THE Madhya Pradesh High Court Monday described health as a basic human right that no popular government could afford to negate.
These observations were made as a division bench of Chief Justice Mohammad Rafiq and Justice Atul Sreedharan issued a slew of directions to remediate the misery of people in the wake of the second wave of Covid19. They are-
- The State Government to ensure continuous and regular supply of Oxygen and Remdesivir not only to all the Government Hospitals, City Hospitals, District Hospitals but also to the Private Hospitals/Nursing Homes, which may give Indent of their requirement of Oxygen as well as Remdesivir in advance, depending on the load of the patients and their condition, as per the modalities decided by the State, to the Collector/Chief Medical & Health Officer concerned and/or Officer nominated by the State;
- Government to consider immediately reactivating 262 hospitals Covid Care Centres (CCC), 62 Dedicated Covid Health Centre (DCHC) and 16 Dedicated Covid Hospital (DCH) as per the details furnished to this Court in its order dated 09.10.2020;
- It will consider strengthening/ augmenting all the District Hospitals and City Hospitals, which generally cater to the medical needs of middle class/lower middle class and poor/below poverty line families, by providing them necessary equipments and the required quantity of Oxygen, Remdesivir injections and other requisite medicines so that considering the spread of Coronavirus, focus of the Covid-19 patients does not entirely remains on major cities like Bhopal, Indore, Jabalpur and Gwalior where due to huge population, the medical facilities are already under immense pressure and rush of the Covid patients to these cities is dissuaded;
- To ensure that the District Collectors and Chief Medical & Health Officers in every District shall periodically hold meetings with the Superintendents/Directors/Head/Representatives of all Government Hospitals, Private Hospitals/Nursing Homes and Diagnostic Centres/Labs to take stock of the day to day situation of the number of patients, availability of normal beds, ICU beds and Ventilators and also as per the requirement consider enhancing the capacity to cater to the need of a given place;
- To fix the rates for being charged by the private Hospitals/Nursing Homes and private Pathological Labs/ Diagnostic Centres for treatment/tests in consonance with its earlier order dated 04.09.2020, 25.03.2021 and 05.04.2021 by indicating capping of such charges and should ensure that these rates are adhered to by them. In doing so, the State Government should also take note of the concerns of the private Hospitals/Nursing Homes with regard to differentiation of charges based upon seriousness of illness of patients;
- It will in consultation with representatives of Indian Medical Association and M.P. Nursing Home Association require the private Hospitals/Nursing Homes to refrain themselves from demanding hefty amount as advance deposit for starting treatment of Covid-19 patients;
- To ensure displaying of data with regard to availability of normal beds, ICU beds and Ventilators on its Sarthak portal (https://sarthak.nhmmp.gov.in) in all the Government Hospitals and Private Hospitals/ Nursing Homes on real time basis. The Chief Medical & Health Officers of the districts concerned should keep a regular watch over such availability and randomly crosscheck the same to verify its correctness. On the basis of regular vigil about the availability of normal beds, ICU beds and Ventilators, the District Collector, in consultation with the Chief Medical & Health Officers, should take day to day decision for increase in the number of such beds by procuring additional infrastructure/hardware/machines etc. from the State Government to ensure continuous availability of medical health care to the increasing number of Covid patients;
- Government will require all the private Hospitals/Nursing Homes, Chemists/Medical Shops to display the rates of Remdesivir per vial, separately for generic and branded injections, and all of them should be mandated not to charge more than the prescribed rates;
- even though the State Government may regulate the supply of Remdesivir injections and other life saving drugs but the process adopted for this purpose should be so hassle free and should not be cumbersome as to ensure the supply of the drug in such a way that time limit from requisition by the treating doctors and supply of medicines does not exceed an hour;
- the State Government, through its representatives, preferably the District Collectors and the Chief Medical & Health Officers shall have regular consultation with the Superintendents/Directors/Heads of the Government Hospitals and leading private Hospitals/Nursing Homes to resolve the day-to-day problems faced not only by the patients but also by such private Hospitals/Nursing Homes, either by physical or virtual mode;
- the State Government should give due publicity to the Toll Free Number 1075 (with the STD code number of respective districts) of its Covid Command and Control Centres so that the Covid patients and their family members/attendants having any grievance with any government or private hospital, may immediately lodge their complaint with such Centres. In that event, expeditious remedial action should be taken to redress the grievances by knowing the stand of both the parties;
