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Radiologists up in arms against rule that curbs their diagnostic practice

New Delhi: The amended Rule 3 of Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act has increased the ultrasound charges and created an artificial scarcity of radiologists in Punjab and some other states, with radiologists up in arms to quash the rule that has imposed restrictions on their diagnostic practice.

In a bid to curb sex determination test and female foeticide, the Central government on June 4, 2012 amended Rule 3 of the PCPNDT Act under which it restricted the practice of radiologists and sonologists to only two centres in a district.

Indian Radiological and Imaging Association (IRIA) approached Delhi High Court which stayed the amended Rule’s implementation in an order dated 23 July 2012, while at the same time questioning the rationale behind the move. The high court also advised the Central government to convey the stay to other state governments and urge them to remove any restriction that was imposed following the amendment.

Similarly, Mumbai High Court also gave an ad-interim stay and directed that radiologists must specify their consultation hours and said it would not prevent them from undertaking ultrasonography test at other centres.

But many states still continue to follow the amended Rule 3 of the PCPNDT Act because of which a dichotomy in its uniform implementation throughout the country has been created. While radiologists in Delhi continue to practice freely at more than two places, radiologists in Punjab are suffering from what they consider a “draconian” rule.

Though the matter is due for hearing in the Supreme Court after it merged 20 cases of this nature filed by different states, the radiologists are seeking an early clarification or modification in the rule by the Central government.

The matter was recently raised by the representatives of IRIA during a meeting with Union Health Minister Dr Harsh Vardhan on October 22.

Dr O P Bansal, secretary general and president elect of IRIA, who attended the meeting, told India Medical Times, “During my meeting with the health minister, I raised the problems that the amended PCPNDT Rules have created. Firstly, many states are not following the stay that was directed by Delhi High Court, while a central law stayed by any high court should have an all India application. The Central government should issue a clarification.

“Secondly, why a radiologist should not practice at more than two places when there is no such bar on any other specialty? With the restrictions, radiologists have stopped visiting charitable institutions and government hospitals and visit only those institutions where they get good payment. There is a shortage of radiologists.

“Thirdly, to address the shortage of radiologists, the government is encouraging MBBS doctors to take up a six-month course in ultrasound. Why doesn’t it optimally utilize the available radiologists by implementing practical guidelines that can be followed?

“Fourthly, the government is depriving doctors, who have just started their career in radiology, of the opportunity to learn and earn. Those who are already established and have enough sources to earn are not affected much by the rules but is it fair to restrict the new comers from discovering avenues to learn and earn more? Poor students have suffered.

“The prices of ultrasound have sky rocketed in some states since the amendment was brought into force. Violators of the spirit of PCPNDT Act should be punished but such rules are only harassing us and is not going to prevent female foeticide,” added Dr Bansal.

Dr Amrita Rana, secretary, IRIA Punjab, told India Medical Times, “This is an infringement of fundamental rights. It has a great impact especially on those who are freelancing for several smaller hospitals and on those nursing homes that cannot afford to have a radiologist on rolls. Already there are very few radiologists. How can you stop them from working? This impractical rule will not solve things but on the contrary has made the healthcare more expensive for the common man.”

Dr Rajinder Sharma, vice president, Indian Medical Association (IMA), Punjab told India Medical Times, “A clarification is needed on the interpretation of the rule. Whether a radiologist cannot practice at more than two places in one district or the whole state?”

Dr Sandeep Gupta, consultant radiologist, Ludhiana told India Medical Times, “Punjab still follows the amended rule. Prima facie this amendment appears absolutely unconstitutional as under the constitution the citizens of India are guaranteed the right to practice their respective trade and profession. There is no bar on any other specialty, why are we targeted specifically? This notification impinges on our right to livelihood. It has also created a shortage of radiologists that has increased the hardship of patients by huge waiting lists. I urge the health minister to look into our problems. The matter should not be dragged any further.”

