Be a part of IMA's Blood Donation Movement

Be a part of IMA's Blood Donation Movement In the midst of stories of assaults on medical doctors and their establishments, National IMA team, with your support, has undertaken a herculean task of collecting more than one lakh blood component units on 1st July on the occasion of the Doctor’s Day. Indian Medical Association (IMA) is now community-friendly and has been engaged in activities that promote the betterment of the health of the community as well as the patients. India is the second most populous country in the world with a population of more than 1.2 billion. Yet, we are only 10% of the world requirement (13 million). India is a “Blood donation deficient” country with a deficit of 2 million in terms of units of blood collected. Blood donation is a humanitarian task. So, I request all IMA members to organize blood donation camps under the banner of IMA and pledge to transform India from a “Blood donation deficient” country to “Blood donation surplus” country. All blood donation camps should be “voluntary donation” “non-remunerated” and “Only components”. No camps should be organized for whole blood donation. “Only components” donation will save more than one life. The World Health Organization (WHO) has set a goal for all countries to obtain all their blood supplies from 100% voluntary unpaid donors by the year 2020. As I had mentioned few days back that IMA is now proposing the 1st of every month, starting from Doctor’s Day this year, as IMA Blood Donation Day. And, what better day than today to reaffirm our pledge as today happens to be the World Blood Donation Day. Be a part of the IMA’s Blood Donation Movement… IMA HQs and State Branches are waiting to felicitate you on your feat… Dr KK Aggarwal National President IMA Dr RN Tandon Hony Secy Gen IMA Dr Naresh Chawla Joint Secy, IMA-CGP National Coordinator, Blood Donation Movement

Over 70, 000 doctors participate in the Indian Medical Association’s Dilli Chalo movement

Over 70, 000 doctors participate in the Indian Medical Association’s Dilli Chalo movement Deliberate on key issues ailing the medical community including the increasing incidence of violence against doctors, unfair nature of the PC PNDT Act, need for compensation capping New Delhi, 6 June 2017: In what was perhaps the largest peaceful Satyagraha against the many issues confronting the medical fraternity in the country, doctors, MBBS students, and others associated with the profession participated in huge numbers in the Dilli Chalo movement held today. The movement was a fitting conclusion to the intensive month-long campaign by IMA aimed at raising awareness on and bringing to light the issues faced by the medical profession. IMA is a unified voice and the collective consciousness of the medical profession in the country. The Protest March started at 8:00 AM from Rajghat and reached the Indira Gandhi Indoor Stadium by 11:00 AM. Earlier, the office bearers paid homage to the Father of the Nation Mahatma Gandhi at 6.30 AM. Over 70,000 doctors from all over India participated in the event including representatives of National Medical Associations such as Federation of Obstetrics & Gynecological Societies of India (FOGSI), Indian Academy of Pediatrics (IAP), Association of Physicians of India (API) and the Cardiological Society of India (CSI) amongst others. Those not present in person joined the movement digitally over a live webcast. Speaking at the deliberations, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "This is one of the toughest times for the medical fraternity. This Satyagraha comes after the realization that enough is enough, and that repeated pleas and appeals by the medical fraternity have materialized into nothing but reassurances. The agitation among doctors has been evident for a long time now. New draconian acts imposing penal provisions on clerical errors and violations of clauses not linked to medical treatment under the PC PNDT Act and West Bengal Clinical Establishment Act are not in the interest of the profession and therefore, the society at large. The need of the hour is collective action and decision which would do justice to this profession." The last few months have seen several other initiatives by the IMA on this front such as STOP NMC Sathyagraha, two National Protest Days against violence on doctors, NO to NEXT strike in medical colleges, and the National Black Day against West Bengal Clinical Establishments Act. Other than this, 3 action committee meetings and 2 meetings of Federation of Medical Associations of India were also conducted. Adding further, Dr Marthanda Pillai, Past President, IMA and Dr Ravi Wankhedkar, President Elect, IMA, in a joint statement, said, “It is imperative for both doctors and patients to understand that their relationship is a sacred one and that the dignity of the profession needs to be upheld. It won’t be wrong to say that justice has been denied to doctors even within the framework of the constitution of India. This movement should not be misconstrued as a strike or an agitation of any kind. Its sole aim is to serve as a wake-up call to the government and take urgent action." Addressing the huge gathering of medical professionals, Dr Vinay Aggarwal (Past President IMA) and Dr R V Asokan, Chairman, Action Committee, added, "This protest is an indication that medical professionals will no longer take any form of injustice. People are indulging in violence against doctors, which is further being condoned by governments and other institutions. Prescription rights of doctors are being trampled upon, which can have disastrous consequences for patients. There is absolutely no end to the injustice being heaped upon the medical fraternity and this noble profession. This movement should be enough to urge the government to take urgent action failing which the agitation is only bound to increase." The Dilli Chalo movement aimed to address the following demands by the medical fraternity. • Criminal prosecution of medical negligence and clerical errors to be an exception • Stringent central act against violence on doctors • Capping the compensation in Consumer Protection Act (CPA) on doctors • Professional autonomy in treatment and prescriptions • Amendments in PC PNDT, Central Clinical Establishment Act (CEA), West Bengal CEA Act • No unscientific mixing of systems of medicine • Empower MBBS graduates • One drug - One company - One price • Implement inter-ministerial committee recommendations in six weeks • Single window accountability • Single window registration of doctors and medical establishments • No to NMC: Amend Indian Medical Council (IMC) Act to maintain professional autonomy • Uniform final MBBS exam instead of ‘NEXT’ • Uniform service conditions for service doctors & faculty • Same work - Same pay - Pay parity - No to adhocism • Fair conduction of NEET exam • IMA member in every government health committee • Central anti-quackery law • Reimbursement of emergency services provided by private sector • 25000 family medicine PG seats • Aided hospitals and retainer ship in general practice • Health budget of 5% of GDP for universal health coverage

