With reference to a report in Times of India (TOI) dated 8th September 2017 which was headlined as "No operations in nursing homes without ICU". The report goes on to state that in the Bijoy Kumar Sinha versus Dr Bishwanath Das case Justices A K Goel and U U Lalit have held that nursing homes without an intensive care unit facility cannot carry out surgeries as absence of an ICU posed danger to the patient's life. Association of Medical Consultants Mumbai and their legal team have perused the entire judgment in question and found that nowhere in the judgment or during the course of the arguments in court have the learned judges commented in the manner reported. The judgment pertained to a case pending for 23 years and the judges while exonerating Dr. Das for negligence in deciding to operate on the wife of the petitioner had awarded a sum of 5 Lakh rupees without interest to the petitioner for possibly ignoring the high risk factors like hypertension and low hemoglobin in the patient while choosing to operate in his nursing home. It is unfortunate that TOI chose to ignore the facts of the cases and rather gave it a headline which gives a complete different impression to the readers of the newspaper and has created a sense of panic amongst the public as well as the medical community. It is pertinent to note that almost 50-60 percent of the healthcare services in our country are delivered by Nursing homes most of which are without ICUs and any move to stop surgeries in these nursing homes will have an adverse impact on healthcare delivery system of our country. Many government hospitals too lack ICUs and they too would be unable to perform surgeries as per your headline. We once again reiterate that the Judgment does not in any way mandate/suggest that all surgeries hence forth must be carried out in Nursing homes with ICUs. As a body of Consultants that represents over 9500 consultants operating in both nursing home owners and consultants in corporate hospitals we would like to categorically state
1) There are international norms of risk grading for surgery and it is well accepted that Grade 1 and 2 and select cases of Grade 3 can be operated in small nursing homes.
2) It is a fact that worldwide there is a focus on opening Day Care Centers for surgery and that is an acceptable modality to reduce cost of surgery to the patients
3) Any move to restrict surgeries to only hospitals/nursing homes with ICUs is in direct contradiction to this concept.
4) If implemented without reasonable thought and all surgeries necessarily move to tertiary centers the cost for a simple operation would go up to 3 times. The strain on patient’s pockets and the strain on the tertiary health care facilities will make access to quality healthcare difficult for the common man.
We therefore call upon you to retract your story and carry an appropriate equally prominent clarification to dispel the misinformation which your earlier report carried. We would like to have an appointment with you to discuss the issues in detail so that the appropriate clarifications can be issued. We are confident that you will understand the gravity of the situation and take appropriate measures to rectify the report. – Medical Buyer Bureau