The healthcare system of West Bengal could safely lay claim to being the eighth wonder of the world, now that it has so palpably moved the stoic state health minister, Surjyakanta Mishra. Mr Mishra, who has remained unperturbed by news of serial crib deaths, death by ant-bite in hospitals or deliveries under trees outside state-run medical institutions, has expressed surprise at the goings-on at the sub-divisional hospital in Uluberia. At this government hospital, a critically-ill patient recently died after being administered an injection by an ‘outsider’ in the presence of the doctor, and then being supplied oxygen from a cylinder that was empty. Although the superintendent of the hospital denied knowledge of the stranger in the emergency ward, neither the doctor on duty nor the nurse seemed to have had any doubts about his competence in performing a function that was technically theirs. Such surrender is not fortuitous. Quacks or quick learners like this ‘outsider’ perform yeoman service to the healthcare system in the state. They are often the chief providers of the fruits of medical science to the poor when an apathetic State fails to keep its commitments. They are also of immense use to the medical staff, which turns to them to perform the tedious job of caring for the sick on their behalf. These men are easily accommodated within the cavernous structures of government hospitals, and are often alleged to receive their training from the doctors themselves.

Mr Mishra should not pretend to be baffled either by the existence of this group of people or the lackadaisical habits of the hospital staff. His department has itself thought of elaborate schemes to tame truant doctors. There have been attempts to legalize private practice of government-employed doctors or to run courses so that doctors could be persuaded to take up service in rural and suburban areas more willingly. At the other end, efforts have also been made to co-opt quacks and midwives into the healthcare service through proper training. The problem, however, is not with the intention, but with the will to carry out the change. Healthcare in West Bengal is a sham that is perpetuated as much by a careless doctor as by an unruffled health minister. The complete lack of accountability is what makes the supply of spurious drugs, the deaths of infants and their mothers, or the contempt shown for AIDS patients such ‘normal’ affairs. Perhaps Mr Mishra should stop wondering and begin reforming the system.