KOCHI: Recently, an incident was reported from Government Medical College Hospital, Kozhikode, where a psychiatric patient was denied admission when he declared that he did not have a bystander. Though the hospital denied the allegation, it is a fact that several patients, especially the destitute and those psychiatric problems, are turned away by some government and private hospitals just because they have no one to assist them.
The practice is in contravention to the Kerala High Court verdict pronounced in September 2021 stipulating that hospitals, healthcare institutions, and medical research and study institutions must be made responsible for the care of the needy people like the elderly, bedridden and distressed hen the licence is issued to an institution or renewed.
“Taking care must also include preventive medicines and palliative care. Monitoring must be done to ensure that such actions are done by institutions. Each institution, according to its category, must be given a certain area. They must carry out the above-mentioned activities with the help of neighbours, neighbourhood groups, palliative organisations and local self-government (LSG) institutions. Coordination and funding for the activities should be done by the LSG authorities,” it read.
Not many hospital authorities or doctors know of these directives, though. Earlier, some agencies took care of the destitute, but post-Covid, such services have become limited and some hospitals do not let outsiders, considering the security guidelines. Home nursing service providers also confirm that post-Covid, people prefer to be served at homes than at hospitals.
On the recent incident, Kozhikode MCH denied turning away the patient but only suggested that having a bystander would be better, for the care of the patient. Doctors from other government hospitals also confirmed that they do not have the right to turn away patients only on the basis of them not having a bystander, but considering their safety, patients, especially the ones with psychiatric issues, are advised to bring bystanders.
‘Patient’s safety main concern’
Dr V R Rajendran, principal of Kozhikode MCH, said, “Admission is 100 per cent possible, but sometimes, when patients who are in life-threatening situation in a psychiatric ward, we suggest to have bystanders, who can be with them throughout to notice any change in their behaviour like suicidal tendency. Nurses, nursing assistants and others available on duty are responsible for their care. There are selected wards for the destitute in some hospitals.
“There are also people who dump their elderly parents at the hospitals. Some years ago, when some men left their elderly father at the hospital, we requested them to take him back. They were not ready and we filed a complaint with the police who arrested them. They took their father home, but we came to know that he was soon admitted to an old age home in Vellimadukunnu,” Dr Rajendran said.
In short
Some prefer to be at hospital than at home
Dr Rajendran also narrated the story of a cardiology patient who preferred to remain at the hospital rather than go back home. There was a man from Ernakulam, who used to come here for treatment, get admitted in the cardiology ward and would not leave even after being discharged. He said he was happier here, but we had to resort to the help of the police to send him home. He returned after three months as he was not comfortable staying with his children. Such people are seen here, sleeping in the corridors. At any point, they should not be denied treatment or admission,” he said.Dr Nizaarudeen A, superintendent of Government MCH, Thiruvananthapuram, said General Hospital in the capital has a special ward to treat the destitute. At the MCH, though there is no special ward, they are attending to 33 patients who are admitted without bystanders at present.
“We do not have enough staff strength, but that is not an excuse to deny service to the patients. If they are conscious, it is easier to manage, but that is not the case with patients who have undergone surgery and have not gained consciousness. They will be provided with one separate bystander from the hospital itself. Though there are agencies that provide food for free, taking volunteer bystanders from outside is not allowed,” the superintendent said. According to Dr Mary Anitha, clinical psychologist and district manager for Disaster Management Inter-agency Group of 44 organisations in Ernakulam, said many hospitals have their own guidelines regarding letting in bystanders. Some of them allow only close relatives.