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Price of reform
Publication Date : 06-03-2013
Nepal’s capitalist evolution is throwing up many contradictions. One is the reliance of the privileged class on exclusively private institutions while at the same time weakening public institutons through corruption, nepotism and the abuse of power. Tragically, this anti-poor tendency is most apparent in health and educational services. The privileged class, which uses private educational institutions and private hospitals, has done its best to ruin public schools and hospitals. The latest example of this is the state of affairs at the government-run Tribhuvan University Teaching Hospital (TUTH), where Dr Bhagwan Koirala, a noted physician and administrator, was compelled to resign due to pressure from unscrupulous doctors and staff driven more by greed than public service. Dr Koirala, it seems, was pushed into taking the unfortunate measure because of the reforms he initiated at the hospital.
One of the nefarious medical practices at TUTH that Dr Koirala tried to stop was the referral system where unscrupulous doctors send sick citizens to private hospitals and clinics for expensive treatment and operations when they could have been treated and operated on at TUTH. This angered the doctors used to receiving kickbacks for referrals. Dr Koirala must be applauded for his efforts to eliminate this despicable practice carried out in collusion between the doctors and the private clinics and hospitals at the expense of the public. Keeping this in mind, some good doctors at TUTH have requested that the Dean of the Institute of Medicine, which oversees the TUTH, not to accept Dr Koirala’s resignation. We hope that the Dean’s office manages to persuade Dr Koirala to stay on at TUTH. Should Dr Koirala refuse, we hope that the reforms started there do not stop with his departure.
Postponing reforms at TUTH, as well as other public institutions, is a punishment to the class of Nepalis that rely on the public sector. This is not the first time the TUTH has made headlines in recent times, and for all the wrong reasons. In July 2012, Dr Govinda KC, who then headed the hospital, went on a hunger strike to ensure that appointments to vital posts in the teaching hospital be made on the basis of eligibility and seniority, not political connections. It has become clear today that merely appointing people is not enough, nor is it sufficient to blame politicians for all the problems in the public sector. Dr Koirala’s resignation only highlights the fact that there is tremendous resistance to change within public institutions because of monetary and other interests. For the sake of the health of tens of thousands of lower and middle class Nepalis, it is imperative that the TUTH, one of the biggest and best public hospitals in the country, is kept out of the clutches of the medical mafia and that reforms initiated by Dr Koirala continue.