Violence to medical staff: murder of doctor prompts demands for action

Shocked and terrified after the horrific rape and murder of a 31-year-old trainee medic in one of the largest government-run hospitals and medical colleges in Kolkata on 9 August, doctors across India have been holding protests demanding justice for the victim and safe workplaces.

In the early hours of 9 August, the victim, who had just completed a 36-hour shift, was taking a rest break in a seminar room at the RG Kar Medical College and Hospital, when a 33-year-old police volunteer, part of a civic volunteer force employed by the government and tasked with assisting police at the hospital, allegedly committed the heinous crime. The victim’s body, with severe injuries, was found later that morning. The police arrested the volunteer, Sanjay Roy, on 10 August, after CCTV footage showed him entering the seminar hall at 4:03am on 9 August.

The victim’s distressed parents revealed to the media that they were initially informed by the assistant superintendent of the hospital that their daughter had committed suicide.

However, when they arrived at the hospital, they learnt that their daughter had been brutally raped and murdered, prompting questions about the adequacy of the response to the crime by the police and the hospital administration. The grieving parents were also made to wait for three hours before the police and hospital staff allowed them to see their daughter’s remains. The father of the murdered doctor said that the police rushed the family into cremating her even though the family wanted to keep her mortal remains for some time.

Nationwide protest
After news of the doctor’s murder emerged, on 12 August, doctor associations began a nationwide
strike and protest, refusing to provide non-emergency medical care.

“She had taken an oath to save lives, not lose her own,” read one of the banners, aptly spelling out the tragedy during a protest on 21 August where thousands of doctors and medical students, some with stethoscopes around their necks, marched through Kolkata city in the eastern state of West Bengal. Women doctors led the march, wearing black t-shirts, and protests of this nature have since become a regular feature in Kolkata and other towns and cities across India.

For almost a month, doctors and medical workers have held protests and strikes – the longest collective protest by the country’s doctors in recent memory. And the protests show no signs of subsiding.

Junior doctors in West Bengal, who have held a number of protests and strikes withdrawing medical services other than emergency care, rejected an appeal on 28 August by the state’s chief minister Mamata Banerjee to return to full duties. A member of the West Bengal Junior Doctors’ Forum said they would not withdraw their protests until their demands were met in full.

On 27 August, thousands of doctors, other healthcare professionals and members of the public marched to the Nabanna, the building in Kolkata that houses the secretariat of the West Bengal government, demanding the resignation of West Bengal’s chief minister, Mamata Banerjee.

A diverse range of voices and people joined the cause, organising candle marches, rallies and sit-ins. Many leading figures in the country’s film industry also joined the protests, participating in marches, rallies and demonstrations. Actor and former Trinamool Congress MP Mimi Chakraborty took to Instagram to voice her support for the campaign to secure justice for the murdered doctor and ensure better protection for the country’s healthcare professionals. She also joined the public protests demanding action by the central and state governments, hospital management, police and judiciary on tackling violence to medical staff.

At a mega protest in Kolkata’s College Square on 1 September, actors and renowned personalities, including Aparna Sen, Swastika Mukherjee, Sudipta Chakraborty, Chaiti Ghosal, Sohini Sarkar and others, marched along Central Avenue, demanding a swift probe into the heinous crime and the arrest of the culprit. The overnight protests saw participants hold sit-ins and shouting slogans.

National task force
While considering a legal petition on 20 August, the Supreme Court urged protesting doctors to return to their duties and assured them they would not be subject to any disciplinary action by their employers or the state or central governments following their strikes and protests. The Supreme Court also ordered the central government to set up a national task force (NTF) to investigate and formulate measures to ensure a safe working environment for healthcare professionals, such as doctors in hospitals.

Issuing the directive to the central government, the country’s top court also revived memories of the tragic case of nurse Aruna Shanbaug to underscore the history of violent attacks on female medical staff and the grave risks they continue to face.

In November 1973, Shanbaug, a 24-year-old nurse at Mumbai’s King Edward Memorial Hospital, was assaulted by Sohanlal Bhartha Walmiki, a janitor at the hospital. The assault left her in a vegetative state due to severe brain damage and paralysed for 42 years until she died in 2015. During the recent Supreme Court hearing, the Chief Justice of India, DY Chandrachud, highlighted the ongoing problems of gender violence and the safety of women in the healthcare sector.

Chief Justice Chandrachud said female health professionals are still at significant risk of violence at work, drawing a parallel to the tragic case of nurse Shanbaug. “Gender violence, as exemplified by the Aruna Shanbaug case, starkly illustrates the systemic lack of safety for women,” said the Chief Justice.

Strike action called off
On 22 August, the Resident Doctors’ Associations of central government hospitals in Delhi, including the All India Institute of Medical Sciences (AIIMS), Dr. Ram Manohar Lohia Hospital, Safdarjung Hospital and Lady Hardinge Medical College, plus the Federation of All India Medical Association, called off their strike action, which had seen hospital doctors withdraw medical services other than emergency treatment. The decision came in response to an appeal and direction from the Supreme Court.

