Shikha Mukerjee | R.G. Kar: Docs’ distrust sign of a wider malaise?

The spontaneous and sustained public protests indicate a distrust of the system of governance under Mamata Banerjee’s leadership by doctors within and outside the public healthcare system in the state. The solidarity of senior doctors with the junior doctors who are on protest, which has affected the usual routines of work, is a measure of the discontent seething within the healthcare system in West Bengal.

The R.G. Kar Medical College rape-murder case prompted the Supreme Court to take suo moto cognisance of it. By setting up a National Task Forde to audit on basic housekeeping and facilities in government hospitals, the apex court has indirectly questioned the safety and adequacy of infrastructure and facilities in all public health institutions across the country. In doing so, it turned the R.G. Kar Medical College incident into perhaps the worst example of “the more malevolent manifestations of the structural deficiencies in public health institutions”, from where “gendered violence” is enabled.

This is a serious indictment. It gets worse when the same court asks for information on compliance with the Prevention of Sexual Harassment Act. This stock-taking clearly indicates a foreboding that the malaise is not restricted to one hospital in one state but is likely nationwide.

By asking the Union government to set up a committee with representatives from all the states, the Supreme Court has expressed its apprehensions about how the State in India is treating its healthcare employees. Following the public outrage over the rape of two toddler girls in a school in Badlapur in Maharashtra’s Thane district, questions on how all public institutions work have come under citizens’ scrutiny.

Public concern is probably rooted in a shared aspiration for all “good students”, be it a girl or a boy, of studying to become a doctor, an engineer or a lawyer. If workplaces like government hospitals are not safe, then where shall the good girl student go to fulfil her dreams and that of her family?

Structural deficiencies, gendered violence and abuse of power by the hierarchy in public hospitals is why the best and the brightest, or call them the timid or ambitious, tend to leave the public health system and move into the private sector.

By turning the R.G. Kar Medical College incident into an example of dysfunctional governance, the apex court evidently apprehends that there is a “lack of institutional safety norms at medical establishments”. The court’s diagnoses of the problems of the public health system include “the hierarchy within medical colleges” and how “career advancement and academic degrees of young professionals are capable of being affected by those in the upper echelons”. This appears to acknowledge the probability that allegations of abuse of power by R.G. Kar Medical College and Hospital’s (now dismissed) principal Sandip Ghosh may also be happening elsewhere.

The public protests, the continuing agitation and cease-work by junior doctors backed up by the support of their hard-pressed seniors and the Supreme Court’s cognisance of the problems points to deepening distrust in governance. It indicates that the public does not seem to believe that there will be a fair investigation and accountability by the government machinery, which is the combine of the political leadership and the police and bureaucracy, unless pressure is exerted through collective action.

The message is difficult to misread.

Can the Mamata Banerjee government realistically expect that the public will be eventually distracted and she will be forgiven and the monstrous incident forgotten, or should Didi take responsibility by cleaning up what is widely believed to be abuse and corruption in the state’s public health system? She has avoided a direct interaction with the protesting doctors. That is a mistake. As both health minister and home minister of the state, Mamata Banerjee cannot dodge being accountable.

In politically polarised West Bengal, the junior doctors have kept out political parties and prevented a takeover of their agitation. That is an indictment of the political class as a whole that tends to cover up the wrongdoers instead of uncovering the perpetrators and the reasons behind the crime.

The wildfire spread of protests across the country reflects a perception that all political parties are equally abusive of power once they acquire it. The cumulative experience of ruling parties seems to have distilled itself into a cynical view of how all governments function.

It does not mean that the public has lost faith in individual political leaders, nor does it mean that for most voters there is no difference between all the available options. There is support for the ideological positions of the different parties as there is a belief that the support can be leveraged to acquire better benefits. And, there is also optimism that change will bring albeit temporary relief from a ruling regime that has turned toxic.

The anxiety that women are not safe inside public institutions only confirms what experts and anecdotal evidence have been saying about why women’s participation in the workforce in India has been historically low. Expert opinion points to the persistent paradox “attributed largely to conservative social norms and due to both the demand side (work opportunities) and supply side (availability of women for work) factors”. Despite the surging numbers of educated women, participation in work is now 37 per cent, which includes unpaid domestic labour.

The safety of women in the workplace has always been a consideration and that includes a transport system that is safe. Between Nirbhaya, who was brutally gangraped and killed in 2012 in a bus, and Abhaya, who was also raped and murdered in a government hospital, the conditions for women’s participation in work are dangerous. Mamata Banerjee’s direction that it is preferable for women not to work at night is not only regressive but it reflects the absence of a political will to bring change to enable women to participate safely.

The performance of the State is under the scanner by citizens. It is a wake-up call for all governments and the entire political class in India.