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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

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