July 19: Top private hospitals in Calcutta have started recording counselling sessions with families of patients on video as proof of doctors and officials providing all the relevant information regarding medical treatment, prognosis and costs.

Some health care institutes now insist on handwritten consent notes from family members or relatives of patients before they are taken for any medical procedure or put on a ventilator. In normal circumstances, hospitals use printed consent forms that need to be filled in and signed.

The prod to record counselling sessions on video came from the administration, sources in the health department said.

The regulatory commission formed by the state government for private health care has already received hundreds of complaints from patients and their families about alleged negligence in treatment and excessive billing.

Counselling rooms across hospitals now have video cameras to record and store the interactions with patients' families. This is usually done when a patient is in a critical condition or requires a surgery whose outcome is uncertain. Cost is also a factor.

A common complaint against private hospitals is that the cost of medical treatment was not fully disclosed to a patient's family. This happens whenever someone has to pay a higher amount for medical treatment than the so-called initial estimate.

Signing a consent form before a medical procedure has also become a grey area. Families of patients are often heard alleging that they were made to sign some forms whose contents they did not understand and, therefore, remained unaware of the risk factors.

"Documentation brings more transparency to the counselling process and can be useful in medico-legal cases. We were not doing this earlier, but now it is being done in most cases where such discussions are required," said Rupak Barua, group CEO of AMRI Hospitals.

AMRI has installed video and audio-recording facilities at its hospitals in Dhakuria, Salt Lake and Mukundapur.

In a private hospital off the Bypass, video documentation used to be done only for counselling of patients and donors before kidney transplant. An official of this hospital said the protocol was extended to other streams of medical treatment around a month ago.

At least one large hospital had introduced the system three years ago but it was discontinued.

One hospital boss said the old system of doctors having "informal" corridor chats with family members or relatives of patients had been all but discarded. "Interactions should be formal and documented to avoid legal complications," he insisted.

Not all doctors agree."Documentation is definitely welcome but it's the relationship of trust between the doctor and a patient that is important. This needs to be restored," said surgical oncologist Gautam Mukhopadhyay.