Constitute "Flying Squads" for Surprise check at Regional level hospitals: Madras HC tells State

Chennai: In order to ensure that doctors, nurses and paramedical staff are attending their duties properly and also to monitor the quality of healthcare, the Madras High Court bench has recently directed the State Government for setting up enough number of "Flying Squads" at Regional levels to conduct surprise checks in government hospitals, primary health centres etc. 

"The 1 st respondent is directed to constitute required number of "Flying Squads" at Regional levels / District levels for the purpose of conducting frequent surprise inspections in Government Hospitals, Primary Health Centres, etc., across the State of Tamil Nadu and ensure that the Doctors, Nurses, Paramedical staff attend their duties as per the rules in force and present during the working hours in the medical institutions, and to monitor the functioning of the Hospitals in all respects including the quality of treatments and medicines supplied to the patients etc," ordered the High Court bench comprising of Justice SM Subramaniam.

The bench has also directed that these "Flying Squads" should be monitored by the Head of the Department or the Government, to maintain the efficiency of these squads.

These observations came from the High Court bench as it was considering a plea by a former Medical Store Officer (MSO) at Coimbatore Medical College and Hospital. However, after retirement, she is now facing disciplinary action for ordering excessive Speciality Drugs during her tenure. Consequently, she received a show cause notice from the Dean of the hospital stating that why a sum of Rs.66,20,356.45/- should not be recovered from the petitioner's pensionary benefits, since the petitioner purchased the Speciality Medicines excessively and she was asked to submit explanations to the show cause notice. Consequently, through an order dated 12.09.2016, the former store officer was asked to pay a sum of Rs.56,45,497.87 and challenging this, she approached the High Court bench.

It was submitted by the petitioner's counsel that the petitioner could not be held responsible for the alleged financial loss and she had purchased the medicines while following the due procedures.

The petitioner's counsel further contended that she was wrongfully held liable for the expired medicines since the medicines purchased had expired after her retirement. Therefore, it was argued that the petitioner could not be held liable for any financial loss. The counsel for the petitioner further submitted that the medicines are supplied on need basis and in the absence of any enquiry, the unilateral decision taken by the authorities is unsustainable.

After considering the submissions by both the parties, the Court noted the gravity of the allegations against the petitioner and also observed that the petitioner had not cooperated in the inquiry process. 

"The allegations against the writ petitioner are serious in nature. Purchase of bulk quantity of speciality medicines without following the procedures as contemplated is a serious misconduct, which caused huge financial loss to the State Exchequer. Thus, the enquiry commenced must be concluded in all respects by following the procedures as contemplated and by affording opportunity to all the officials concerned. The financial loss caused to the State Exchequer must be recovered from all concerned and public cannot made to suffer on account of irregularities or illegalities committed by the public servants," observed the court.

The bench further clarified that "Pendency of the writ petition before the High Court, cannot be a ground to plead limitation for the purpose of exonerating an employee from departmental disciplinary proceedings."

Therefore, the Court ordered, "The respondents / competent authorities are directed to conduct a detailed enquiry, if required by obtaining an appropriate permission from the 1 st respondent / Government and initiate all appropriate actions against the officials concerned, including the petitioner, by following the procedures and by affording opportunity to the concerned officials and dispose of the same. Such an exercise is directed to be completed within a period of three (3) months from the date of receipt of a copy of this order."

"The petitioner is directed to co-operate for the early disposal of the enquiry proceedings and in the event of non-cooperation on the part of the petitioner, the same shall be recorded in the minutes by the competent authorities, and in such circumstances, the petitioner is not entitled to seek any relief on the ground of delay in disposal of enquiry proceedings," further read the judgment.

Meanwhile, during the pendency of the plea, the Court had asked the State for filing a Status Report on regulatory mechanism regarding the matter of purchase and utilisation of speciality medicines. Responding to this, the State had submitted a detailed report claiming that State Government mechanism ensures that only quality drugs are available at Government hospitals.

"The Tamil Nadu Medical Services Corporations Limited purchases drugs with shelf life to the extent of 95% period and that too for the next six months needs and the same are issued to the Government Hospitals. Hence, purchase of nearing shelf life expiring drugs by the Tamil Nadu Medical Services Corporations Limited does not arise. At the institutions, short expiry drugs with less than three months of validity are periodically taken out by the Pharmacists and redistributed to other needy institutions," submitted the State.

The State also informed the court about the existence of a Grievance Redressal System that is being operated through toll free number 104 and ensured proper action in case serious complaints regarding abuse/misuse/corruption are received.

"If any complaints of this nature are received, necessary Departmental disciplinary action under Tamil Nadu Civil Services (Discipline and Appeal) Rules will be initiated against the doctors / concerned officials who abuse/misuse/indulge in corruption of medicine," submitted the State.

Claiming that there is effective implementation of health care system across the State of Tamil Nadu, the State authorities submitted that Aadhar Enabled Biometric Attendance System in all 2302 Primary Health Centres and in other Public Health Institutions had been implemented. These 2302 devices and institutions are monitored as "Aadhar Enabled Biometric Attendance System (AEBAS)" data generated and maintained by National Informatics Centre (NIC), Government of India on their website https://tamilnadu.attendance.gov.in. Therefore, now the Government is monitoring the attendance of the Doctors, Nurses and Paramedical staff in all the medical institutions across the State of Tamil Nadu.

Taking note of the status report, the bench observed that "Right to Health is a facet of Article 21 of the Constitution of India. It casts an obligation on the State to preserve life. Right to Health and medical care is a Fundamental Right under Article 21 read with Articles 39(e), 41 and 43 of the Constitution of India. Self-preservation of one's life is the necessary concomitant of the right to life enshrined in Article 21, fundamental in nature, sacred, precious and inviolable."

Therefore, the High Court bench directed the state for setting up required number of "Flying Squads" at Regional levels/ District levels for conducting frequent surprise inspections in Government Hospitals, Primary Health Centres etc. 

"The activities of the "Flying Squads" are directed to be monitored by the Head of the Department / Government as the case may be, so as to maintain the efficiency of the "Flying Squads"," further read the order.

To read the Court order, click on the link below:

https://medicaldialogues.in/pdf_upload/madras-hc-healthcare-191358.pdf

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