- the State Government should by taking over the buildings of government and private schools/colleges, Training Centres, Marriage Halls, Hotels and Stadiums etc. wherever needed, set up more number of Covid Care Centres (CCC), Dedicated Covid Health Centres (DCHC) and Dedicated Covid Hospitals (DCH), either by itself or by involving the private hospitals or reputed NGOs;
- the State Government should take steps to setup more number of Electric Crematoriums, in at-least big cities of the State, and get the Electric Crematoriums repaired, wherever they have gone out of order;
- the RT-PCR and Rapid Antigen Tests shall be conducted by the Government Laboratories as well as duly approved private Pathological Labs/Diagnostic Centres. The State should consider increasing per day testing number of Covid infected persons for their early detection so as to prevent further spread of Coronavirus. Test reports should be provided to concerned patients positively within 36 hours from the time of collection of sample;
- the State Government ought to consider the suggestions made on behalf of Indian Medical Association and M.P. Nursing Home Association for providing them soft loan to set up their own Air Separation Units so that some of them may become self-reliant with regard to their requirement of Oxygen;
- the State Government should work out the modalities for ensuring that patients from Below Poverty Line families having BPL Cards under Deendayal Antyodaya Upchar Yojana and those having Ayushman Cards and CGHS coverage facilities are not dishonoured by the Hospitals/Nursing Homes if they are approved for their treatment;
- the State Government should place on record correct data with regard to number of sanctioned posts and working strength of Senior specialists, Specialists, Medical Officers, Health Officers, PGMOs, Ayush Medical Officers, Staff Nurse, Support Staff/Ward Boy, Other Health Care Workers, Lab Technicians, ECG Technicians, X-ray Technicians, Scientists, OT Technicians, Radiographers, Lab Attendants, ICU/Ventilator Technicians, Pharmacists, and Oxygen Technicians etc., within a period of 15 days. If the furnished data are correct, such huge vacancy position in the Government Hospitals, City Hospitals and District Hospitals poorly reflects on the health care system of the State. The State Government ought to therefore consider engaging the Medical Officers on emergent and short term basis on the basis of walk-in interviews by issuing advertisement for short duration so as to cater to the emergent requirements of Districts & City Hospitals and Primary Health Centres (PHCs) and Community Health Centres (CHCs);
- looking to the scarcity of adequate number of staff in the emergent situation, the State Government should consider reappointing those Medical Officers, Para Medical and Nursing Staff, who have retired during past two to three years, to cope up with the ongoing crisis; and
- all the hospitals whether government or private, shall not refuse to attend the patients suffering from other serious ailments and provide them timely treatment depending on the seriousness of the ailments.
Apart from being a fundamental right, the high court said, “Health has its own prerequisites of social justice and equality and that it should be accessible to all. It includes the ability to obtain all kind of healthcare services including prevention, diagnosis, treatment and management of diseases, management of health disorders, diseases and illness as also the management of other health impacting conditions.”
The court asked the Central Government to consider stepping in to arrange the oxygen, firstly, by diverting the available stock of Liquid Medical Oxygen from the Steel Plants and other industries located in different parts of the country and secondly, if that was not sufficient, by importing it.
It said the Centre should also step in to ensure an increase in the production of Remdesivir and till such time it was not done, it should consider procuring the Remdesivir by importing it so that by the time the peak of Coronavirus is reached, oxygen and Remdesivir are both available to the affected persons in sufficient quantity.
The directions came to be passed by the court on applications filed by the amicus curiae in a suo motu case registered by the hgh court last year in the aftermath of nationwide lockdown.
The applications brought to the notice of the court the acute medical crisis in Madhya Pradesh due to sudden spread of Covid-19, not only in urban areas but in villages as well.
The applicant submitted that many deaths had been reported during the past few days from various hospitals across the state due to the nonavailability of oxygen.
It was said that there was an acute shortage of Remdesivir– a life-saving drug, crucial for Covid-19 patients.
The amicus curaie of also alleged that oral instructions had been issued to all private labs, private hospitals and nursing homes to not conduct any RTPCR and Rapid Antigen Tests. This was, however, refuted by the government.
