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Let’s not rubbish Lancet just yet

It looks to me as if Prof Timothy Walsh may have overstepped his research mandate by calling for caution over nascent attempts to promote British medical tourism in India. Walsh cites moral reasons.

world Updated: Aug 16, 2010 23:37 IST
Dipankar De Sarkar

It looks to me as if Prof Timothy Walsh may have overstepped his research mandate by calling for caution over nascent attempts to promote British medical tourism in India. Walsh cites moral reasons. He is responsible to the British taxpayer who funds the National Health Service, which may end up sending Britons to India for cheaper treatment at its cost, he tells me.

Morals are hard to argue over, but one thing is clear to me: if one day a surveillance system is put in place in India to track post-surgery hospital infections and laws are enacted to regulate antibiotic use, then the man on the street, who doesn’t necessarily have the money to use Escorts or Apollo, will have a lot to thank Lancet for.

The regulation of antibiotics absolutely fundamental to the way Britain approaches the care of its citizens.

The NHS, as is well known, runs through a system of insurance fees, where every Briton who is employed or in business pays a mandatory fixed sum to the government which in turn ensures free consultation with a local, government-approved doctor of their choice and free hospital treatment for everything from a broken nose to heart surgery. Medicines are charged at a standard rate of £7.10 for those able to pay and free for the young, the old, the disabled and the jobless.

It’s a system that works superbly at its best (you could be speaking on the phone to emergency and the ambulance would be on a street next to yours even as you spoke). But the system, founded in 1948, is creaking through overload: the commonest complaint is over the waiting time to be operated upon. And India has shown a way to beat the queue.

I spoke to my local pharmacist – someone whom I have used for nearly 25 years – about the antibiotic regulation and this is what he had to say:

“A lot of it is about trust. I have never and will never sell antibiotics without a prescription. That’s just the way it is. Also, there are routine checks by the health department, and it’s just not worth it. “Of course, there are rogue pharmacists” he said.

I don’t really want to add fuel to this particular fire, but my pharmacist left me pondering a potential problem of massive proportions: Where do illegal immigrants, who are not registered with the NHS, get their antibiotics from? When they fall ill, who tells them which antibiotic to have and in what doses?

Who regulates those invisibles who are outside of the law?