majumdar; Shri BB Patil; Shri Asaduddin Owaisi; Shri Raja Amareshwara Naik.

Will the Minister of Health and Family Welfare be pleased to state:

a. whether assaults on doctors and hospital staff have been reported in various Government hospitals across the country including recent incidents in West Bengal;

b. if so, the details of such cases reported during the last three years, hospital and State/UT-wise;

c. whether Indian Medical Association (TMA) has directed all its States the members to stage protests against such attack on doctors across the country which led to the shutdown of OPD, Emergency services which resulted into death of patients, if so, the details thereof;

d. whether the Government has implemented the recommendations of the Inter-Ministerial Committee constituted in the Ministry to review various issues including issue of assault on doctors, if so, the derails thereof;

e. whether there is urgent need for a specific legislation to protect doctors/health professionals; and

f. if so, the preventive steps taken/ being taken by the Government in this regard

Cyber Attacks: Lives at Risk

Reproduced from India Legal, http://www.indialegallive.com/health/cyber-attacks-lives-at-risk-68579, published July 14, 2019

An alert by India’s drug regulatory agency about some insulin pumps posing a “cyber security risk” shows the increasing vulnerability of medical instruments to online warfare

Medical devices are increasingly connected to the internet, hospital networks and other medical instruments, to provide features that improve healthcare and increase the ability of such providers to treat patients.

However, they also increase the risk of cyber security threats. Medical devices, like other computer systems, can be vulnerable to security breaches, potentially impacting their safety and effectiveness. The need for effective cyber security to ensure medical device functionality and safety has become more important with the increasing use of wireless, internet and network-connected devices, portable media (USB or CD) and frequent electronic exchange of medical device-related health information.....read more

European drug regulatory authority proposes new recommendations to prevent dosing errors with methotrexate

Pharmacovigilance Risk Assessment Committee (PRAC), the safety committee of European Medicines Agency (EMA) has recommended new measures to avoid dosing errors with methotrexate that have led to some patients incorrectly taking methotrexate-containing medicines.

Methotrexate is used to treat both inflammatory diseases and cancer. When used as an anti-inflammatory in the treatment of diseases such as arthritis and psoriasis, it is taken once a week. For the treatment of some types of cancer, a much higher dosage is needed and the medicine is taken more frequently......read more

Vedanta Laws

For every action, there is an equal and opposite reaction.

Knowledge proceeds from the known to the unknown. This is the basic law of learning.

Yesterday’s miracles are today’s science and today’s miracles will be tomorrow’s science.....read more

Healthcare News Monitor

Health Min bill proposes scrapping NEET-PG; MBBS final exam enough for admission to MD/MS progs

Mint- Payal Banerjee , PTI

In a relief to medical students wanting to pursue post-graduate courses, the Union Health Ministry has proposed to do away with NEET-PG and instead the final MBBS examination would be enough for admission to MD and MS programmes. The amendment has been incorporated in the revised draft National Medical Commission (NMC) Bill which would be sent to the Cabinet soon, official sources told PTI. According to them, the changes have been incorporated in the bill on the directions of the Prime Minister's Office (PMO). "According to the amendments made in the fresh NMC Bill, entry into the PG programmes will be on the basis of the results of the National Exit Test (NEXT), which would be held as a common exam across the country. So the candidates would not have to appear in a separate exam after clearing the MBBS final exam for admission to PG courses," the source explained. The students would also not be required to appear in a separate exam after MBBS to obtain a license to practice. However, for admission to PG programmes at AIIMS, clearing a separate exam will remain mandatory. Also, the NEET Super Speciality, which is a national-level entrance exam for admission in DM/MCh courses, will continue, sources said. Every year 80,000 students take admission into MBBS courses in about 480 medical colleges in the country, while 1.5 lakh students appear for entrance exams for admission to around 50,000 PG seats.

