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India's best medical institution has been wounded
T V R Shenoy
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July 06, 2006

I hate strikes. No, I am not talking about pinpricks like cable operators going off because of some silly dispute or the other. But there are some professions whose absence are quite literally a matter of life and death. And doctors unquestionably come in that category.

That said, what happens when you get the sinking feeling that the government is out to crush you, to deprive you of all sense of self-worth?

Sadly, that seems to be happening in the All-India Institute of Medical Sciences. The Union health minister's ego has led to the unceremonious sacking of the director of India's premier institution in the field of medicine. This has already led to at least one death, and I fear that it will not be the only such case.

Let me give a brief recap for the benefit of those who might be otherwise occupied with work and the World Cup. Union Health Minister Dr A Ramadoss has been openly contemptuous of Dr P Venugopal for several weeks now.

The origins of the dispute are something that the minister has not spelt out, but everyone in Delhi believes that Dr Ramadoss is trying to seize control of the All-India Institute of Medical Sciences. The minister rammed home a resolution dismissing Dr Venugopal in a meeting of the governing body that was held on July 6.

That resolution was not on the agenda papers, and there is utter confusion whether an actual vote was held. Dr Venugopal has moved the Delhi high court, in a move to strike down the order.

Meanwhile, Dr Venugopal's colleagues -- everyone from the doctors to the karamcharis' union -- went on a flash strike as soon as the news broke of the Dr Ramadoss-engineered coup. Doctors across Delhi -- and possibly in other cities in India -- are considering supporting their All-India Institute of Medical Sciences peers even as I write. The Indian Medical Association has already described the sacking of Dr Venugopal as 'a blatant slap on the face of the medical profession' that smacks of 'tremendous political interference.'

Even as Delhi's other premier hospitals grind to a halt, the strike at the All-India Institute of Medical Sciences claimed its first casualty. Sarvesh Kumar had come to Delhi, complaining of an irregular heartbeat. He died in the compound of the hospital since there were no doctors on duty. His bereaved family insists that he might have been saved had there been any physicians around. Whatever the truth of that allegation, I fear that Sarvesh Kumar could be the first of many whose condition deteriorates with time.

It is a bitter irony that Sarvesh Kumar died of a chronic heart problem in an institution whose recently-sacked director was one of India's most renowned cardiac specialists. Dr Venugopal has an excellent record in his field, and he spent something close to 40 years in government service. Given his experience, how many other doctors will seriously consider the public health institutions rather than the more lucrative private sector?

The saddest part of the tale is that the Union health minister cannot cite any principles that have led him to sack Dr Venugopal, precipitating the current crisis. It comes across purely as a matter of ego, wanting his own way no matter what the cost. But how do you resolve the dilemma?

I fear there is no political solution. An embarrassed Congress was quick to distance itself from the Union health minister, saying it was an issue between the Union health ministry and the All-India Institute of Medical Sciences.

Technically, the sacking of Dr Venugopal needs the sanction of the Union Cabinet, given that the All-India Institute of Medical Sciences is under the purview of the Government of India. But the health minister is not a Congressman, and his father S Ramadoss, the president of the PMK, is backing his son all the way.

The prime minister is, in other words, helpless to rein in his colleague because the matter has become entangled in Tamil Nadu's caste politics.

The rapid reaction of the Congress was not the only signal -- nor even the first one -- that Dr Anbumani Ramadoss has become an embarrassment. A previous burst of abuse had led the harassed prime minister to appoint a special committee led by Dr M S Valliathan to look into the functioning of the All-India Institute of Medical Sciences.

Dr Valliathan -- whom I happen to know -- is a stickler for autonomy; in 2004 he resigned from the Kerala [Images] State Science and Technology Council rather than put up with the interference of the Oomen Chandy ministry in Kerala. Appointing him was a subtle message from the prime minister to his health minister to lay off.

On a day full of ironies, the Supreme Court was sending the Union health minister a message that was not in the least subtle at almost exactly the same time that he was sacking Dr Venugopal. The Union health ministry had decided -- once again without Manmohan Singh's [Images] knowledge -- that those resident doctors who took part in the anti-reservation movement would not receive their salaries.

This broke the government's assurances that there would be no punitive action. The Supreme Court was unforgiving in its condemnation of the Union health ministry when the doctors appealed. 'Why are you playing Dr Jekyl and Mr Hyde,' the Bench asked Solicitor General Ghoolam Vahanvati, 'Till May 28, you were on your knees. It was after we passed orders that the doctors withdrew the strike. And after this you choose to become wiser.'

Can anyone tell me why on earth Anbumani Ramadoss went out of his way to sack Dr Venugopal precisely when the All-India Institute of Medical Sciences staff were already feeling bitter and betrayed? (As, judging by the Supreme Court's reaction, they had every reason to be.)

The supreme irony is that Anbumani Ramadoss is himself a doctor by training. (Although he is not exactly renowned in the profession, and in fact chose to study economics rather than specialise!) The All-India Institute of Medical Sciences staff -- once again, I don't mean just the doctors -- snigger that the only way a man of his meagre qualifications could enter the institution was through politics -- so much so that the health minister has chosen to stay on the campus rather than in a ministerial bungalow. Is it envy of the doctors in the All-India Institute of Medical Sciences -- the cream of the profession in India -- that led Dr Ramadoss to trample on its integrity and autonomy?

However, I am not bothered about the Union health minister's motives as I am about the consequences of his actions. Whether or not the courts reinstate Dr Venugopal, India's premier medical institution has been wounded. That is a very sad way to celebrate the golden jubilee of an organisation that was created by an Act of Parliament in 1956.

As I said, I loathe strikes. But what answer would you give should the doctors, the nurses, and even the karamcharis of the All-India Institute of Medical Sciences ask you for an alternative route, when they have seen that even the prime minister is helpless?

T V R Shenoy

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