‘Local Appropriate Authorities Lack Adequate Understanding of PCPNDT Act; Demands Are Arbitrary, Without Uniformity’

Pune: Doctors across the state on Friday called for uniform directives and checklists for officials inspecting sonography and abortion centres.

"We have made certain observations based on the ongoing state–wide inspection drive. There is too much variation in the officials’ way of inspecting sonography machines, checking records, form F etc," senior gynaecologist Sanjay Gupte, pastpresident of the Federation of Obstetrics and Gynaecological Society of India (FOGSI), told TOI on Friday. "There needs to be some kind of cohesion in the inspection methodology to avoid confusion among doctors wishing to adhere to the norms of the Pre–Conception and Pre–Natal Diagnostic Techniques (prevention of sex determination test) (PCPNDT) Act," he said.

Gupte, who is also a member of the Central Supervisory Board (CSB) for the PCPNDT Act, collated and compiled the various experiences of the doctors during the ongoing drive initiated by state health officials.

"We have made certain recommendations based on these experiences. The data is representative. Doctors practising in other states must have had similar experiences. Hence, this needs to be brought to the notice of the higher authorities," said Gupte.

"We will present this data along with our recommendations (see box) on bringing uniformity to the approach, during the Central Supervisory Board’s meeting which is scheduled to take place in Shimla on July 20," Gupte said. The meeting is to be chaired by Union health minister Gulab Nabi Azad.

"Local appropriate authorities lack adequate training and understanding of the PCPNDT Act and Rules, especially the Medical Termination of Pregnancy (MTP) Act," said gynaecologist Shantanu Abhyankar of Wai. "Their demands are arbitrary and there is no uniformity in the demands regarding the fulfillment of actions by the doctors," he added.

"At some places, the appropriate authorities have mentioned that they have been given targets to seal a number of machines and hence they have to act on even the most flimsy of grounds to save their jobs," said another doctor.

In some cases, the authorities still demanded a certificate of training and experience from gynaecologists when the Central Supervisory Board (CSB) has clarified that the gynaecologists can do USG (ultrasonography), said gynaecologist Vinayak Khedkar of Aurangabad.

"Doctors suffer harassment if the patient’s identity is not clearly mentioned, when the information which a doctor takes is dependent only on what the patient says and it is beyond the scope of doctors to verify this in all situations," said gynaecologist J J Shah of Baramati.

Proper training of the appropriate authorities

Clarity in the information to be reported under both acts – PCPNDT and MTP

F form needs improvement so as to make it less ambiguous and more relevant

Information obtained should be collated and analyzed which should help authorities track the possible wrongdoers.

The authorities should seek the help of doctors willing to assist in implementation of this act (there are instances where doctors have pointed out the names of erring colleagues and no action was taken against them)

There should be a helpline for doctors in case an appropriate authority demands unreasonable and uncalled for records and actions which are outside the purview of the act.

Even though the filling of F form is a must, the appropriate authorities should not harp on trivial and insignificant mistakes to seal the machines. This further leads to prolonged court cases and even cancellation of registration.

These actions of depriving the doctor of his livelihood for a trivial mistake are clearly draconian. Hence discretion has to be shown regarding the type and significance of errors.

Targeting abortion or medical termination of pregnancy (MTP) centres, especially first trimester MTPs which have no relevance for sex determination should be stopped as it is against the spirit of the MTP Act.

The Food and Drugs Administration (FDA) has to circulate directives regarding the correct record and stock maintenance about the drugs, particularly its position regarding use of Misoprostol should be clarified since it is used in many other instances other than MTPs.