Medical system in smaller cities, villages Ram bharose: Allahabad HC slams UP Govt

The remark was made in connection to the death of a 64-year-old patient who got admitted to the Meerut-based hospital and fainted in the washroom. Later, the doctors and paramedical staff failed to recognize the patient and the body of the deceased was marked as unidentified, packed in a bag and disposed of. The news soon became viral and the High Court division bench comprising of Justices Siddhartha Varma and Ajit Kumar also addressed the issue during the hearing of the Suo Motu Public Interest Litigation. The court remarked,

"If this is the state of affairs of treatment at medical College in the city like Meerut then the entire medical system of the State pertaining to the smaller cities and villages can only be taken to be like a famous Hindi saying 'Ram Bharose'."

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"A patient is admitted to the hospital in an absolute care of doctors and paramedical staff and if the doctors and para medical staff adopt such casual approach and show carelessness in the performance of their duty, then it is a case of serious misconduct because it is something like playing with the lives of innocent people," the Court added further directing the State to take stern action against those responsible, compensate the dependents of the patient, and file an affidavit after fixing responsibility in the matter.

"The Additional Chief Secretary (Medical and Health), Government of U.P. is, therefore, directed to file an affidavit fixing responsibility in the matter. An affidavit shall also be filed on behalf of the Chief Secretary as to what is the stand of the Government and how it intends to compensate the dependents of the deceased. Necessary compliance affidavit may be filed within a week," the order mentioned.

The matter would be next heard on May 22, 2021.

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Apart from this, several other issues were addressed by the Court during the hearing. Medical Dialogues had earlier reported that the Allahabad High Court on Friday directed the Uttar Pradesh government to explain how it was dealing with the surge in COVID-19 cases in rural and sub-urban areas, and smaller cities of the state.

The smaller districts and cities got unfortunately ignored and also did not get the attention of the media, the petition claimed. "Surge in cases is now being seen in rural areas also and the situation has alarmingly worsened for want of proper medical care," it said.

In the last order, the Court had directed the State to appoint a three-member Pandemic Public Grievance Committee in every district to look into the grievance of individuals and to redress their respective grievances and further to look into all the viral news relating to the district concerned.

Although the State submitted an affidavit along with the copy of a Government Order complying with the direction, the Court noted that the State has not been directed as to how and in what manner the public grievance committee would redress the grievance of an individual.

"We accordingly direct that all the complaints received by the committee, will be discussed by the Committee with the District Nodal Officer appointed in every district by State Government and the Nodal Officer shall ensure that each and every grievance stands redressed within 24-48 hours. We also enlarge the scope of the Committee to look into the complaints of supply of oxygen to those who are in home isolation, the private hospitals and nursing homes of the district concerned," directed the Court.

The Court had also directed the State to submit the details of the health infrastructure of five districts and the District Magistrates complied with the order. However, after perusing the details, the Court noted, "we have no hesitation in observing that health infrastructure is absolutely insufficient in city areas to meet the requirement of city population and the rural areas the Community Health Centres are virtually lacking in respect of life saving gadgets. In most of the districts, the Level-3 hospital facilities are not there." In this respect, the Court pointed towards the details related to Bijnor district and mentioned that the details of health infrastructure of the district paint quite a contradictory picture from what the State had claimed.

Further mentioning that the district administration should have a robust way of conducting tests considering the affects of pandemic in the rural areas, the Court expressed its dissatisfaction regarding the statistics of testing as mentioned in the case of Bijnor district.

"If this is the state of affairs of five districts, one can guess where we are leading people of this State to i.e. third wave of the pandemic," the Court expressed its concern in the order.

"Therefore, we direct the State Government to immediately improve and increase the testing methods of the rural population and the population of small cities and towns and also provide sufficient health care infrastructure in compliance of our direction no. 19(iii) of our order dated 27.04.2021," the judgment added.

Finally, addressing the issue of vaccination, the Court noted that the State Government has invited a global tender to address the issue. However, the Court gave some further suggestions in this matter. The Court suggested,

(ii) Big business houses who take various advantages under the taxation laws by donating to various religious organizations may be asked to divert their funds to vaccines.

(iii) Central agencies may give the green signal to various manufacturers who have the infrastructure to manufacture the vaccines on a large scale so that they may manufacture vaccines of whichever kind they feel suitable. The vaccines may be first vigorously tested and only thereafter may be given out for use by the public.

(iv) Big medical companies which are working in the country may not have their own vaccines but they may take the formula from just any of the vaccine manufacturers in the world and start producing the vaccine.

"For that matter, one cannot understand as to why the Government of ours which is a welfare state is not trying to manufacture the vaccine itself on a large scale," further mentioned the Court while giving these suggestions. The Court also asked the State to check the viability of these suggestions and submit a report regarding this by the next date.

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However, the Court also noted that, "So far as the medical infrastructure is concerned, in these few months we have realized that in the manner it stands today, it is very delicate, fragile and debilitated."

Mentioning that when the medical infrastructure couldn't tend to people in normal times it definitely had to collapse in the face of present pandemic, the Court also asked the State to check whether several requirements to improve the infrastructure could be addressed.

(i) All nursing homes should have an oxygen facility on every bed.

(ii) Every nursing home/ hospital which has more than 20 beds should have at least 40 percent beds as Intensive Care Units.

(iii) Of the designated 40 percent; 25 percent should have ventilators, 25 percent should have High Flow Nasal Cannula and 50 percent of the 40 percent reserved beds should have BiPAP machines. This should be made compulsorily for all the nursing homes/ hospitals in the State of Uttar Pradesh.

(iv) Every nursing home/ hospital which has more than 30 beds should compulsorily have an oxygen production plant.

(v) Medical Colleges in Prayagraj, Agra, Meerut, Kanpur and Gorakhpur should have enhanced facilities as are there with the Sanjay Gandhi Postgraduate Institute within a period of four months. Emergency laws should be applied for the acquisition of land for them. Funds should be provided to them forthwith so that they graduate from a medical college to an Institute of the standard of the Sanjay Gandhi Postgraduate Institute.

(vi) Villages and small urban areas should be given all kinds of pathology facilities and treatments should be made available in Community Health Centres which are at par with the treatment given by Level-2 hospitals in bigger cities. If a patient however becomes serious in the rural areas or in small towns then ambulances with all kinds of Intensive Care Unit facilities should be provided so that the patient can be brought to a hospital which has proper medical facilities in a bigger town.

"The Government should not linger this matter but by the next date it should come up with a definite report as to how this upgradation of Medical Colleges shall be done in four months' time," the division bench mentioned in the order.

To view the original order, click on the link below.