Has the PCPNDT Act become a source of harassment for doctors?
A lot has been said about the PCPNDT Act. The Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994, was introduced to curb the prevalent practice of prenatal child sex determination, which has plagued India for as long as one can recall. The act has been amended from time to time, keeping in mind the emerging technologies, which help in determining the sex of the child. But the question arises, has the PCPNDT Act become a tool in the hands of unscrupulous authorities to harass radiologists and gynaecologists to extort money from them?
Dr P K Shah, president, The Federation of Obstetric and Gynaecological Societies of India (FOGSI), told PG Times that the act was good as the male-female ratio was going down at a fast rate, but it was never implemented in the right way. He said, “It’s sad when doctors are held culprits for things like not keeping a PC&PNDT Act booklet, not putting up a board of the correct size that declares they do not encourage sex determination, not wearing an apron while doing an ultrasound and also for not putting a nameplate on the apron. The officials come and simply seal the machine, which can’t be released unless the judge gives a decision. Doctors are jailed for three months if the Form F is not correctly filled. The officials don’t understand a simple thing that this can be a clerical mistake and in no way proves that the doctor is into pre-natal child sex determination or is a criminal for god’s sake!”
Many in the healthcare profession feel that the act has hardly helped to improve the low sex ratio in India; rather the sex ratio in 2011 was the lowest since independence. Even after so many efforts to keep the practice in check, abortions are still done every day and reports suggest people are still getting pre-natal child sex determination done. But, why is it that Form F has become a matter of utmost concern and gynaecologists and radiologists fail to fill it accurately?
According to Dr Shah, 19 points have to be filled in the Form F, while performing ultrasound, out of which the last 9 points are related to interventional ultrasound. “In 99 per cent cases the ultrasound is just done for diagnostic purposes and it is unnecessary to fill the last 9 points for this. The saddest part being that despite numerous requests to simplify the Form F so that the harassment stops, the form has been further complicated,” he said.
Dr Mangla Dogra, a gynaecologist from Chandigarh, told PG Times, “In the name of checking Form F and cracking down on clinics that are involved in illegal sex determination the medical officers scrape us brutally. At times, the officers raise an issue even if we sign out of a set space for Doctor’s signature on Form F, forget about leaving a blank space in the form. This is totally uncalled for and as far as I can see no amendment in law can erase the harassment that we face every now and then. The harassment has definitely led to medical corruption.”
Doctors, who believe in practicing ethically and legally, have time and again said that more than helping the cause of improving male-female sex ratio, the PCPNDT Act has become a constant source of harassment. From asking doctors to stop their practice to sealing their clinics and to paying a heavy fine to going behind bars, even those who follow a healthy practice have been dragged in the scene without any fault of theirs.
In conversation with PG Times, Dr Jignesh G Thakker, secretary general, Indian Radiological and Imaging Association (IRIA), said, “NGOs alleged that it was a hand in glove situation when doctors were performing the duty of medical officers. Because of this accusation the responsibility shifted to collectors, which in plain words has gone to dogs. They are so stubborn and refuse to listen. They somehow feel as if they are the undisputed king of their territory. What is happening is that these collectors have other work to do as well and there is also a dearth of people who can perform such checks. So, now, the government has started deputing people who are Tehsildars and lower than a Tehsildar in rank. What can you expect from them? Obviously, a revenue officer will just ask for money, what else. There is no proper department and shortage of staff has added to the situation.”
It is claimed that there are many doctors who are giving a monthly protection amount to make sure their name doesn’t get tainted with any kind of false allegation, even though they are not indulging in any unethical practice. This has obviously led to a new kind of medical corruption.
Dr Thakker said, “There are always two sides of a coin and corruption in this case also has two faces. One, the officers come and threaten doctors and two, just to make sure that no trouble crops up, the doctors bow down to the demands of these officers. But little do these doctors realize that they are showing these crooks a way to make easy money. Just because they have the power to seal clinics does not mean that we embrace all their demands.” Adding to this Dr Shah said, “PC&PNDT Act is not clear and because of this ambiguity same lines are interpreted in a different way by different people and that has resulted in harassment and corruption.”
Showing her anger towards such incidents, Dr Mangla affirmed, “There are black sheep in every profession and such goons simply need an excuse to extract money, and somehow they succeed to despite the so-called strict laws. If doctors don’t bow down to their demands, these officers leave no stone unturned to damage a doctor’s reputation. Rather than valuing someone’s time, all they want to do is harass professionals. They will simply enter a clinic and plant themselves there for at times 2-3 hours at a stretch, without even thinking once that patients are waiting outside.”
Why is it that the government or law never acts against these corrupt officers? “You will be surprised to learn that if an officer is wrong all he has to say is that ‘the act is done in good faith’ and this one sentence is powerful enough to escape all bad he has done. Trust me, the authorities (inspection officers) have tasted blood in the form of money and they will not give up easily,” said Dr Thakker.
If this is such a serious matter where a doctor’s practice is at stake, what measures should be taken to ensure that the PCPNDT Act is not misused at the whims of any officer?
According to Dr Shah, it is very difficult to catch such officers as they have a lot of power. “This heinous and shameless practice, which is also harassing reputed doctors, can only be stopped if some of them are caught on tape red handed with a sting operation,” he said.
Dr Thakker added, “The whole process of inspection should be recorded for complete transparency. The inspection officers should give an inspection slip and whatever they collect for their records, a copy should be given to the doctors as well. And if a doctor is found guilty, then he or she should be given a graded punishment.”
Many radiologists and gynaecologists believe that this kind of harassment will only end by taking long term-measures for improving the male-female sex ratio. What is really needed is to educate and empower women. Rallies should be taken out by doctors against sex determination and people should be educated that just like a boy even a girl child is a blessing and has the right to live. Merely sealing ultrasound clinics and harassing doctors for their perceived crimes won’t help in this much.
