There can be little palliation for a son’s pain and anger when he has watched his critically ill mother die on the pavement before the gate of a cancer hospital. It is not that Chandrama Prasad Sharma had not tried. He had done the best he could, bringing his mother from the sub-divisional hospital in Kharagpur to the Nil Ratan Sarkar Medical College and Hospital, to which she had been referred, and thence to the Chittaranjan National Cancer Institute, where the doctor on duty in NRS had sent her on. The referral was valueless. The CNCI does not take in patients without a registration card, and the cards are given out only for a few hours each morning. A patient in terminal pain from another town, referred from another hospital in a situation of emergency, is not even allowed on the premises. And her son, in this case, cannot fulfil his mother’s last request of taking her to a good doctor.

This is not the first of such tragedies in Calcutta. What is most striking is the inhumanity of Rajpati Devi’s story, the lack of coordination between two city hospitals, and the heartless tangle of red tape. Similar incidents over the years have shown up apathy, neglect, human error, and an indifference to the fact that institutions meant to serve the sick should have patients dying on their thresholds or under a tree because they have not been admitted. The Supreme Court directive that no hospital can refuse a critically ill patient has had a peculiar outcome. While it is true that it makes the officers in government hospitals anxious to cover their backs when accused of negligence, it is also true that the infrastructure of government hospitals in West Bengal has not been upgraded to match the number of patients who now have to be admitted. The callousness is perhaps to be located in policy-making. When there is no space, the hospital must accord priority to those who are critically ill. As the director of health services said when Badal Chakraborty died under a tree in the campus of the Seth Sukhlal Karnani Memorial Hospital in 2003, why should a renal failure patient have to queue up for admission?

The policy of admission in government hospitals and institutes is strangely blind. If the CNCI does not take in anyone without a registration card, its rules regarding referrals should be transparent and familiar to the relevant departments of all other hospitals, and alternatives provided in cases of emergency. Besides, a system cannot be corrected at the top if its base is not functioning adequately. The worst, and most tragic, experiences befall those who come from the hinterland of the city; yet many hospitals in the districts seem incapable of — or unwilling to — cope with the comparatively simpler diseases. As a result, everyone comes to the government hospitals in the city, pushing their capacities to the limit. And keeping critically ill patients out. A logical policy addressing all aspects of the problem, better coordination among hospitals and the long-awaited improvement of government hospitals in the districts may go some way towards ensuring that the terrible tragedy of Rajpati Devi is not repeated.