We call on govt not to ignore doctors’ demands and urge medical practitioners to pay heed to the sufferings of the general public due to their protests

What happened on Sunday was in the making for quite some time. Doctors took to the streets and tens of thousands of patients suffered. At the heart of this lies the new Criminal Code Act that came into force on August 17. Medical practitioners in the country are up in arms against some provisions in the new penal code, which they say “criminalise medical negligence”. The new Criminal Code Act proposes some tough penalties for medical negligence. For example, Section 232 of the Act proposes jail sentence not exceeding five years and a fine not exceeding Rs 50,000 on a doctor if s/he is found to have caused death or maimed a patient “by reckless acts during the course of treatment”. Seeking amendments to provisions in Sections 231, 232 and 239, Nepal Medical Association (NMA), the umbrella organisation of doctors, on Sunday halted all medical services, save emergency.The NMA has also warned of more protests if its demands are not addressed.

Medical negligence has been a subject of debate for long across the world, and it demands detailed and repeated examinations. Negligence is a breach of duty of care which results in damage. It is defined as carelessness in a matter in which the law mandates carefulness. So a breach of this duty gives a patient the right to initiate action against negligence. In Nepal’s context, it must be noted that there have been some recorded cases where there has been negligence on the part of doctors.And time and again we have come across reports of doctors being attacked after someone’s death or injury “due to negligence”. In some cases, members of general public have taken matters into their own hands and vandalised hospital infrastructure. As a result, health facilities were forced to cough up hefty sums of money for out of court settlements. This situation must end.

In a country where doctor-to-patient ratio is one of the lowest in the world, it’s but obvious that members of the general public are often at the receiving end. It is also frustrating for patients when they have to pay exorbitant fees and wait for hours only to get barely 5-10 minutes from doctors to discuss his/her problem. But this does not mean we can paint all the doctors with the same brush. The country does have many a wonderful, diligent and selfless doctor in service. While the state needs to protect patients’ rights, it also must create a safe environment for doctors to perform their duty without any fear of being jailed. Negligent doctors need to be punished but there is a way to go about it. In case of  injuries or deaths resulting from doctors’ negligence in the course of treatment the victim needs to be properly compensated. That’s how negligence and willful misconducts are dealt with around the world. But for this, strong mechanisms should be put in place to conduct thorough investigations. An independent commission can be set up in case of disputes so as to settle the case. Portraying doctors as criminals could do more harm to patients than doctors. While we call on government not to ignore doctors’ demands, we also urge medical practitioners to pay heed to the sufferings of the general public due to their protests.

Settle differences

It has been forty months since the devastating 2015 earthquake damaged the iconic Ranipokhari and Bal Gopaleshwor temple located in the middle of the man-made pond. However, the National Reconstruction Authority (NRA) which is coordinating the reconstruction of the pond and the temple has been unable to finalise its detailed plan as the cultural experts, architect engineers and civil-society members are divided over a rebuilding model of the Ranipokhari, built by then king Pratap Mall in 1670 AD.

An 11-member panel, headed by Bishnu Raj Karki, entrusted with submitting a plan to reconstruct them has insisted on rebuilding the temple to its Malla-era design, also known as Granthakut model. However, other experts dismissed the possibility of rebuilding it to the Malla-era design based only on references from a painting that is hundreds of years old. Both the Ranipokhari and the temple were renovated during the Rana period about 150 years ago. Referring to Vienna Charter 1964, other archaeologists have advised NRA to stop rebuilding the historic monuments on original model when confusion occurred. Whatever the arguments they may have the NRA and the stakeholders must settle their differences amicably and start rebuilding them at the earliest.