DR Subarna Goswami, additional general secretary of the All India Federation of Government Doctors' Associations (AIFGDA), stated that the death of a young trainee doctor is closely tied to corruption in the state’s health system. The tragic incident at R G Kar Medical College and Hospital in West Bengal was reported on August 9, 2024. This has led to a wave of protests in the state and across the country, waking up the ruling Trinamool Congress (TMC) government. People in West Bengal are standing strong against chief minister Mamata Banerjee and the ruling party’s threats, showing they will not back down.

The terrible incident at R G Kar Medical College and Hospital has highlighted how the public healthcare system in West Bengal has been severely damaged by the ruling Trinamool Congress (TMC) government. Doctors and experts involved in the health movement have previously warned that government policies are causing declines in important public health indicators, such as infant mortality rates. The government has shifted its focus from primary healthcare to building super specialty hospitals, without properly implementing health services or hiring enough doctors.

This neglect has led to a resurgence of public health issues in the state. Many patients are now traveling to southern India for medical treatment, not just for major surgeries but also for chronic diseases. Experts have noted that policies from both the central and state governments have allowed corporations to take over the health sector in ways we have never seen before. Programmes like Ayushman Bharat and the West Bengal Clinical Establishment Act are making it harder for poor people to access medical care. The recent events have exposed just how broken the healthcare system in West Bengal really is.

The former principal of the institute, Dr Sandip Ghosh, is under investigation by the Central Bureau of Investigation (CBI) for his involvement in corruption related to the hospital. The previous deputy superintendent, Akhtar Ali, acted as a whistleblower, filing a police report with evidence in 2022. He also made formal complaints to the State Vigilance Commission and the State Health Department about issues like illegal officer transfers for money, misuse of government funds, and the sale of hazardous biomedical waste. Instead of receiving support, he was transferred to a remote district.

Dr Subarna Goswami described a troubling situation, suggesting the presence of a "medical mafia" supported by government bodies. She stated that Dr Ghosh operated a syndicate involved in illegal activities, such as dealing with biomedical waste from the hospital and selling cadavers to foreign countries. They were also running a drug racket that included counterfeit medicines and substandard medical equipment, from orthopedic implants to lifesaving drugs.

The corruption had been worsening for some time, but since the pandemic began in 2021, it became more systematic, with R G Kar Medical College and Hospital being used as a testing ground for new corrupt practices. This syndicate has spread its influence across all levels of medical care, from top-tier facilities to smaller units.

In a 2013 essay published by The Lancet titled "Tackling Corruption in Indian Medicine," it was noted that increasing corporatisation and a lack of proper regulation have led to corruption in the healthcare sector in India. However, the involvement of state representatives in establishing these corrupt practices through state organisations is particularly concerning.

Dr Goswami highlighted that several bodies, including the State Medical Council, the West Bengal Health Recruitment Board, and the West Bengal Medical Services Corporation Ltd., are part of this system. Allegations have been made against the West Bengal Medical Council, which includes office-bearers like Dr Sudipto Roy, Nirmal Maji, and Santanu Sen – all of whom were elected to the parliament or state assembly on TMC tickets. For example, Dr Sudipto Roy serves as both an MLA and the vice-president of the Medical Council, while also being part of the Health Recruitment Board.

Dr Goswami emphasized that a small group of powerful individuals has undermined democratic processes to maintain control. This syndicate, known as the "North Bengal Lobby," has used violence and intimidation to silence dissenting voices in the healthcare sector. They have effectively taken over the West Bengal Medical Council, turning it into a farce by printing counterfeit ballots and rigging elections. While Sandip Ghosh was not a member of the West Bengal Medical Council, he and some council members have misused this regulatory body to threaten and extort doctors.

The West Bengal Junior Doctors' Front has several grievances and demands in their ongoing protests, with their main demand being justice for the victim. Currently, the public health sector relies heavily on their services. The state’s Health Recruitment Board has not hired enough doctors, particularly residential medical officers, for hospitals and medical colleges.

One junior doctor at SSKM Hospital in Kolkata, who wished to remain anonymous, mentioned that there are about 8,000 junior doctors in West Bengal working in various medical institutions. However, the process for recruiting doctors after their internships is highly uncertain. They are expected to work long hours but receive inadequate pay.

In 2017, the current government introduced a 'Bond' system, which requires doctors to work for three years in government institutions after completing their Master of Science or Doctor of Medicine degrees. But, there is no guarantee of permanent positions in state hospitals after this period, and overall, permanent recruitment is extremely low.

CRIMINALISATION OF COLLEGE CAMPUSES

The current situation of job casualisation in healthcare is accompanied by increasing violence from the student wing of the ruling party on medical college campuses. Pulastya Acharrya, a junior doctor at Nilratan Sircar Medical College, explained that the Trinamool Congress Chatro Porishad (TMCP) didn’t have a presence in these colleges until recently. In 2019, after a junior doctor was assaulted during a protest, the TMCP took the opportunity to establish units in various medical colleges, especially in district towns. Since then, a culture of intimidation has developed, with students facing bullying from TMCP leaders.

One of the most troubling aspects is the attempt to normalise cheating during exams, including practices like supplying unauthorised copies of materials, leaking question papers, and charging money for passing grades. Students who speak out against these issues often face threats and coercion. This "threat culture" is especially common in medical colleges located in district towns, such as Medinipur, Purulia, and Arambagh. R G Kar Medical College and Sagar Datta Medical College are particularly notorious for the oppressive tactics of the ruling party.

According to Acharrya, various ethics committees in these colleges are supposed to handle complaints related to medical and legal issues. However, these committees are often led by individuals linked to the syndicate and the ruling party, resulting in little to no actual investigation. Instead, they often serve to victimising doctors and students who oppose them politically.