The five-point agreement reached between the government and the Nepal Medical Association (NMA) on Wednesday evening is a welcome development. It ends the nationwide protest by doctors and, more importantly, provides an opportunity to address the deeper problem that triggered the confrontation: the growing insecurity faced by doctors and other health workers. Under the agreement, the government has committed to effectively implementing the Health Worker and Health Institution Security Act, 2009, including promptly formulating implementation guidelines. It has also pledged stronger legal action against attacks on health workers and vandalism at health facilities, better coordination among concerned ministries, and the preparation of a security action plan for health institutions. A joint task force involving the government and NMA will oversee implementation and regularly review progress. These commitments must now translate into action. The agreement should not become another document that generates headlines when signed but is forgotten once the immediate crisis has passed. The protest followed an assault on a doctor at Narayani Hospital in Birgunj, allegedly by relatives of a patient who died while undergoing treatment. What particularly angered the medical community was not only the reported assault but also the alleged failure of the local administration and police to respond adequately. Doctors have also alleged that they were mistreated during discussions with authorities following the incident. If substantiated, such conduct would represent a serious failure of the state to protect health workers.
Near 50,000 patients hit by doctors' strike
Violence against doctors is not an isolated problem. According to NMA representatives, two to three incidents involving doctors are reported every week, ranging from physical assaults and verbal abuse to death threats. Doctors also face forced entry into hospitals and their rooms, unauthorized recording and threats. Such behavior cannot be tolerated. Patients, of course, have legitimate concerns about medical negligence, excessive charges, inadequate attention and poor communication. Doctors, like professionals in any other field, can make mistakes and must be held accountable when they do. But grievances must be addressed through credible legal and institutional mechanisms. Dissatisfaction with medical treatment can never justify physical assault, vandalism, intimidation or threats against health workers. This is why effective implementation of the security law is so important. The government must formulate the promised guidelines without delay and ensure that the new security action plan is practical rather than merely bureaucratic. Hospitals need adequate security arrangements, threats must be taken seriously, and perpetrators of violence must face prompt legal action. The proposed joint task force can play a useful role if it is given clear responsibilities and sufficient authority. It should monitor security risks at health institutions, assess responses to incidents and identify weaknesses in coordination among health authorities, police and local administrations. The government should also review its handling of the Narayani Hospital incident and take corrective action if officials are found to have acted negligently or inappropriately.
At the same time, doctors must recognize that suspending non-emergency services places a heavy burden on patients. The NMA has every right to protest against violence and demand a safe working environment. But when regular services are suspended, patients—many of whom have no connection to the dispute—pay the immediate price. The NMA's decision to resume regular services following Wednesday's agreement is therefore welcome. Ultimately, this is not a choice between protecting doctors and protecting patients. Both are essential. A doctor cannot provide quality care while working under the threat of assault, intimidation or humiliation. Equally, patients should not be denied timely treatment because of failures by the authorities to protect health workers. The government and NMA have taken an important first step by ending the confrontation. The real test begins now. The government must implement its commitments swiftly and visibly, while doctors must uphold their professional responsibilities and pursue legitimate demands through responsible means. Protecting doctors from violence is not a privilege for one profession; it is a prerequisite for a functioning healthcare system. Safeguarding patients' right to timely treatment is equally fundamental. Only by protecting both can Nepal strengthen public trust in its healthcare system.
