Recently, first meeting of National Task Force (NTF) to address Medical Professionals' Safety, constituted by the Supreme Court, was held.
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The NTF was constituted following the murder of postgraduate doctor at RG Kar Medical College Hospital (Kolkata).
NTF mandated to formulate effective recommendations to remedy the issues of safety, working conditions and well-being of medical professionals and other related matters.
Four thematic sub-groups were formed under the NTF that will look into:
strengthening of infrastructure in medical institutions,
strengthening of security systems,
revamping of working conditions, and
the legal framework across the states.
About Healthcare Professionals
Healthcare Professional includes a scientist, therapist or other professional who studies, advises, researches, supervises or provides preventive, curative, rehabilitative, therapeutic or promotional health services (As per NCAHP Act 2021).
Healthand law and order are State subject.
Therefore, it is primary responsibility of State government or Union Territory administration to take note of events and eventualities and prevent violence.
Private sector also provides majority of secondary, tertiary, and quaternary care institutions with a major concentration in metros, tier-I, and tier-II cities.
According to the WHO:
Health workers are at high risk of violence all over the world.
Between 8% and 38% of health workers suffer physical violence while other face verbal aggression.
Most violence is perpetrated by patients and visitors.
Also, in disaster and conflict situations, health workers may become the targets of collective or political violence.
Other Initiatives taken to ensure Safety of Healthcare Professional
India:
Centre
Epidemic Diseases (Amendment) Act, 2020: It provides that acts of violence against healthcare personnel during an Epidemic situation are considered cognisable and non-bailable offences.
Prevention of Violence Against Healthcare Professionals and Clinical Establishments Bill, 2022.
Sexual Harassment of Women at Workplace (Prevention, Prohibition and Redressal) Act 2013: It applies to hospitals and nursing homes (including private health providers).
State
Karnataka Medical Registration and Certain Other Law (Amendment) Act, 2024
Kerala Healthcare Service Persons and Healthcare Service Institutions (Prevention of Violence and Damage to Property) Amendment Act, 2023.
Global:
Framework guidelines for addressing workplace violence in health sector by ILO and WHO.
Zero-tolerance policy on Violence: Enforced by UK's National Health Service,supported by a dedicated security team and a comprehensive reporting system.
Safety measures like security personnel, panic buttons, and mandatory de-escalationtraining introduced in Australian hospitals.
Challenges associated with Safety of Healthcare Professional
Inadequate security provisions: There is lack of security personnel in medical care units in government run hospital.
One-third of doctors in India feel unsafe during night shifts (survey by Indian Medical Association (IMA).
Poor Infrastructure:
Lack of properly functioning CCTV cameras to monitor entry and exit to hospital and to control access to sensitive areas.
Inadequate resting spaces for medical professionals who are posted for night-duties. For instance, One-third of available duty rooms did not have an attached bathroom (IMA survey).
Either inadequate or no transportation facilities for safe commute to hostels or places of stay for medical professionals.
Lack of screening arms and weapons equipment at the entrance of hospitals.
Long Working hours: Interns, residents and senior residents are made to perform 36 hour shifts in conditions where basic needs of sanitation, nutrition, hygiene, safety, etc. are lacking.
Easy Access: Unrestricted access to patients and their attenders to most of the places within hospital and doctors resting rooms.
Health Hazards: Healthcare Professionals are prone to exposure to hazardous substances, viruses etc. E.g. nearly 1,600 doctors succumbed to COVID in India.
Only 14 have set up state councils and even these councils are not functioning properly.
Way ahead
State Responsibility: State governments must establish mechanisms to prevent violence against doctors, including imposing penalties and setting up helplines for immediate assistance.
Mandatory Institutional Reporting: If any violence occurs against a healthcare worker while on duty, the head of the institution is required to file an institutional FIR within six hours of the incident. (MoH&FW)
Infrastructural development: It includes CCTV cameras installation at all entrance and exit point of hospitals, use of bio-metric and facial recognition to access sensitive areas, transport provision from 10 pm to 6 am, etc.
Employees Safety Committees (composed of doctors, interns, residents and nurses): It should be constituted at every medical establishment to conduct quarterly audits on institutional safety measures.
Ensuring due security in medical establishments: Employees Safety Committees (composed of doctors, interns, nurses, etc.) at every medical establishment to conduct quarterly audits on institutional safety measures.
Effective crowd managed by training of security personnel at hospitals.
WHO Recommendations
Develop and implement national programmes for occupational health for health workers in line with national occupational health and safety policies.
Appoint responsible officers with authority for occupational health and safety for health workers at both the national and facility levels.
Promote a culture of zero tolerance to violence against health workers.
Establish a 'blame-free' and just working culture through open communication and including legal and administrative protection from punitive action on reporting adverse safety events.
Establish policies to ensure appropriate and fair duration of deployments, rest break and minimizing the administrative burden on health workers.
