Delhi High Court: The Court initiated suo moto proceedings due to certain incidents reported from time to time that reflected an acute lack of medical services in Delhi. The Division Bench of Manmohan, ACJ.*, and Manmeet Pritam Singh Arora, J., after considering the medical field to be specialized which required experience, appointed a Committee of experts (‘the Committee’) to make specific and concrete recommendations on various issues, for instance, lack of timely availability and accessibility of ICU beds for patients in need of emergent care, non-admission of patients in the hospitals and large number of unfulfilled vacancies in hospitals, which could be considered by the Court to pass appropriate order.
The Court noted that not much progress had been made on this issue as the attention of the courts had been drawn by Amicus Curiae from time to time to the dismal state of affairs that existed, and the assertion was confirmed by the tragic incidents that had come to be reported from time to time in the media. The Court also took note of the tragic demise of Pramod in January 2024, who was denied medical treatment by three hospitals of the Government of Delhi and a Central Government hospital. The denial of treatment was on account of various reasons ranging from the non-availability of ICU or ventilator beds to the non-functionality of CT scan machine. The tragic incident was recorded in the order dated 08-01-2024 of the Court. On 05-02-2024, the Health Minister had filed a status report in which he admitted that there was an acute shortage of doctors, especially in specialities, a shortage of paramedics like OT or ICU Technicians, assistants, nurses, pharmacists, shortage of medicines, non-availability of orthopaedic implants, non-functional radiological equipment due to difficulty in their maintenance. It was stated that bureaucracy was ‘not obeying’ the order of the Health Minister.
Amicus Curiae submitted that there were no ICU beds in nine hospitals of Delhi and medical equipment was non-functional. He also emphasized that in the department of radiology and imaging of the Delhi hospitals, the patients were given appointments between May 2025 and March 2027, thereby making access to medical care illusory.
The Secretary, Health and Family Welfare, Government of Delhi (‘Health Secretary’) specifically denied that the bureaucracy was not following the instructions of the Health Minister. He stated that the Health Minister had filed a writ petition in the Supreme Court with regard to the implementation of various schemes including “Farishtey Scheme” under Delhi Arogya Kosh (DAK) Society.
The Health Secretary informed the Court that patients possessing Aadhar cards with residential addresses of Delhi could get their scans done free of cost from private hospitals or clinics and that the Municipal Corporation of Delhi (‘MCD’) owned and ran eight hospitals. The Court noted that MCD had difficulty in paying salaries and pensions to its employees and opined that it was unlikely that MCD had the wherewithal to invest in the infrastructure of eight hospitals under its management.
The Court opined that the infrastructure including machines, medicines or manpower was woefully inadequate at hospitals in Delhi. With only six CT scans in nineteen hospitals which provided service to a population of more than 3 crore, the infrastructure needed to be ramped up manifold. Without critical infrastructure being available at Delhi Government hospitals, the ‘golden hour’ of saving a life might be lost as there would be no time to shift patients in critical condition to private clinics. The Court further opined that the authorities in whom the power of administration was vested were not on the same page.
The Court stated that under Article 47 read with Article 21 of the Constitution, it was the obligation of the State to ensure a robust public health system. The Court opined that huge investments along with structural reforms in the functioning of Government hospitals were needed. Since this field was an extremely specialized area that required subject experience and domain knowledge, the Court appointed the Committee that should consider the matter in detail and place their recommendation or report on record.
The terms of reference of Committee were as follows:
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To suggest ways for optimization of existing resources in various hospitals located in Delhi, which were either owned by the Government of Delhi including Delhi Government autonomous hospitals or MCD.
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To suggest ways and means to devise a mechanism for establishment of control room that would enable the provision of real time information concerning availability of ICU/HDU beds in various hospitals and their timely availability for patients in need thereof.
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To suggest ways and means to ensure availability of infrastructure, medicines, and adequate manpower in hospitals for operating/managing high end medical equipment/critical care units in various hospitals.
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To suggest ways and means to reduce stress on referral hospitals by strengthening peripheral hospitals located in various districts of Delhi.
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To suggest an end-to-end mechanism for ensuring uninterrupted supply of medicines, injections, and consumables in government hospitals.
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To suggest mechanisms to immediately fill vacant posts of specialists (teaching/non-teaching), medical officers and paramedics on contract basis, till regular incumbents join through UPSC/DSSSB.
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To make any other recommendation that the Committee thinks was fit and proper for improving the medical services provided by hospitals in Delhi to the public at large.
The Court held that in making its recommendations, the Committee must give primacy to the aspect of critical health care and should consider the suggestions given by the Health Minister, the Health Secretary, and the Amicus Curiae. The Court further requested the Committee to make specific and concrete recommendations on various issues, for instance, lack of timely availability and accessibility of ICU beds for patients in need of emergent care, non-admission of patients in the hospitals and large number of unfulfilled vacancies in hospitals, which could be considered by the Court while passing appropriate order.
The matter would next be listed on 01-04-2024.
[Court on its own Motion v. Union of India, 2024 SCC OnLine Del 938, decided on: 13-02-2024]
*Judgment Authored by: Acting Chief Justice Manmohan
Advocates who appeared in this case :
For the Petitioner: Ashok Agarwal, Advocate, Amicus Curiae; Ashna Khan, Kumar Utkarsh and Manoj Kumar, Advocates
For the Respondents: Kirtiman Singh, Santosh Kr. Tripathi, Avnish Ahlawat, Ajjay Aroraa, Standing Counsel; Satyakam, ASC; Waize Ali Noor, Shreya V. Mehra, Vidhi Jain, Arun Panwar, Prashansa Sharma, Tania Ahlawat, Nitesh Kumar Singh, Laavanya Kaushik, Aliza Alam, Mohnish Sehrawat, Kapil Dutta, Vansh Luthra, and Ravinder Agarwal, Advocates
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