The alleged assault on doctors and nurses by a local Shiv Sena corporator and his supporters at a civic hospital in Dombivli on Tuesday, July 7, has put the spotlight on the safety of health workers in the state. The incident has sparked state-wide protests by resident doctors and nurses. In February 2010, an ordinance – Maharashtra Medicare Service Persons and 3 Medicare Service Institutions (Prevention of Violence and Damage or Loss to Property) Act – that made violence against doctors a non-bailable offence became an Act; however, in the backdrop of the recent Thane doctors’ assault case, the attention has now centered on whether the legal frameworks of the Act have been effective enough.What is Maharashtra’s special Act to deal with such cases?Between 2006 and 2008, various associations of doctors and medical staff demanded the implementation of a stringent law against violence against healthcare workers in view of an increase in such cases.During that time, those booked for such offences were charged under the existing laws of the Indian Penal Code (IPC). Political leaders, including the then Deputy Chief Minister, RR Patil, had given assurances to the associations that a special law will be enacted.In one of the meetings with Patil, the Association of Medical Consultants had cited a similar law enacted in Andhra Pradesh, suggesting that its provisions could be introduced in Maharashtra as well.In 2009, an urgent ordinance was passed to deal with such violence. It came into effect from March 30 that year. It became an Act in February 2010 when it was introduced as a Bill in the next legislative session.What are the key provisions of the Act?The Maharashtra Medicare Service Persons and Medicare Service Institutions (Prevention of Violence and Damage or Loss to Property) Act, 2010 was enacted for the protection of medicare service persons, including registered medical practitioners, registered nurses, medical students, para-medical workers, and other staff or workers directly or indirectly employed by a medicare institution.Under this Act, any individual who commits or attempts to commit or abets or incites the commission of any act of violence against the healthcare workers, faces imprisonment of up to three years and a fine which may extend to Rs 50,000. It is a non-bailable and cognisable offence.Story continues below this adThe Act also mandates that the accused are liable to pay compensation totaling double the cost of the damage or loss to properties. Acknowledging the need to hear patients as well, the Act requires the government to establish an authority to hear grievances of victims of medical negligence or mismanagement.Has it been effective?In 2020, legal research think tank ‘Vidhi’ cited as many as 56 news stories, including seven from the Mumbai Metropolitan Region, from January 2018 to September 2019, on violence against healthcare professionals.Another study by the Indian Medical Association (IMA) in 2015 highlighted that 75 per cent of doctors have faced at least some form of violence, with 12 per cent reporting physical attacks.A PIL unheard since 2021In 2020, during the Covid-19 pandemic, a Public Interest Litigation (PIL) was filed before the Bombay High Court (HC) by a Pune-based doctor, Rajeev Joshi, seeking protection for healthcare workers. He said in his plea that the current provisions are not sufficient to curb violence against them.Story continues below this adAmong the directives that came out of the proceedings was to have adequate police personnel at hospitals and furnishing of proper information on line of treatment to the patients’ kin.During the proceedings, the court was informed that from 2016 to 2021, 636 attacks were reported in Maharashtra, and 1,381 persons were arrested. Only 36 of these cases were decided and only four resulted in convictions.The PIL has not been heard since 2021.Do other states have similar laws ?While similar laws were enacted in Tamil Nadu, Gujarat, and Uttar Pradesh with varied versions of the law prevailing in nearly all the states in the country, there is no Central law regarding this.In 2019, a Bill was drafted by the Union Health Ministry following nationwide protests over an incident of violence in West Bengal. The draft was, however, rejected during consultations with the Home Ministry, as it was felt that there were sufficient provisions in the existing criminal laws.Story continues below this adPrivate Member’s Bills were introduced on this issue too, including one by Shiv Sena MP Shrikant Shinde, whose party councillor was allegedly involved in Tuesday’s incident.In September 2020, the Central government brought an amendment to the Epidemic Diseases Act, 1897. A whole section was added to the Act to deal with the violence, harassment, obstruction to healthcare service personnel, and damage to property of medical institutions, during an epidemic.