State seeks tough law against ‘cut practice’ by doctors’

The state (Maharashtra) government is set to introduce a Bill against the cut practice by doctors in the upcoming monsoon session of the state legislature which will begin on Monday. The government wants to make provisions for punishment under the Prevention of Corruption Act, 1988, to be applicable to doctors and others who are found guilty of the practice. If passed, the guilty will face minimum imprisonment of six months, extending up to five years.

Speaking to Mumbai Mirror, a senior official from the state’s medical education department said, “The state government has appointed a committee under former Director General of Police Praveen Dixit to draft the law. The state will be receiving the draft very soon and once the cabinet approves it, it will be tabled in the monsoon session of the state assembly.”

Cut practice is the act of accepting favours, cash, gifts or free trips from other doctors, hospital chains or diagnostic laboratories for referring patients to them. The practice is known to have originated in the United Kingdom where it started at 5 per cent. But according to recent government data, in India the rate has reached up to 40 per cent. Experts say, this is mainly due to increasing competition and one-upmanship.

Under the proposed Act, receiving gratification for referring patients to specialist doctors or ordering medical tests from one particular lab will be considered a criminal act.

Similarly doctors receiving expensive gifts from pharmaceutical companies, diagnostic laboratories or hospital chains on special occasions like birthdays, marriage anniversaries, children’s weddings etc. will be also considered a crime. Besides this, junkets sponsored by pharma companies will be also considered against the law.

A senior official from health department said, “Whether a particular test or procedure recommended by the doctor was necessary or not has been kept out of the proposed law’s purview. However under the law, investigating agencies will only examine whether a doctor or a hospital received material benefits for referring patients to another organisation or doctor.”

Dr Praveen Shingare, director medical education and research said, “The basic aim of the Act is to end the cut practice and if we succeed in doing so, it will bring down the cost of treatment by almost 30 per cent.”

A publicity stunt?

Medical sector activists are not convinced if the Act will be fool proof. An activist, Dr Arun Bal said, “The so-called bill against the cut practice is nothing but a publicity stunt. How is the government going to procure proofs of these payments and gifts? Most of these are done off the books. And even if they do, how are the authorities going to establish a pattern of these payments to prove their guilt?”

“We have built our health care system in such a way, that a young medical practitioner entering the profession will not survive unless he joins the menace of cut practice. Unless we change the system, we won’t be able to curb this,” he added.

According to Dr Bal, doctors constitute just 25 per cent of the health sector, big corporate hospitals, diagnostic centres and pathological labs constitute the major chunk of 75 per cent.

Dr. Shivkumar Utture, treasurer of the Maharashtra chapter of Indian Medical Association said, “We have made several representations to the government that one of our representatives should be included in the drafting committee. We should at least be given a hearing by the committee.”

“We would also like to request the government to not provide investigating agencies with sweeping powers under the proposed law. The doctor should be arrested only if he or she is found guilty by the court. Otherwise if the doctor is arrested today and found not guilty after five years, he stands to lose both his practise and his reputation,” he added.