AMBULANCE AND HOSPITAL CHATS REDUX

After a gap of fourteen and a half months, my now 91-year-old father spent three nights in a private hospital in November, whose rates for various services and supplies have been jacked up by many multiples of 10% on a long list.

“Don’t you provide a bottle of water in the patient’s ward?” I asked a nurse the first evening. She said she’d ask for one to be supplied (by the sub-contractor in charge of the pantry).
“It’ll be charged,” she muttered under her breath.
“So I could just get one from across the road?”
“Yes.”
Cheap (in both senses of the term).

Quick however/moreover.

A bit earlier, while having brief conversations with one of the hospital representatives re major problems with Internet access in the ward and twiddling thumbs as she checked her screen which was taking its time, I asked (mindful of the #MeToo movement):
“Out of sheer idle curiosity, Ma’am, do you have an Internal Complaints Committee?”
“Yes, we do,” she said in what sounded to me a confident tone. “We brief staff every month.”
(Disclosure: She’d asked me about my profession.)

But I fidgeted. Having noticed aspects of the hospital’s labour relations that are far from what may be deemed best practice, I wonder how much of staff briefing actually takes place.

For one, most of the staff seem harassed all the time. Short-staffed in almost all departments, be it reception, accounts/billing, nursing or cleaning.

As for the last named, i.e. cleaning, their distinctly different-coloured uniforms and lapel logos mark them out as contracted from another company. Meaning they’re not hospital staff.

Room cleaning and cleaning of patients as well as assisting patients to go to the washroom when able to do so or to take a walk in the – rather too narrow – corridors when so advised by the doctors is the responsibility of the cleaning staff, not the over-stretched nursing department.

So, I got talking with a few of the cleaning staff.

Had to.

As I and/or my brother were expected to tip them for services rendered such as ensuring my father had his … er … ablutions, had his diaper changed, got himself cleaned up through a ‘sponge bath’ and so forth.
They had subtle and not so subtle ways of letting us know that tips were expected.

“Saar, I gave your father a sponge bath…
“Saar, I cleaned the toilet even though it was not my duty but only because – here come a couple of almost untranslatable words from Kannada – ‘neevu vicharskotheeri’ (broadly meaning you pay attention or rather pay attention to the need to tip).

Only one – or so I was told by one of my interlocutors among the cleaning personnel – and I can personally endorse this, based on my experience as of November 2018 – of the actual hospital staff in charge of cleaning can be recognized by way of a different-coloured uniform: Grey.

Now, there is a broadly predictable caste-wise break-up of the hospital personnel: 1. Doctors/specialists, managers, 2. Receptionists/accountants/front-managers 3. Nurses 4. Cleaning and security personnel with salary scales and employment conditions too being on a declining scale. At any rate none of them is unionized and some categories being contract workers ensures they won’t even begin to consider unionizing.

A while after this hospital experience, at a meeting at SCM House to release a small booklet, Right to Love (about the implications of the Supreme Court’s Navtej Singh Johar verdict), Prof Babu Mathew who has a long labour rights background, brilliantly linked the issue to assaults on other disadvantaged sections. To wit the absent/denied (with backing of the full force of the state) right to association of informal sector workers. “Structurally adjusted”, as Prof Mathew quipped balefully. Hoary International Labour Organisation (ILO) conventions a century in the making are being trampled on blithely.

There is a term for workers lacking stable employment conditions, insurance, paid holidays and so forth: ‘Precariat’ described elsewhere.[1]

After the 2017 hospitalisation episode when the final bill was presented, my elder brother took a careful look, argued with one of the surgeons who – so my brother repeatedly tells me – said, “the hospital is looting you and you are keeping quiet”, and got a small discount.

In late November this year, we learned a lesson for questioning the hospital’s billing practices: I’d noticed that in the final bill before my father’s discharge could be effected, the discharge order having been pronounced pre-noon, there was a mention of a medication costing Rs 200+ – a MERE Rs 200 in hindsight – that had not been administered.

Punishment: my 91-year-old father, and elder brother had to wait until nearly 3 pm before we were let go. Incidentally my brother and I also had to watch while my corpulent father devoured a standard meal while we’d both wished the hospital had provided for a wee bit of variation. The hospital having contracted out the catering, perhaps there was little the physicians and surgeons could do by way of suggesting appropriate diets.

On the way to and from the hospital, we’d been provided ‘complimentary’ ambulance pick-up. I noticed that the driver was not the same one I’d met in 2017 and described in the following:

https://walkerjay.wordpress.com/2017/09/16/an-ambulance-chat-gauri-lankesh-and-hindutva-abroad/

The current one sounded tense and preoccupied. In the few minutes it took to get home, I asked him about his work.

“Neighbours just watch, they don’t offer any help (with getting the patients into and out of the ambulances),” he muttered.

[1] https://www.opendemocracy.net/n-jayaram/universal-declaration-of-human-rights-at-70

 

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About walkerjay

The author, N. Jayaram, a journalist now based in Bangalore after more than 23 years in East Asia (mainly Hong Kong and Beijing) and 11 years in New Delhi, was with the Press Trust of India news agency for 15 years and Agence France-Presse for 11 years and is currently engaged in editing and translating for NGOs and academic institutions.
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