West Bengal seems to be drifting towards some sort of a medical renaissance. After a long and grim trail of dead infants, woeful infrastructure, stinking premises and superannuated practitioners, there is a sense within the government that it wouldn’t be a bad idea after all to give this whole dreary matter a bit of thought. And some sensible ideas have emerged. But the problem with any reform, calling for drastic or extensive measures, is that it inevitably ends up sounding quixotic and impossible to implement, given the depth and scale of the problems in the state’s health sector. This automatic scepticism, although entirely understandable, could easily become unfair and, as it were, unhealthy.
Take, for instance, the idea of making around 40,000 doctors renew their registration every five years in order to ensure the updating of their professional knowhow. This suggestion, from the West Bengal Medical Council, is founded on laudable principles. Doctors in the state must keep pace with the advances of knowledge and methods in their fields in order to maintain the quality of the services they provide their patients. The implementation of this idea would require, however, a revolution at several levels. First, keeping vigil on the doctors to ensure that they abide by this regulation would require a major bureaucratic reinforcement. Second, regularly organizing refresher programmes for upgrading their skills and making sure that they attend these would require another feat of management. Third, users of medical services must also be made aware of their entitlement to up-to-date medical care. This consciousness on the part of consumers is crucial to the standards maintained by the service providers. Finally, the proper running of hospitals, clinics, laboratories and general practices is also dependent on modern methods of administration, management and hygiene, and is not simply a question of specialized medical knowledge. For this to happen in West Bengal there has to be a profound change in attitudes to, and in the training and quality-control of nurses, midwives and administrative personnel. The environment in which doctors and other staff work and often live must physically foster a sense of professionalism, cleanliness, safety and well-being. Without ensuring these basic physical conditions, larger reforms will be impossible to sustain. Making sure that doctors do not treat patients in grotty old medicine stores is a step towards this new vision of things. But nothing short of a combination of political will, public consciousness and perseverance will sort out the state’s chaotic, and often hellish, healthcare system.