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How will the Rs 500 and Rs 1,000 note ban impact doctors, healthcare and medical education in India?

Even the most casual visitor of this column (The Antagoniser) would have noticed that we don’t shy away from stating things as we see them. We criticise governments often, and regularly, for their lack of action and bureaucrats for their lack of planning and efficiency. We admonish the average doctor to not give into the apathy as that will change nothing and we hold the so-called leadership of the medical profession accountable for the current state of the healthcare in India.

Dr Kamal Mahawar
Dr Kamal Mahawar

However criticism for the sake of criticism will not lift us out of the mess we are in and if somebody is trying to make a positive change, it is incumbent upon us all to support him. It is with this ethos that I say the current move by the government of India to demonetise Rs 500 and Rs 1,000 denomination notes will prove to be a cornerstone for the future of India.

I have been vocal against the cut practice within the medical profession as one of the biggest sources of medical corruption that leads to a significant escalation of healthcare costs and puts off honest hard-working doctors while the corrupt and the dishonest enjoy success, wealth, and fame. These commissions are not given in the form of a bank cheque; they are shared in cash. Unaccounted for money is a big source of corruption and criminality in every walk of life, whether it is admission into private medical colleges or unfair nexus between the industry and the profession. Demonetisation will at least for once bring everything out in the open. It will suck the system dry of hidden cash and put an abrupt brake to all nefarious practices. Those with honest money in banks, no matter in howsoever small quantities, will feel rich while the corrupt rich with crores of rupees in cash stacked under the mattresses will feel very middle class. The prices of everything should hence in the short term come down.

At the same time, there is no doubt that the things will tend to revert to the old ways. Doctors will still be taking consultation fees in cash, which some will accumulate away from the exchequer and then share with colleagues. Hospitals and nursing homes will keep collecting cash and then be able to decide how much of it, they disclose to the taxman and how much they keep in the lockers to share with those who refer patients. It is, therefore, only a matter of time before the black economy raises its ugly head again and this will not stop until we ban large cash transactions in the country or at least force people to disclose some of the basic details (like name, address, phone number, Aadhaar card number) of the buyers for every cash transaction. For example, it will become very difficult for the jewellers to help dispose off large sums of black money if they also had to obtain a number of identifiable details for every customer. Such a move will, of course, have to be backed up by adequate monitoring and punitive action against the offenders.

But the government has nonetheless sent a very strong signal to the corrupt and the dishonest this time around. The fear that they could do it again will play on people’s minds and prevent them from accumulating large amounts of undisclosed cash. The unscrupulous will know that if they earn secret money, they will have to somehow spend it very quickly as the last one with the money in this black money musical chair risks getting caught out.

Following his graduation from Calcutta Medical College and post graduation from Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, Dr Kamal Mahawar is now a Consultant General and Bariatric Surgeon with Sunderland Royal Hospital in the United Kingdom. He is also an Associate Clinical Lecturer with Newcastle University and editor of renowned scientific journals. His recent book ‘The Ethical Doctor’ published by Harper Collins India examines some of the serious issues affecting Indian healthcare.

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