IMA to organize Dilli Chalo movement

IMA to organize Dilli Chalo movement Over a lakh doctors to join the movement digitally and physically to bring to light atrocities faced by the medical fraternity New Delhi, 22 May 2017: The National IMA is organizing the Dilli Chalo Movement on 6th June 2017 to bring forth the atrocities faced by the medical fraternity and has urged all its members to join the movement in entirety. The Protest March will start at 8:00 AM from Rajghat and reach the Indira Gandhi Indoor Stadium by 11:00 AM. The march, which will be joined by over a lakh doctors in the country, both digitally and physically, will be followed by deliberations on issues ailing the medical profession. The last few months have seen several other initiatives by the IMA on this front such as STOP NMC Sathyagraha, two National Protest Days against violence on doctors, NO to NEXT strike in medical colleges, and the National Black Day against West Bengal Clinical Establishments Act. Other than this, 3 action committee meetings and 2 meetings of FOMA were also conducted. The IMA is undertaking targeted intensive lobbying in the month of May. Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "The medical profession is facing the most difficult time of the era. Both doctors and patients have to understand that the 'Doctor–Patient' relationship is a sacred one and that the dignity of the profession should be maintained. It won't be wrong to say that justice has been denied to doctors even within the framework of the constitution of India. People are indulging in violence against doctors which is further being condoned by governments and other institutions. Prescription rights of doctors are being trampled upon which can have disastrous consequences for patients. There is absolutely no end to the injustice being heaped upon the medical fraternity and this noble profession. It is after having decided that enough is enough that the IMA has given this clarion call, Dilli Chalo." IMA is also initiating a signature campaign on the issues at hand on social media and has urged all doctors to join and collect hundreds of thousands of signatures to demand justice from the government. Adding further, Dr Aggarwal, said, "NEXT was stopped on track by the all-India strike by medical students on 1 February. IMA is now launching No to NEXT 2.0 on 6th June 2017. As part of this, all medical students and colleges in the country will go on strike and conduct protest meetings. The Pen Down Satyagraha will see all doctors across India, in all sectors, not giving any prescriptions for one hour between 10 am and 11 am in solidarity with the Dilli Chalo movement to save professional autonomy." The Dilli Chalo movement aims to address the following demands by the medical fraternity: • Implementation of the Inter-ministerial committee meeting report within six weeks • Stringent Central Act against violence on medical professionals • Single-window accountability with no criminal charges on doctors without intent to harm a patient • Single-window registration of doctors and medical establishments • Preserving professional autonomy by amending Indian Medical Council Act instead of bringing national medical commission • Uniform final MBBS exam instead of 'NEXT' • Pan-India uniform service conditions for medical doctors and other health care providers • Amendments in PC PNDT, Central CEA, and West Bengal CEA Acts • IMA member in every government health committee • No commercial rates on medical doctors providing subsidy • Anti-quackery laws (no one other than qualified MBBS or BDS can prescribe scheduled modern medicine drugs) • Protection of professional autonomy (no interference in freedom to choose quality affordable drugs, investigations, and treatment) • No variation in market prize for generic-generic, trade-generic, and brand-generic drugs • Reimbursement of all emergent services in private sector for people who cannot afford treatment • Health budget of 2.5% in the coming year • Promotion of family medicine in India with 25,000 PG seats in family medicine

