2 APRIL 2016
Accidents and criminal liability
It is not god or divine chance but human error and negligence that cause accidents. The collapse of a portion of a flyover under construction in Kolkata that crushed to death 24 people and injured scores of others points to gross mismanagement and neglect by the construction company IVRCL, as well as poor oversight by the Kolkata Municipal Corporation, run by the ruling Trinamool Congress. The project, which began in 2008 as part of the Jawaharlal Nehru National Urban Renewal Mission, was delayed following objections from local residents, difficulties in land acquisition, want of mandatory clearances and cost escalation. It acquired a fresh life only recently with West Bengal Chief Minister Mamata Banerjee asking for the work to be completed before the Assembly election in April-May. The contractor was allowed to continue as further delays in implementation would have been politically inconvenient for the administration. More than three-fourths of the work had been completed at the time of the accident, when construction was on at a frenetic pace. Nothing can explain the collapse of a 100-metre section of the 2.2-km flyover other than the failure to adhere to safety norms and the deviations from standard operating procedures by the builder. Attempts by representatives of the builder to first suggest it was an “act of god”, hinting perhaps that it was the result of an unexplainable disaster, and later to claim that it could have been the consequence of an explosion, have so far not been substantiated by accounts of eyewitnesses or evidence on the ground. Indeed, such explanations are but feeble efforts to evade responsibility for a disaster brought about by criminal negligence and wanton disregard of safety norms.
The scale of the tragedy, which saw pedestrians and passengers in vehicles passing through the busy junction on Vivekananda Road trapped under concrete slabs and metal structures, should prompt the State government to rethink the way such projects are executed and awarded. The tragedy is all the more heart-rending because the accident was entirely preventable. Instead of indulging in a blame game, and trying to shift responsibility for the loss of lives on to the previous Left Front government, Chief Minister Banerjee must take corrective measures and ensure an impartial investigation into the cause of the accident. To say that the builder had been blacklisted does not absolve the government of its regulatory and monitoring responsibilities. If there is sufficient evidence of prima facie guilt, those in the administration who did not discharge their regulatory role must be made to stand trial for their acts of omission and commission, and not just the private builder for the seemingly gross negligence. The Kolkata flyover collapse is another reminder that accidents are not unfortunate incidents beyond human control, but man-made tragedies that are wholly avoidable. When they do occur, accountability must be clearly fixed.
Medical Council needs urgent therapy
It is a strange incongruity that in a democratic country with over 1.2 billion people, the systems of health-care delivery and medical education are poorly regulated, expensive, opaque and, by the government’s own admission, considerably corrupt. In December, the Centre acknowledged the need to modernise the Medical Council of India (MCI), the apex body that was temporarily superseded six years ago in the wake of a corruption scandal. The functioning of the MCI has been controversial on several counts, culminating in the arrest of its president in 2010 on a graft charge. Reviewing its record, the Standing Committee on Health and Family Welfare expressed shock in a recent report tabled in Parliament that a body like the MCI, which sets ethical norms for medical professionals, could itself be headed by someone who was arrested for corruption. The report is a severe indictment of the Council and the Centre, for failing to stop the sale of medical seats in private colleges for capitation fees going up to Rs.50 lakh, and allowing a single, all-powerful agency heavily influenced by corporate hospitals to provide accreditation to institutions and assess their quality, ignoring blatant conflicts of interest. Clearly, a thorough clean-up in the manner medical education and health-care institutions are regulated is overdue; no compromise should be made on transparency, public interest and the highest ethical standards in doing this.
Comprehensive reform of the MCI should begin with the separation of functions: approving standards and accreditation requirements for medical education, fixing norms to assess the competence of medical graduates and laying down ethical practice guidelines. Here, it is worth considering the suggestions made by the government-constituted committee of experts led by Ranjit Roy Chaudhary, notably the creation of a National Medical Commission to oversee education and policy, and separate boards for undergraduate and postgraduate training, assessment of institutions and medical ethics. It is certainly untenable for the Centre to retain the present structure of the MCI, which seems designed to benefit vested interests. Inducting non-medical professionals of integrity and community health experts to regulatory bodies would help advance public interest. The NDA government would also do well to follow up the demand of the parliamentary committee for a time-bound probe into the curious phenomenon of a large number of inspectors from Gujarat and Bihar being sent for visits during 2014, in the absence of clear guidelines on selecting evaluators. The larger goal of a revamp should be to produce medical professionals, especially postgraduates, in such numbers that would improve the doctor to population ratio and ensure their availability across the country. The possibility of having an exit test for medical graduates at the end of their course and before they start practising, as a measure of standardisation across States, is worth debating. The commercialisation of health education needs to be given a quick burial.