Delhi High Court: A PIL was filed by the petitioner, a member of the legal fraternity, raising concerns on behalf of citizens residing in the National Capital Territory (NCT) of Delhi based upon the critical findings outlined in a performance audit report prepared by Comptroller and Auditor General (CAG), highlighting that the Directorate of AYUSH, Government of NCT of Delhi, has failed to perform its functions effectively, leading to deficiencies and irregularities in the State healthcare system. A division bench of Satish Chandra Sharma, CJ., and Sanjeev Narula, J., dismissed petition for not being represented before relevant state authorities and directed the GNCTD to amplify the utilization of alternative medical systems in healthcare, and bolster research and education in these domains through strategic planning and efficient execution of AYUSH schemes and initiatives.
Between May and August of 2017, the CAG undertook a comprehensive performance audit that scrutinized the operations of 24 dispensaries and 3 hospitals under the purview of the Directorate. This audit, which covered a five-year span from 2012 to 2017 (hereinafter termed “the performance audit”), aimed to evaluate the efficacy of the Directorate’s initiatives and programs. Specifically, the audit sought to determine whether these initiatives were well-conceived and effective to advance the use of alternative medicinal systems in healthcare delivery, as well as to promote research and education in these domains.
CAG’s performance audit was officially published under the title, “Report of Comptroller and Auditor General of India on Social, General and Economic Sectors (Non-Public Sector Undertakings) for the Year Ended 31st March 2017, Government of National Capital Territory of Delhi, Report No. 3 of the Year 2018” (hereinafter referred to as the “CAG Report”). It contains three performance audits, on the functioning of the Directorate, strengthening/ development of road network by MCD, and the working of the Department of Weights and Measures, Delhi with a special focus on safeguarding consumers. The CAG Report exposes significant shortcomings in both, the planning and implementation of AYUSH-related schemes/ programmes, by the Directorate.
According to the Petitioner, the shortcomings highlighted in the CAG report are that the citizens access to quality healthcare services under the AYUSH framework of medicine within Delhi has been denied. The petitioner is seeking the issuance of a series of directives aimed at rectifying the issues highlighted in the said audit report.
The Court noted that the GNCTD has also candidly acknowledged the challenges/ shortfalls spanning from administrative delays in the disbursal or utilization of funds to procedural oversights in sanctioning publicity or advertisement expenditures. Additionally, there are infrastructural hurdles that have impeded the roll-out of specific policies. The failure to comply with the stipulation for three distinct rooms in every AYUSH dispensary is one such example. There is also an evident shortfall in personnel, as is evident by the fact that the sister in charge shoulders the responsibility of data management at the hospital, a role ideally earmarked for a specialized Medical Record Department. However, the State has adopted a proactive approach to rectify many of these challenges. A case in point is the resolution of discrepancies in the stock register entries, a concern flagged in the CAG Report. Additionally, in response to the findings of the CAG Report alterations have been made to procurement policies as well as initiatives undertaken addressing the need to conduct market surveys to detect illegal drugs, ensuring compliance with relevant laws/regulations, and the deployment of Drug Inspectors in these processes, as elucidated in the GNCTD’s affidavit.
The Court further noted that based on the details presented in GNCTD’s affidavit, it is evident that constructive steps are undeniably underway. Thus, there is no reason to direct any court-monitored investigation. A court-monitored investigation is a significant measure, typically invoked when there is a palpable sense of governmental neglect or oversight. It is not a mechanism to be employed routinely or without just cause. Resorting to such an investigation without substantial reasoning could inadvertently diminish its efficacy.
The Court remarked that the CAG Report commences its observations by highlighting a marked increase in in-patient admissions and out-patient visits across all three hospitals and dispensaries of the Directorate during the period 2012-2017. Such a trend signifies a growing recognition and trust in the effectiveness of the Indian System of Medicines. Given this backdrop, GNCTD must continue to amplify the utilization of alternative medical systems in healthcare, and bolster research and education in these domains and the same must be achieved through strategic planning and efficient execution of AYUSH schemes and initiatives.
The Court concluded that setting standards for healthcare facilities, be they centered on allopathic or traditional Indian medicinal systems, entails a depth of expertise, rigorous examination, and nuanced understanding. The intricate nature of procurement, healthcare standards, and administrative oversight is best addressed by the executive and legislature, which possesses, both, requisite expertise and the mandate for such tasks. Consequently, restraint must be exercised and unnecessary intervention in such matters should be avoided. The Court must not dictate procedures concerning medicine supply, purchase, or the detection of illicit drugs, unauthorized manufacturing and retail units. Such issues are policy-oriented which is beyond purview of the Courts.
[Tarun Narang v State, 2023 SCC OnLine Del 6199, decided on 05-10-2023]
Advocates who appeared in this case :
Mr. Avinash Chaudhary, Mr. Surjeet Singh, Mr. Amit Naagar, Advocates for petitioner
Mr. Anupam Srivastava, ASC, GNCTD with Mr. Ujjawal Malhotra, Advs for R-1 to R-3.