Enough is Enough: Dilli Chalo on 6th June

Enough is Enough: Dilli Chalo on 6th June Dear Colleague IMA has declared “Dilli Chalo” movement on the 6th of June to bring to the attention of the nation regarding atrocities faced by the medical profession. The charter of demands is as follows. Kindly go through these and suggest more and also suggest modifications in the existing ones. We want to cover all segments of the medical profession (specialities, service doctors, residents, junior doctors, students, practitioners, consultants etc.). How come the government and the celebrities are watching violence against doctors without any empathetic response? Make violence against health care providers a non-bailable act with minimum 14 years imprisonment How come, gradually and now consistently, modern medicine doctors are increasingly being tried as criminals? We are not against accountability but not to be tried under criminal provisions. We want a single window accountability under the council or under a central tribunal. Why is the health ministry sitting on the minutes of the inter-ministerial committee - regarding violence, amendments in PCPNDT act, Clinical Establishment Act, capping of compensation and cross pathy? We want time bound implementation in six weeks. Why should we be the victims of the limitations of the government? If the government cannot provide free primary and emergent care to all, why are they not engaging the service of doctors in the private sector to provide the same at government rates? Are AYUSH not qualified doctors in their respective field and are they not qualified to treat common illnesses, then why force them to leave AYUSH practice and treat patients with modern medicine drugs? Is this allowed in other professions? Is this not cheating and injustice to the patients? We respect AYUSH doctors and their pathies. Let AYUSH practitioners develop their own pathy and grow in their respective pathies and not indulge in crosspathy. Recently, the government banned 344 fixed dose combinations drugs on the plea that two drugs when combined becomes a new drug. Then why are some state governments allowing AYUSH to co-write allopathy modern drugs? Let the public be given the best of their system of medicine. Any mix has to be as per a clinical trial registry. Are we not short of doctors? Are our MBBS doctors before starting practice not giving enough exams conducted by recognized universities? IMA wants to uphold the highest standards in UG and PG medical education. We are against the proliferation and establishment of poor quality medical colleges. The limitations of the government are already being faced by the doctors, then why introduced another exam in the name of EXIT? Would anyone like an elected government to be run by a nominated panel of retired Supreme Court judges or similar eminent people? Then why is the government thinking of replacing it with 20-member nominated body instead of amending the Indian Medical Council Act? Can the same be done to the Bar Council of India and the Institute of Chartered Accountants of India? Do all the doctors not have the right to be treated equally in all states? Doctors are already facing the wrath of the limitations of the government, then why does the West Bengal Clinical Establishment Regulatory Commission provide extra separate provisions of fine, compensation and jail up to three years, thereby treating WB doctors like criminals ab-initio? Are we not supposed to provide easily approachable services e.g. tackle cardiac arrest within five minutes? Then why are we restricted from opening clinics in the vicinity of residences of citizens? This is the most needed facility available to any citizen. Are we not responsible for the treatment provided to our patients? IMA is committed to upholding the rights of the people to get good, reliable and competent medical care. Then how can the government take away our right to choose the drugs and the company? Will the chemist be responsible for any death that occurs? Will the government pass a legislation and ask the voters to vote and which button to be decided by the clerk helping the polling booth? Then how can the government allow a chemist to decide which drug is best for the patient and a lab technician to authorize a laboratory report? If the quality and cost of manufacturing of generic- generic, trade-generic and brand-generic is the same, then why is the government allowing them to be sold at three different prices by the same company? We want one drug, one company, one price policy. Every citizen in the country has a right to receive quality and safe medical treatment. Then why push the poorer to treatment from unsafe and unqualified people? We want 25000 extra seats for post MBBS 'Family Medicine' course to provide comprehensive primary and emergent care to the public. An ideal GP clinic can be a combination of a doctor, a nurse and a pharmacist. When Arabian countries provide income tax free pay to look after their patients in rural areas along with higher pays, why can’t Indian government do the same? Doctors posted in challenging and difficult distinct areas should be given income tax-free pay higher than that given in metro cities. Are doctors not entitled for equal work- equal pay? Then why the difference in working conditions and pay scales of residents, service doctors across the country? All doctors in the country should be treated at par. How can you allow doctors to work for years under contract without making them permanent? Doctors working in bad service conditions because of limitations of the government is injustice and should be resolved immediately pan India. Reporting the name of the victim of sexual assault is a punishable offence in POCSO and IPC. We want a central law that any allegation against a doctor be not reported by the media until the doctor is convicted. How come increasingly Judicial powers are been given to administrators in various acts. Are we not going back to a Jury system? A doctor should have powers to challenge any regulatory decision in lower courts and not directly in high courts. Why are the government IEC advertisements not that effective? Why can’t they involve Indian Medical Association (IMA) and eminent doctors in their advertisements? If the government is dependent on private sector and is asking all of us to provide free OPDs in government sector on 9th of every month then why not give IMA a room at Nirman Bhavan (similar to that has been allotted to WHO) and work together. This is the minimum they can do. This step will lead to result-oriented coordination between Government and Doctors. Public-Private Partnership is the need of the hour to uphold and develop health sector in India. Dr KK Aggarwal National President IMA & HCFI

