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Denis the menace

Sir — Denis Thatcher, the almost forgotten husband of Margaret Thatcher, died months ago, and Lady Thatcher herself is medically unfit to talk publicly. Yet, the rekindled interest in the Thatchers cannot be explained alone by their daughter’s recent release of the interview she had filmed with them (“Denis had last laugh at ‘ghastly’ Major”, August 2). The British seem to be suffering from a wave of nostalgia following two “ghastly” leaderships — not only John Major’s, but Tony Blair’s as well. The past month has been particularly demonstrative of the sorry plight of Blair’s government and leadership. A series of scandals in the government, followed by a terribly confused war with Iraq, topped by an equally confused government stand on the David Kelly episode may be gradually turning the nation back to the Conservative fold. Which means Denis Thatcher could have had more reason to have his “last laugh” had he lived a while longer.

Yours faithfully,
K. Chatterjee, Calcutta


Inhospitable

Sir — With the state health minister, Surjya Kanta Mishra, taking a lot of interest in bringing errant doctors to book and the chief minister showing an interest in introducing private medical colleges in West Bengal, it appears that the state government really wants to improve the medical infrastructure.

But it took a newspaper to break the story of meritorious Iti Baidya for the state government to sit up and take notice. Rural Bengal surely has many more such examples. After the recent media revelations, one can surely ask, what has the health minister been doing all this while' A hike in medical fees is justified only to the extent that it is not possible for the state government to continue with subsidizing professional education. Should not the government have set aside funds to help meritorious students realize their dreams' Although there are no statistics to prove this, it is probably true that poor students turn out to be more sincere doctors than those who study paying capitation fees. If the government does not do anything to help the poor and the deserving, the loss will be the state’s, not the students’.

Yours faithfully,
Subhadip Pal, Calcutta


Sir — The talk about the chief minister approaching the Union health minister for approval to the medical colleges at the Seth Sukhlal Karnani Memorial Hospital and in Midnapore illustrate how seriously diseased the health sector of West Bengal is.

The argument put forth for starting these new medical colleges is that students admitted in them will be paying higher fees to cross-subsidize students admitted through merit studying for lower fees. To set up a medical college (for a yearly 100-student intake) from scratch requires no less than an investment of Rs 100 crore, for well-equipped lecture theatres, laboratories, examination rooms, staff quarters, hostels, along with a good 500-bed hospital. For the teaching departments, more than 150 full-time teachers are required. In addition, there are nursing personnel, technical staff, paramedics, clerical staff and so on. The teaching hospital should attract at least 800 sick to the out-patient ward daily, and the daily average bed occupancy rate should be 80 per cent. The patients need to be free patients, as paying patients will not allow students to examine and study them. The annual running expenditure of such an establishment will be no less than Rs 20 crore. If all the 100 admitted students pay Rs 2 lakh annually, the recovered cost will be Rs 2 crore, which is less than 10 per cent of the expected minimum annual expenditure. Does this make any financial sense'

The Medical Council of India, an autonomous body, has been created to ensure that the standards of medical education are properly maintained in all medical teaching institutes. For this, the MCI inspects different medical colleges and accordingly gives its recommendations to the Union government. The MCI inspects an institute in three main divisions: physical infrastructure, teaching faculty and availability of adequate clinical materials, that is, patients. At this moment, almost all the relatively new medical colleges all over the country have not been given approval to admit students, as they have not met with the required criteria. It will be unethical for the Union government to interfere with the functioning of the MCI and allow ill-equipped medical colleges to churn out half-baked doctors. The Union health minister should not entertain any such requests from any chief minister.

Also, those paying higher fees will want their wards to pass the examinations with flying colours, whether they merit it or not. The pass rate of Calcutta University’s MBBS examinations is rarely above 60 per cent, although all these students have got admission through the tough joint entrance examination. On the other hand, in medical colleges where students have been admitted on payment, the pass rates are rarely below 90 per cent, and in many institutions, the increments of the faculty are linked to student pass rates.

Then why the sudden interest of the powers that be to open new medical colleges in West Bengal' First, the JEE is conducted in a fair and impartial way, minimizing chances of sub-standard students getting into the medical colleges. Second, it is no longer possible for private bodies to run medical colleges, the costs are too high and returns uncertain. Third and most important, the new political-business-bureaucratic-professional class in West Bengal have no qualms about paying huge capitation fees for putting their children into medical colleges if they fail to clear the JEE.

It is the people’s responsibility to refuse to let this sham prosper. For, those who spend lakhs to become doctors will fleece their patients too. Do we want to pay through our noses to be treated by undeserving doctors'

Yours faithfully,
S. Sen, Calcutta


Sir — The reason behind a fee hike in medical colleges is quite clear — the financial mess the state government has landed itself in. As things stand now, it makes sense if the government follows a differentiated fee structure. The government’s decision to give a 50 per cent waiver on the tuition fees for 10 per cent of the medical students who are “meritorious but poor” is commendable but unreliable (“Iti opens can of questions”, July 11). The All-Bengal Medical Students’ Action Forum has raised a few pertinent questions: how the government will decide who is “poor” and who is not and what purpose does waiving only the tuition fees serve' However, just as they fail to see the government’s logic, we fail to see how they hope to solve the problem by striking work.

Yours faithfully,
Rajarshi Sengupta, Kharagpur


Sir — The Left Front government’s decision to substantially raise the monthly tuition fees in the MBBS, BDS, Ayurvedic and homoeopathic courses is illogical. Has hiking the service charges in the state-run hospitals improved conditions in hospitals' What purpose will the hike in tuition fees serve other than depriving a number of deserving students'

Yours faithfully,
Saibal Basu, Calcutta


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