Adityanath bats for dialogue to improve doctors-patient relationship

Outlook India

Uttar Pradesh Chief Minister Yogi Adityanath Sunday batted for a dialogue between the doctors and the patients, saying it will help them to improve their relationship. "There should be an emotional dialogue between the patients and the doctors. We have lost it in this commercial age. The respect for the doctors has diminished due to priority being given to commercial interests," he said. Adityanath was addressing the inaugural ceremony of the ''Smile Mashal Jyoti'' event at his residence here. He said projects like this bring happiness on the lives of the people and also helps a doctor to present his humane face before his patients. "This initiative is an attempt to restore the dialogue between the doctors and the common man," the chief minister said. During the programme, he felicitated the children associated with the Smile Foundation. Many doctors from different districts of the state were also felicitated. Adityanath also released a book on cleft care authored by Dr A K Singh of KGMU, Lucknow, on the occasion. A Smile Mashal Jyoti rally was also organised at the 1090 intersection here.

Heart Network: A registry that maps heart health data in India

Financial Express- BV Mahalakshmi

Apollo Hospitals has become the first hospital chain in India to adopt Abbott’s High Sensitive Troponin-I blood test technology to screen otherwise healthy people for risk of developing heart diseases. The collaboration will focus on generating India-specific insights to enable physicians and patients to better manage cardiac outcomes. The registry would be a method of determining the risk of future cardiac events. The data would be used for risk-stratification to better determine cardiac risk. Abbott’s Troponin blood test can help doctors have a better understanding of their patients’ heart health and this technology could be used at hospitals across the country. Cardiovascular diseases (CVDs) are the biggest cause of mortality in India with nearly 25% of mortalities in the age group of 25-69 years attributed to CVDs. The condition also seems to affect Indians at least a decade earlier as compared to Europeans. With the aim of improving preventive care for cardiovascular disease in India, Apollo Hospitals and Abbott are working towards building the country’s first cardiac registry. As part of the registry, both the organisations will collect heart health data of patients visiting Apollo Hospitals across the country, including Troponin levels measured by Abbott’s high sensitive troponin-I blood test.

Superbugs on the rise, India must regulate antibiotics to avert disaster

The Print - Sugandha Mahajan

Alexander Fleming’s discovery of penicillin in 1928 set off an unprecedented healthcare revolution. With great power – of saving lives with antibiotics – comes great responsibility. India now is trying to shoulder that responsibility and avert an antibiotic apocalypse. We need to save our saviours. Antibiotics are foundational to public healthcare not just to treat infections, but also because medical procedures like surgeries, organ transplants, treatment of burns, and management of ailments like cancer are heavily dependent on the effectiveness of antibiotics. Yet, today, we stand on the brink of an antibiotic downfall. Over 7 lakh people are dying each year of illnesses that could ordinarily have been cured with medication. So, what’s going wrong and how do we fix it? When microbes (bacteria, or other microbes) are exposed to antibiotics for prolonged periods in any setting, it triggers mutations and evolutionary selection of strains that are resistant, producing a line of ‘superbugs’ that can no longer be killed by that antibiotic. Traditionally, the term AMR – or antimicrobial resistance – has been associated with people overusing antibiotics without a prescription from a doctor or stopping mid-way through their course of treatment. In reality, there are many other drivers of AMR, ranging from non-therapeutic use of antibiotics in poultry and livestock, to dumping of antibiotic waste into the environment in the form of pharmaceutical manufacturing waste and hospital waste, and improper disposal of expired medicines.

Homeopathy doctor administrating allopathic medicines is medical negligence: NCDRC

ET Healthworld- Amit Anand Choudhary

A homoeopathic doctor is not qualified to prescribe allopathic medicines and will be liable for medical negligence and will have to pay compensation if a patient suffers from medical complications, the National Consumer Disputes Redressal Commission has ruled. The ruling by the apex consumer commission came almost two decades after a woman in Nagpur died soon after a homoeopathy doctor gave injections to her for her stomach pains. The commission directed the doctor to pay compensation of Rs 10 lakh to her family members, stating that he is a diploma holder in homoeopathy and is not qualified to practise allopathy. The incident took place in 2000 when the woman was taken to the doctor by her family members after she complained of stomach pain. The doctor gave two injections —Baralgan and Dexamethasone. Immediately after the injections, the woman felt uneasy and died. The post-mortem report attributed the death to anaphylactic reaction caused by the injections. Holding the doctor guilty of medical negligence, a bench of Dr S M Kantikar and Dinesh Singh said the doctor is a diploma holder in homoeopathy and is unqualified to practise allopathy, and liable for medical negligence. It upheld the state consumer commission order holding the doctor guilty but increased the amount of compensation from Rs three lakh to Rs 10 lakh and granted him four weeks’ time to pay the money.