Straight from the heart - Enough is Enough: ‘Chalo Dilli’ on 6th June

Straight from the heart Enough is Enough: ‘Chalo Dilli’ on 6th June Dr KK Aggarwal National President IMA Dear Colleague The Indian Medical Association (IMA) has declared “Chalo Dilli” movement on 6th of June to bring to the attention of the nation that the medical profession is being strangulated from all directions. Justice has been denied to doctors even within the frame work of the constitution of India. • Why is everybody silently watching violence against doctors? We become doctors to serve and not to harm the community. We are not against accountability but no one can be allowed to take law in their hands. Violence against healthcare professionals is occurring with growing frequency in India and there is often an attempt to soften the outcry by blaming the medical professionals being the cause of provocation. While every hospital and healthcare facility should identify high-risk violence prone areas in their establishment to be manned by adequate number of doctors, CCTV cameras and adequate security, all healthcare providers, who are victims of violence, must be adequately compensated. A well-structured and effective Grievances Redressal mechanism at each clinical establishment should be established (both for patients or their relatives and for the healthcare providers), timely and transparent root cause analysis of every case of violence should be done and entered in a centralized IMA registry. It’s our luck that Hon’ble acting Chief Justice of Delhi Smt Geeta Mittal and Hon’ble Justice Anu Malhotra in a suo moto order dated 3.05.2017 have made IMA as a party in the case. Directly or through the court, we want the Ministry of Health and Family Welfare, Government of India to urgently and promptly implement MCI suggested amendments of making soft skill communications compulsory for UG and PG curriculum. Also based on the inter-ministerial committee recommendations, the Central Government should enact a central act against violence at the earliest on the lines of one enacted in 19 states and make the violence against doctors as non bailable offense punishable with up to 14 years imprisonment on the lines of abatement of a murder because violence against doctor can end up with death of other unattended patients. • How come we are suddenly being tried as criminals? Of late, medical professionals are being tried under criminal law for medical negligence. In order to establish criminal liability, it is important to ascertain whether intent to harm (mens rea) was present or not. But in criminal negligence cases, intent to harm has been replaced by gross negligence. Gross negligence itself is not defined in IPC. Moreover, criminal law punishes only affirmative harm but in medical negligence failure to act in a prudent manner also is a crime. It should not be forgotten that medicine, especially emergency medicine, is inherently risky. Adverse outcomes or mistakes do not necessarily mean that care was negligent or that health care providers are criminally at fault. The sections of IPC 304 A (death due to negligence), 336 (act endangering life or personal safety of others), 337 (causing hurt by act of endangering life), 338 (causing grievous hurt by act of endangering life) are being frequently applied against medical practitioners. Moreover, sections of MTP Act, PCPNDT Act, POCSO Act, HIV-AIDS Act, West Bengal Clinical Establishment Regulatory Commission Act etc. are also being applied against medical practitioners for technical reasons and medical professionals are prosecuted. To treat a patient, the medical professionals often have to take calculated risks and take decisions. If they fail to do so it may further complicate the situation. So it becomes difficult to define gross negligence. Besides, one has to consider Section 88 of IPC, which saves medical professionals from criminal liability when the act is done in good faith. Hence, Section 304 A and similar sections of IPC should only be considered along with Section 88. Yet with every passing day, doctors are being prosecuted under 304 A when there is no mens rhea between the doctor and the patient. Under the new acts including the PCPNDT Act, even clerical errors are being