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