The Resident Doctors’ Association (RDA) of AIIMS said in a statement that it was grateful to the Supreme Court for taking action following the killing of the female doctor at RG Kar Medical College Hospital by ordering the establishment of a central government-led task force to address the overall issue of the safety and security of healthcare workers in hospitals across the country.

As public fury mounted over the rape and murder of the female doctor at RG Kar Medical College Hospital and similarly shocking incidents across the country, including recent incidents where nurses were allegedly raped in Uttarakhand and Maharashtra, the Union Ministry of Health and Family Welfare wrote to all state governments instructing them to follow the Supreme Court orders to establish “certain basic requirements... to assuage doctors over workplace safety”.

Immediate measures to enhance security
The ministry’s letter to all chief secretaries and director generals of police forces in states and Union Territories set out a list of “immediate measures... to enhance security and provide safer working environment for healthcare workers” that hospitals should consider adopting, in order to meet a two-week deadline set by the Supreme Court for the government and health authorities to take action to better healthcare professionals from violence, aggression and sexual assault.

According to The Hindustan Times, under the terms of reference issued by the Health Ministry, the task force will prepare an action plan under two streams. These are to prevent violence against medical professionals and provide safe working conditions; and provide an enforceable national protocol for dignified and safe working conditions for interns, residents, senior residents, doctors, nurses and all medical professionals.

Following the first meeting of the task force in early August, the Ministry of Health launched a national portal inviting interested parties, such as unions representing medical staff, helathcare professionals and the public, to suggest ways of improving the safety of doctors and other healthcare staff. In the first few days following the establishment of the portal, the task force reported it had received around 400 suggestions for improving staff safety in hospitals from various stakeholders and individuals. These ideas will be considered by the task force, which includes Union Home Secretary Govind Mohan and Union Health Secretary Apurva Chandra, reports The Hindu newspaper.

Short-term measures
Following the second meeting of the task force on 28 August, the central government issued instructions to the chief secretaries and director generals of police of all states and Union Territories (UTs) on short-term measures to take to protect healthcare workers from the risk of violence.

According to The Indian Express, these include setting up control rooms in large district hospitals and medical colleges with a duty roster to monitor CCTV cameras, store the data and respond to emergency situations; and installing CCTV cameras to cover blind spots. Union Health Secretary Apurva Chandra also reportedly told the states and UTs that the number of security staff should be increased, there should be routine security patrols and regular security drills in the style of fire drills, and all hospitals should form a security committee that includes doctors as members, says The Indian Express.

The Indian Express also reported that the central government told states and UTs to introduce access control in large hospitals to ensure that only authorised personnel, patients and their relatives can enter the appropriate areas and to conduct regular checks on all hired security and service staff, such as helpers and porters, to ensure the safeguarding of healthcare employees they work alongside.

According to The Indian Express, Health Secretary Apurva Chandra also wrote to hospitals and medical colleges instructing them to establish internal sexual harassment committees, and to take steps to ensure the safe movement of resident doctors and nurses within different blocks and hostel buildings during night hours.

At the second meeting of the task force the states and UTs told Union ministers they had already begun taking action on short-term measures to ensure safety in hospitals, including appointing district magistrates and superintendents of police to conduct security audits of hospitals and arranging police verification of contractual and outsourced employees in government hospitals, reports The Indian Express.

Nurses’ associations demand places on task force
However, The Times of India reported that several nurses’ associations and a leading patient advocate have written to the central government urging them to appoint nurses’ and patients’ representatives to the task force. The nurses’ associations say although the task force has called for ideas and feedback from all healthcare professionals, the task force only features doctors’ representatives and three government ministers. “Nurses bring invaluable insights and experiences that are essential in crafting effective and inclusive safety regulations,” the Association of Nurse Executives (India) wrote in an open letter to the Chief Justice Dhananjaya Y. Chandrachud, reports The Times of India.

Meanwhile, the Indian Medical Association (IMA) has demanded that laws around the protection of doctors and medical staff from violence and punishments for those who assault and attack medical staff are immediately strengthened. Although 25 states have legislation aimed at preventing violence to hospital staff and punishing offenders, the IMA says the central government should introduce a central, nationwide law that strengthens the existing state legislation, rather than leaving decisions on the strength of the healthcare security legislation to individual states.

The IMA adds that in 2020, during the pandemic, the central government introduced an amendment to the Epidemic Diseases Act, 1897 to make violence against healthcare workers during the epidemic a non-bailable offence with a penalty clause and jail term of up to five years. It argues that a new central act of legislation should incorporate and re-introduce these tougher penalties nationwide to act as a stronger deterrent.

The IMA also says the government should consider incorporating into the new central Act legislation introduced in Kerala State in 2013 following the murder of a patient by a doctor in hospital that provides for sentences of up to seven years imprisonment and maximum fines of Rs 5 lakh for those found guilty of causing grievous bodily harm to health service workers. The Kerala legislation also means that anyone committing, or attempting to commit, or inciting or inspiring an act of violence against a healthcare worker or others working in healthcare institutions faces imprisonment for a term of not less than six months and up to five years and a fine between Rs 50,000 and Rs 2 lakh.

