There is no question that the practice of giving or taking cuts among doctors is hurting the healthcare system, but both the statutory medical council and the civic body are in a quandary over the punishment of those caught indulging in this unethical activity.
The Maharashtra Medical Council (MMC) had written to the Brihanmumbai Municipal Corporation (BMC) a couple of months ago, asking it to take action against Kokilaben Dhirubhai Ambani Hospital (KDAH) which was found to be practicing the cut system.
But the BMC replied that it was helpless in this matter as there was no municipal rule that provided for action against the hospital.
A senior official said the civic health department issued licences to hospitals, but there was no rule according to which it could punish the institutions for such unethical practices like giving cuts to doctors for referring patients to hospitals.
Sanjay Deshmukh, additional municipal commissioner in charge of the health department, said, "The hospital has apologized to the MMC. We don't have any rule under which we can take action against them. We have asked the MMC what it expects from us."
The civic body also wants the Medical Council of India (MCI) to decide what action should be taken against hospitals that resort to unethical actions like cut practice. MCI is responsible for maintaining high standards of medical education and ensuring proper standards in the practice of medicine.
In May, the MMC had sent a show-cause notice to Kokilaben hospital for giving cuts to doctors. The hospital apologized, but passed the blame to its marketing department. The MMC, which is a quasi judicial body, then wrote to the BMC asking it to take action.
According to the MMC, the hospital had been sending registration forms for an "Elite Forum" to doctors.
"We received the form from two doctors... it clearly showed rewards according to the number of admissions. This indicated that doctors were offered a cut for referring patients for admission to the hospital," Dr Kishor Taori, president of MMC, told dna.
The two-page "Elite Forum" form promises doctors a "reward" of Rs1 lakh for 40 admissions per annum, Rs1.5 lakh for 50 admissions and Rs2.5 lakh for 75 admissions.
Doctors who register with the forum are required to sign a statement that reads: "I am very happy to know that KDAH has introduced an ELITE FORUM for membership by invitation to senior doctors, for partnering KDAH, and jointly help bring about unique patient experience in line with the best of global hospitals."
"The matter has been referred to the BMC in the public interest, to uphold the highest ethical norms in medical practice that is expected by the public, as only MMC can take action against doctors. If BMC is clueless, we will assist them," Taori said.
Dr Himmatrao S Bawaskar, renowned physician, who had filed a complaint with the MMC against a private diagnostic laboratory which offered him a cut, said: "Cut practice is a very big problem that is very dangerous. All stake holders should come together to fight it. More than the law, it is also about the moral behaviour of the person."