Either Govt fixes standard rates for private hospitals or we will implement CGHS rates: Supreme Court issues Ultimatum

New Delhi: The Supreme Court on Tuesday slammed the Union Government for its failure to specify a range of rates for availing services at private hospitals and clinical establishments.

Even though Rule 9 of the Clinical Establishment (Central Government) Rules, 2012 mandates that the Government shall determine the rate of fee chargeable from the patients at private hospitals and clinical establishments, it has not been enforced till now.

Issuing directions to the Union Health Secretary to hold a meeting with the State Counterparts and come up with a concrete proposal before the next date of hearing, the Supreme Court bench has warned that if the Government fails to comply with the directions, the Court shall consider issuing CGHS rates instead.

"Insofar as the suggestion of the learned counsel for the petitioner with regard to adoption of CGHS rates, as an interim measure, is concerned, in the event the Central Government does not come out with a concrete proposal by the next date of hearing, we will consider issuing appropriate directions in this regard," observed the top court bench comprising Justices B.R Gavai and Sandeep Mehta.

The Apex Court was considering a Public Interest Litigation (PIL) filed by an NGO 'Veterans Forum for Transparency in Public life'. Filing the plea under Article 32 of the Constitution, the NGO prayed for a direction on the Union Government to determine the rate of fee chargeable from the patients in terms of Rule 9 of the Clinical Establishment (Central Government) Rules, 2012.

Rule 9 states, "every clinical Establishment shall display the rates charged for each type of service provided and facilities available, for the benefit of the patients at a conspicuous place in the local as well as english language." It further mentions that the clinical establishments shall charge the rates for each type of procedures and services within the range of rates determined and issued by the Central government from time to time, in consultation with the State governments. 

The counsel for the petitioner submitted before the Court that the Union of India itself has notified the rates that apply to the CGHS-empaneled hospitals. He submitted that till a solution is found the Central Government can always notify the said rates as an interim measure.

Defending its position, the counsel for the Government pointed out that the rates are to be determined under the Clinical Establishments (Registration and Regulation) Act, 2010 and the Rules framed thereunder.

He submitted that the said Act of 2010 has been adopted by 12 State Governments and 7 Union Territories. The Union Government's counsel further submitted that considering the provisions of Rule 9 of the 2012 Rules, the rates cannot be determined by the Central Government unless there is a response from the State Governments/Union Territories. In this regard, he argued that even though various communications have been addressed to the State Governments/Union Territories, there has been no response and therefore the rates could not be notified.

While considering the matter, the top court bench referred to the judgment in the case of Paschim Bangal Khet Mazdoor Samity v. State of West Bengal and Pt. Parmanand Katara, Advocate v. Union of India and Another, where the Apex Court held that it is the duty of the State to provide medical assistance to the citizens.

"The Act of 2010 has been enacted with an avowed object of providing medical facilities to the citizens at an affordable prices. The Union of India cannot shirk away from its responsibility by merely stating that communication have been addressed to the State Governments/Union Territories and they are not responding," opined the Apex Court bench.

The court opined that the Secretary of the Union Health Department can always hold a meeting with his counterparts with the State Governments/Union Territories to do the needful. "Nowadays, physical meetings are also not necessary, it can be arranged through virtual mode," the bench pointed out.

Issuing necessary directions, the bench mentioned, "We, therefore, direct the Secretary, Department of Health, Union of India to hold a meeting with his counterparts in the State Governments/Union Territories and come with a concrete proposal by the next date of hearing."

At this outset, the bench also took note of the submission by the petitioner's counsel that the Union Government has notified the rates which are applicable to the CGHS empaneled hospitals. The petitioner's counsel submitted that till a solution is found the Central Government can notify the said rates as an interim measure.

Considering this suggestion, the bench clarified that if the Central Government does not come up with a proposal by the next date of hearing, it may consider implementing the CGHS rates.

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/supreme-court-cghs-rates-233326.pdf

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