Writing to the Health Minister, the IMA said: “The doctors are vulnerable in their workplace. The state has a duty to provide safety and security to the doctors and other healthcare personnel. ‘Right to Life’ is a fundamental right.

“25 state legislations in this regard have not prevented violence across the country. Very few FIRs [first information reports bringing criminal charges against perpetrators] have been lodged and very few convictions have happened. There is an urgent need to bring in a Central Act on Violence on Doctors and Hospitals. This is felt acutely by the medical fraternity of India.”

Online reporting platform launched
Meanwhile, in a separate move aimed at ensuring the safety of women in all types of workplace, in August Union Minister of Women and Child Development Annapurna Devi launched a central online platform for registering and monitoring complaints about sexual harassment at work. 

The new SHe-Box portal acts as a centralised repository of information related to sexual harassment complaints being handled by Internal Committees (ICs) and Local Committees (LCs) across the country, covering both the government and private sectors. Under the Sexual Harassment of Women at Workplace (Prevention, Prohibition, and Redressal) Act, 2013 (PoSH), if an organisation employees 10 or more people it must establish an internal complaints committee to investigate complaints of sexual harassment from female workers, and every district in India must establish a local complaints committee to handle complaints from female workers in businesses with less than 10 employees where an IC has not been set up.

The Ministry of Women and Child Development says SHe-Box “offers a common platform to file complaints, track their status and ensure time-bound processing of complaints by ICs”.

It adds: “The portal, through a designated nodal officer, will enable real-time monitoring of complaints.”

Following criticism of the local police’s slow progress in investigating the murder of the doctor at RG Kar Medical College and Hospital in Kolkata, the Calcutta High Court ordered the Central Bureau of Investigation (CBI) to take over the investigation. The CBI has carried out polygraph tests on the chief suspect for the crime, Sanjoy Roy, Sandip Ghosh, principal of the RG Kar Medical College and Hospital when the rape and murder occurred, and five others.

As part of its overall investigation into the doctor’s death, the CBI has been questioning Sandip Ghosh, who in 2023 was subject to separate claims about alleged past malpractices at the hospital, including allegedly handing out government assets, wasting government money and illegally selling used biomedical wastes.

During Ghosh’s tenure as principal of the hospital, the hospital’s former Deputy Superintendent Akhtar Ali alleged there had been financial and other irregularities at the hospital and called on central agencies to investigate. Ali had also filed a complaint with the state police in July 2023.

Ghosh was arrested by the CBI’s anti-corruption branch on 2 September over allegations of ‘financial misconduct’ at the RG Kar Hospital, officials said.

Following complaints from the family of the murdered doctor, the Indian Medical Association subsequently suspended Ghosh. The IMA chief said the panel had taken into account the family’s allegation that Ghosh had erroneously informed them their daughter had committed suicide.

“Indian Medical Association (IMA) headquarters has suspended the membership of Dr Sandip Ghosh, former principal of RG Kar Medical College and Hospital and the vice president of the Calcutta IMA branch,” said IMA president Dr RV Ashokan. “A disciplinary committee was formed in the IMA headquarters which took into cognisance the grievances as expressed by the parents of the victim, where they were not able to meet the head of the institution [Ghosh] and were also appalled by the information given to them that their daughter had committed suicide.”

The Supreme Court also criticised Ghosh for incorrectly stating that the doctor’s death was suicide, rather than rape and murder.

Political turn
The case has also taken a political turn, after the opposition parties, in particular the BJP (Bharatiya Janata Party) and the CPI(M) (Communist Party of India, Marxist), were at the forefront of the public protests demanding central government action on the safety of hospital staff. The opposition has also accused the West Bengal government of interfering in the official investigation into the crime, alleging attempts have been made to shield certain individuals from scrutiny.

Questions have been asked about Ghosh’s alleged close relationship and dealings with West Bengal’s chief minister Mamata Banerjee. Ghosh treated the minister for a leg injury during the state assembly polls in 2021.

The BJP has demanded Mamata Banerjee’s resignation, claiming she has failed to ensure the safety and security of women, making West Bengal the most unsafe state in the country for females.
However, the Trinamool Congress Party, which Banerjee chairs and is currently in power in West Bengal, rejected the BJP’s charges, accusing the BJP of exploiting public discontent over the rape and murder and attempting to destabilise the democratically-elected Banerjee-led Trinamool Congress government in West Bengal.

However, when the West Bengal Legislative Assembly unanimously passed the Aparajita Women and Child (West Bengal Criminal Laws Amendment) Bill, 2024 with a voice vote on 3 September, both legislators of the Trinamool Congress and the BJP supported it. The Bill introduces the death penalty in West Bengal for
the offence of rape when it results in the victim’s death or leaves them “in a vegetative state”.
However, although bill was passed unanimously by the West Bengal Legislative Assembly, it requires Presidential approval to become law, and it remains unclear if will be enacted.

The portal seeking suggestions for ensuring the safety of medical staff is at:
serviceonline.gov.in
SHEBox portal is at:
shebox.wcd.gov.in