Our first speaker, Uma Nambiar, noted that clinical engineers have to make their value obvious in the medical hierarchy. She suggested that one way to do this would be to make clinical engineering patient oriented, specifically to assert that clinical engineering is about patient safety. Another speaker mused about how the Indian clinical engineering profession might get there, given that he thought Indians had a cultural problem with safety, using the way Indians drive as an example. This gave me pause for thought on the basis of what I had already concluded about Indian driving. There are two ways to approach safety. One is to prevent accidents happening, and the second is to deal with the consequences. Our second speaker mentioned people not using safety belts and cycle helmets – that's minimising the consequences. There is some evidence that minimising consequences actually makes people drive less carefully as they begin to believe they will not get hurt. My view is that it's not a cultural thing so much as an economic thing – safety features in cars, good maintenance of buses, proper replacement of tyres, rebuilding of roads all prevent accidents but don't happen unless they can be afforded. In terms of culture, if anything it goes the other way – Indians, possibly because of their culture, are, in my view, better drivers than people in the UK are.
In terms of patient safety that made me think that there is probably an Indian way of doing patient safety. It will be different from the western way, it will have different strengths and different weaknesses, but it will work better in India becvuase it will be specifically Indian. Western patient safety is based on two principles which are not encessarily the most effective. The first is the highly materialistic Judaeo-Christian life model of western culture in which everything that can be done must be done regardless of the cost in money or the patient's dignity. The second is that a lot of safety features, devices and practices are not about patient safety so much as about doctor safety – there for the purpose of vitiating litigation. It may even work against patient safety in the long run. I would not like to see either of those features replicated in other countries.