linked to penal provisions. In West Bengal Clinical Establishment Regulatory Commission Act, the word used is ‘shall’ for imprisonment of up to three years for any violation of the act. We want de-criminalization of clinical practice. • Why are the limitations of the government being faced by the doctors? It is the constitutional duty of the governmental to provide free drugs and investigations for primary care and emergent care. The very fact that 80% of health care services are handled by private sector means either the services of the government are not up to the mark or they do not have enough infrastructure. The private sector is doing the job of the government. Then why so many exams for the medical students, so many registrations for opening a new medical establishment and so many windows for accountability? Why can’t we have single window registration and single window accountability? • When it is the government who has allowed the same company to manufacture generic-generic, trade generic and branded generic medicines at differential prices, then why punish and defame the doctors? Why take away the prescription rights of doctors and give it to un-qualified chemists. Why is the government allowing pharmacies to be run by outsourced non-professional chemists? It’s not the doctor’s job to search for the cheapest brands. It’s like government saying that we will allow drugs to be sold at variable prices but you should not write the costlier ones. In other words, we will give licenses to five-star restaurants but no one is allowed to go there. The right to choose the brand or the company name is with the doctor who owns the legal responsibility of the case. If the brand is chosen by the chemist, who will be responsible if the patient dies during treatment. • Why do we need a government? Why not a Supreme Court Monitoring Committee or twenty nominated members to run the government? If not then why attempts for an autocratic, bureaucratic, undemocratic, non-representative, 20-member nominated body including 8 non-medical persons to oversee medical education, ethics and practice by abolishing a democratically elected federally represented 168 members Medical Council of India (MCI). If you feel the IMA Act needs amendments, go for that. • The country is already short of doctors then why an MBBS graduate who has gone through 36 examinations in 3 dimensions to get his degree is being asked to sit for another 3 hour MCQ paper to obtain his license under NEXT. • By promoting AYUSH to practice modern medicine are we not finishing the very existence of AYUSH in the country? Scheduled drugs should only be allowed to be written by MBBS or BDS doctors. • The floodgates of modern medicine practice are being thrown open to quacks and no action is taken. No unqualified person should be allowed to prefix doctor in front of their name. • When medical profession is considered noble and doctors provide subsidy in the consultation to all patients then why compensation is awarded in crores basing it on the patient’s income? And why another act to compensate in West Bengal Clinical Establishment Regulatory commission? • Why are professional decisions taken without taking the medical profession into confidence? Why can’t IMA be in every policy making committee of the government. There is no end to the injustice heaped on the medical profession. Every doctor in India should participate in the “pen down strike” on 06.06.2017 while “IMA Satyagraha is walk in protest”. All Medical Colleges in the country SHOULD remain shut as well on 06.06.2017. Let us not compromise on our demands • Central Act against violence • Stop NMC and Amend IMA Act • No to NEXT • Decriminalization of medical practice and clerical errors • Modern medicines to be prescribed only by MBBS or BDS doctors. • Professional autonomy in prescriptions. • Immediate implementation of the inter-ministerial committee recommendations. • Amendments in Clinical Establishment (Registration and Regulation) Act 2010 and West Bengal Clinical Establishment (Registration, Regulation and Transparency) Act 2017. • No unqualified person should be allowed to prefix ‘Doctor” before their name. • No chemist should be allowed to sell or run a pharmacy without a degree in pharmacy.