Launch a Dedicated Helpline for grievances of private hospital doctors, nurses: Delhi HC tells Govt

The petition seeking this effect was filed by one concerned Distress Management Collective which approached the HC with a PIL seeking relief measures for our COVID warriors who are facing abrupt violence besides shortage of Personal Protection Equipment (PPE).

Via the petition, several grievances were ventilated by the petitioner about the safety protections to be provided to the nurses and other healthcare professionals working at private hospitals/nursing homes, i.e. PPE kit, gloves, masks etc. as well as insurance protection under the Pradhan Mantri Garib Kalyan Yojana and facility of ex-gratia payment posthumously.

The principal contention raised by the petitioner was that nurses and other healthcare professionals working in private hospitals/nursing homes treating Covid-19 patients are not being provided with protective equipment and other facilities. It was submitted that persons who are working in healthcare facilities, even if they are not assigned to COVID duties, should also be granted the same facilities and protection, as they also run a significant risk of exposure to the coronavirus. Such persons would come in contact with COVID-infected but asymptomatic patients approaching healthcare facilities for treatment unrelated to COVID 19, or come in contact with other healthcare workers in the same facility who are taking care of COVID patients.

The bench headed by honourable Chief Justice Prateek Jalan, while addressing the plea, took into account all the prayers presented by the concerned petitioner for ensuring the safety of all healthcare workers and passed the respective directives to the Delhi government and observed:

in the present pandemic situation, utmost effort must be made by all concerned to ensure the safety and protection of all healthcare workers. The contribution and commitment of healthcare workers to meeting the needs of society at such a time, often at considerable personal risk, is indeed noteworthy and deserves wholehearted appreciation

On one of the suggestions about the provision of a dedicated helpline number (with Whatsapp facility) for nurses and healthcare workers of private hospitals and nursing homes to approach the government authorities in the event of any grievance, the bench observed:

If a special dedicated helpline can be provided for the grievance to be ventilated by the nurses and other healthcare workers, it will render great assistance at this time. The nature of the grievances which they might have (e.g., regarding non availability of PPE kits at their places of work) would be quite different from the grievances which may be ventilated by the general public, and requires a different response. The respondent no. 2 is directed to consider this aspect in the light of these observations and take appropriate action.

So far as the appointment of nodal officers is concerned, Directorate General of Health Services (DGHS) shall appoint such nodal officer to deal with the complaints of the health workers received by DGHS. The names and contact numbers of such nodal officer(s) must be circulated to all healthcare facilities, with the direction that the healthcare workers deployed in the facility be suitably informed. The information should also be duly publicised on the official website of GNCTD and/or DGHS so that the availability of such redressal mechanism is known to the affected persons.

With regard to the provision of masks, PPE kits etc. to healthcare workers in private facilities, the bench directed:

Necessary PPE kits and N-95 Masks be made available to all the Government and private nursing homes, doctors, nurses, para-medical staff, house-keeping staff, irrespective of whether they are working in a Covid hospital or not, and in a Covid ward or normal ward, so as to ensure their safety and security. An undertaking has also been called for from the establishments concerned. This would also ensure accountability for compliance with the safeguards mandated by the respondents, and enable the respondent authorities to affix responsibility for the same, if so required.

Coming to the next aspect of the matter which deals with a provision for ex-gratia payment in the event of the unfortunate demise of any nurse or other healthcare professional who is deployed for COVID duties, the bench noted the petitioner's submission which was that this facility should be extended also to those healthcare professionals who are not specially assigned to COVID duties but acquire the infection in the course of performing other duties in healthcare facilities.

Rejecting this suggestion, the bench said:

This is a matter for the respondents to consider as a policy decision. It is not possible to hold that all healthcare professionals, whether on Covid duty or not, are equally at risk and must therefore be entitled to identical beneficial measures. However, the respondents may consider the cases of other affected individuals also, and it would be open to them to extend the benefit, if they are satisfied that the individual was similarly placed as those assigned to Covid duties.

The next suggestion for consideration dealt with the quarantine facilities for nurses and other healthcare professionals after completion of their period of duty. On this, the bench noted the prayer made by the petitioner and issued its rejection asserting that for each and every healthcare professional, quarantine facility is not at all required. According to the govt order, the quarantine facility is required for only those persons who are regularly working at high-risk exposure, the bench noted.

The judge observed that as per the guidelines dated 18th May 2020 issued by the Ministry of Health and Family Welfare especially clause 5.1, initially a period of one week quarantine (with a further extension of one week as per discretion of nodal officer) is warranted only in the High Risk/Low-Risk exposure cases.

On the prayer concerning the extension of coverage of the policy which provides insurance of Rs. 50 lakhs to all public as well as private healthcare workers assigned to COVID duties under the Pradhan Mantri Garib Kalyan Yojana, the bench noted that this benefit has been extended to only those categories of healthcare workers, who may be in direct contact with COVID patients.

The bench refused to accept the submissions made by the petitioner seeking the extension citing that all the nurses and other healthcare professionals should be covered by the Yojana and there should not be any discrimination between two types of persons i.e. those who are working with Covid-19 patients and those who are not working with Covid-19 patient. It asserted that the decision as to who will be covered under the Yojana is a policy decision to be taken by the government.

"If we include other persons under the Yojana, and if we change the policy decision and the applicability of this Yojana, it may affect the very budget of this Yojana. Therefore, it is a policy decision to be taken by the respondents as to whether to include other healthcare workers or not. "
Nurses and healthcare professionals working directly with Covid-19 patients are at a high risk and there are higher chances that these persons may get infected, and hence the insurance benefit has been extended for them. Persons who are not working with Covid-19 patients e.g. those who are working with orthopaedic patients who are not suffering from Covid-19, are not in the same position. The State authority can always create such classification and give extra benefit to those who are working directly with high risk Covid-19 patients. Such categorisation cannot be held to be irrational or lacking any nexus with the object of the benefit being provided.

Ultimately, while disposing off the plea, the bench directed concerned authorities to ensure full compliance.

It ought to be kept in mind by the concerned authorities that they are duty-bound to ensure the due compliance of the measures they have put in place for the safety and protection of the healthcare workers, whose contribution in the present pandemic situation has been, and continues to be, invaluable.
In particular, it is directed that the authority which has issued the office order dated 14th July, 2020 (Annexure-A to the counter affidavit filed by respondent No.2) shall see that this office order is properly executed and implemented by the private nursing homes. Additionally, as and when any type of breach is pointed out to this Court, in an individual writ petition against any nursing homes, after hearing such nursing home, individual orders can be passed