Dr KK Aggarwal and Ira Gupta
In a recent judgement, the
Hon’ble Division Bench of the High Court of Allahabad has issued directions to
the State Government, UP for improving the medical facilities in the Hospitals
maintained by State Government. These directives were issued in response to two
writ petitions filed before the High Court in the matter of Sneh Lata Singh
& Others vs State of UP & Others, PIL No. 14588 of 2009 and in Raj
Kumar Singh vs State of UP bearing PIL No. 65217 of 2008. The Chief Secretary,
Lucknow was directed to ensure supervision and compliance to these directions
of the Hon’ble High Court.
In the matter of Sneh Lata
Singh & Others versus State of UP & Other, the complainant asked for
reimbursement for medical expenses, as well as compensation for physical
suffering relating to a pregnancy-related complication (vagina fistula) due to
incompetent care provided to her at a govt. hospital. Simultaneously, the writ
petition also highlighted various shortcomings in the hospital, notably poor
infrastructure, staff shortage, unaccountability and apathy, underutilized
funds.
The second petition, Raj Kumar
Singh vs State of UP, was filed by a social worker and Editor of Weekly
Newspaper, who asked the court to make it mandatory that all District Private
Hospitals and Nursing Homes should display qualification and designation of
Paramedical staff. The petition filed by him also asked for an inquiry into
MTPs being done by Hospitals and Clinics without being registered the Medical
Termination Pregnancy Rules 2003.
· Immediate steps shall be taken
to fill in existing vacancies of Medical, Para Medical and other
attending staff at various levels
· Necessary supply of quality
medicines to all
Medical Care Centre at different levels must be ensured.
· Similarly availability of
requisite apparatuses, instruments, operation theatres and other
medical requirements as per status of Medical Care Centres be maintained and
continuous maintenance should be ensured
· For medical care of women,
especially pre-natal and post natal treatment, lady Doctors and supporting lady
Para Medical and Nursing Staff be recruited and their availability be
maintained.
· Director General Vigilance
shall constitute special teams at District level to find out Medical Officers
of State Government who are engaged in private practice or running Hospitals,
Nursing Homes or attending or providing treatment to patients in such private
Hospitals etc. Said teams shall also investigate into cases of radio diagnosis
and pathology test from private institutions and establishments, in respect of
patients who are under treatment at State Medical Care Centres.
· Team shall find out reasons
for non conduct of radiodiagnostic or pathological services by Govt.
institutions.
· Wherever private
Radiodiagnosis and pathology tests are found as conducted from private hands,
encouraged by Govt Medical Staff, appropriate action including criminal and
departmental shall be taken against them.
· It shall also be ensured that all
Govt Officials should avail Medical Care services from Hospitals run and
maintained by Govt.
· Whenever any High level
officials, political Executives or other dignitaries go for treatment, Medical
Officer on duty, by roster, shall attend him and there shall be no special
VIP treatment.
· If medical care is obtained
in Private Hospital etc., Govt must not reimburse the same.
· However, if there are some
kinds of diseases or ailment, treatment /cure whereof is not available in
Government Hospitals, and for that purpose, treatment in private becomes
necessary, this condition may be relaxed but in such contingency, Govt
must ensure that for similar ailments and deceases if suffered by common poor
people, arrangement should be made for their treatment also at Government
expenses in such Private Medical Care Institutions.
· State Government shall ensure
transportation of patients to Trauma Centres.
· Whenever vehicles are stopped
for any reason including traffic signals, people must stop the same in a
single line ensuring clear passage for ambulances and fire brigades etc.
· Traffic Police Force including
other Police Personnel shall ensure clear passage, proper parking of vehicles,
non-encroachment of roads. Local Traffic Police people, if any congestion is
caused, should be held personally responsible. Any damage suffered by
injured/serious patients due to obstruction in smooth passage for ambulances
etc. must be held a criminal liability including of traffic persons
· Responsibility shall be fixed
upon the residents and persons running commercial activities without providing
parking space, by imposing heavy penalty etc.
· Provision restricting purchase
of new vehicles and registration thereof unless person(s) purchasing vehicle
have parking place at their residences.
· State Government shall also
take immediate steps for providing dedicated corridors for movement
of vehicles of essential service as an honor of fundamental right to
patients and injured people to get quickest medical services and travel on road
without any obstructions and also to ensure other essential services to be
carried out without obstruction.
· Special Committees at District
and Block levels be constituted on permanent basis which may have participation
of common people and members of society to monitor proper functioning of
Medical Care Centres
· Free food to patients and
their attendants shall also be ensured in all State run Medical Care Centres
· Fields, lawns etc. maintained
in medical colleges, hospitals attached to medical colleges and other
Government hospitals shall not be allowed to be used for any celebration or
function like marriage ceremony of non- residential staff etc.
· In no case any unregistered
hospital or clinic (MTP Act) shall be allowed to function. Any laxity shall be
treated personal responsibility of the concerned CMO.
· State Govt shall also ensure
that in no case funds allocated for Medical Services remain unutilized and
unspent. Funds allocated for welfare of Medical Services, if are not spent, it
means that requisite service to that extent has been denied.
· Any authority in State
Government if finds expedient, may approach this Court by filing an application
for clarification/modification of this order
We have been repeatedly
raising almost all of these issues at least for the last three years and have
written to the govt. to address these deficiencies in health care delivery. The
rising expectations of the patients is a major factor accounting for the
widening gap and the distrust between doctors and their patients. When the
expectations of the patients are not met, they may sometime resort to violence.
Self-regulation is the answer
to this conundrum. Each one of us must work and carry out our duties and
responsibilities wholeheartedly and with all sincerity. If we do not
self-regulate, then the govt. will and it will do so with penal
provisions.
If the govt. will not
regulate, then the courts will do so. And if the govt. fails to comply with the
orders of the court, it may find the govt. in contempt of the court.
Health is a state subject.
Therefore, all govts. should take note of these directions of the Hon’ble
Allahabad High Court and implement them in their states.
Such matters should suo moto
be taken up by the govt. if not the govt. then the High Courts in the interest
of the general public.
Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
Group Editor-in-Chief IJCP Publications
Vice President CMAAO
Group Editor-in-Chief IJCP Publications
President Heart Care
Foundation of India
Immediate Past National
President IMA
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