Dr Rajiv Garg, radiologist, Unique Scan, Ludhiana told India Medical Times, “The rationale that restricting a sonologist to two centres will lead to reduction in sex determination test and female foeticide is totally baseless. Government should conduct some studies and assess has it really helped in doing so?”

According to the experts, only a closer scrutiny of centres where facilities for ultrasound and abortion are available will help in lowering down cases of female foeticide. Such rules that curb the freedom and spirit of the profession create an environment of opposition and displeasure towards the lawmakers. Also, it is not only the duty of the doctor to work ethically to prevent female foeticide, but also of the couples who ask for sex determination test. Mass awareness campaigns against sex-selective abortion are required in lieu of cutting the wings of doctors to practice freely.

by Vidhi Rathee

6 Comments

  1. Shantanu Sarkar Shantanu Sarkar Monday, July 15, 2019

    can anybody say which article in PCPNDT is amended where it curbs a radiologist to work in not more than 2 centers.

  2. Kusuma Kumari G Kusuma Kumari G Tuesday, March 1, 2016

    MTP is done by Gynaecologists and not radiologists. Make strict MTP laws then female feticide will disappear. i feel there is a no point in punishing radiologists who does only a diagnostic job

  3. Dr Poornima Ramesh Dr Poornima Ramesh Sunday, November 30, 2014

    I agree with this fact that the corruption has increased at DHO in the name of PNDT ,even to renew the license we have to pay almost 50% of official cost , despite all records being correct., it unnecessarily increase the clerical work , storage and retrieval.
    If one shuts up his conscience no law can make any difference.
    In smaller places it is difficult to offer scans
    It may add to the maternal mortality.- when you look at the comprehensive abortion care (govt of India)- on of the prerequisite is that there should not be an ectopic pregnancy when you offer medical abortion. if the sonografer/sonologist at least confirm intrauterine pregnancy before medical abortion , it will be safer.In a very basic set up it is impossible to detect fetal sex that early in gestation of 7-8weeks .
    stricter abortion laws , documentation of indication in pregnancy termination beyond 1st trimester would better way to control female foeticide.

  4. Dr. Rajesh Gothi Dr. Rajesh Gothi Saturday, November 29, 2014

    The PNDT act has succeeded in breeding corruption and increasing clerical work.nothing else.
    It has certainly not impacted femae feticide. For this society must change and MTP act must have a relook.

  5. Dr.L.L. Sehgal Dr.L.L. Sehgal Saturday, November 29, 2014

    PNDT laws are harsher than POTA..
    No doctors association/ body has ever raised this issue because very few docs are doing ultrasound.
    No rule can stop feticide unless society,social causes are addressed.
    These rules have put so many restriction on doctors and they are the cause of corruption.
    Cheapest non invasive modality of ultrasound is beyond the reach of common man due to PNDT law.
    Radiologist lobby is trying to stop MBBS SONOLOGISTS from doing ultrasound.
    This will lead to increased maternal mortality and infant mortality. Common man will suffer if this happens.all MBBS doctors should learn this simple tech. Of ultrasound.
    It is modern day stethoscope
    Dr.Sehgal

  6. Dr Bala Shetty Dr Bala Shetty Monday, November 3, 2014

    All acts, regulations, laws and rules of PNDT have not reduced Female Foeticide, but increased the corruption in District health offices !!!
    Radiologists who want to disclose the sex during or after the Ultrasound are doing it in many means in-spite of stringent rules and regulations.
    The restrictions should be on un necessary and rampant abortions. All abortions should be done after the permission from authorities, registered and documented.
    At least the present government is working on less rules more actions. The action should be on the root cause of female foeticide, that is the burden of female child on family. If not abortion, the parents would get rid of the female child, by various means, as long as they are burdened.
    All money, time and energy spent on PNDT/ Abortion rules regulations etc. should be spent on female welfare activities and get rid of the root cause by which parents are comfortable with the female child.

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