Treat first, document and bill later: Rajasthan medical education dept directs Govt hospitals

The directive specifically addresses medico-legal cases (MLCs) such as road traffic accidents, assault, and poisoning. While hospitals must inform the police in such cases, they have been clearly told not to wait for police arrival before initiating treatment. First aid, resuscitation and stabilisation must begin without delay, particularly during the “golden hour” when timely intervention can be lifesaving.

The department reiterated that Article 21 of the Constitution guarantees the right to life and places the protection of life above administrative requirements. The order emphasises that emergency care must be provided immediately to all patients, including those from other states or countries, and even those who do not possess identity documents, as reported by The Times of India.

In line with Indian Public Health Standards (IPHS) and guidance from the Ministry of Health, all government medical colleges and attached hospitals have been asked to maintain round-the-clock emergency services. This includes a structured triage system with designated zones, including a radiological zone, and the adoption of the principle: “Treat first, document and bill later.” Hospitals have been directed not to insist on advance payment or prior registration in emergencies.

Patients with clearly defined life-threatening conditions, as well as unconscious patients, are to be triaged directly to the red zone and managed under a “zero delay” approach. The department has also stressed that referrals and internal administrative processes must not interfere with timely intervention during the golden hour, reports The Daily.

For survivors of sexual violence, the guidelines mandate free treatment, strict confidentiality, and care in the presence of a female attendant. Copies of the Parmanand Katara judgment, the present order, and relevant IPHS guidelines have been circulated among doctors, nurses, and emergency staff to reinforce legal and ethical obligations in emergency care.

Additionally, the department has directed regular training and sensitisation sessions for healthcare personnel. Hospitals are required to prominently display a Citizen’s Charter or posters outlining patients’ rights to emergency care. At the same time, department heads and trauma and emergency in-charges have been instructed to put internal checks in place to prevent misuse of emergency provisions by non-emergency cases.