Delhi HC Directs Immediate Implementation Of Recommendations To Optimize Medical Infrastructure

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Synopsis

Court noted that individuals had died because government hospitals (whether state or central) had refused admission due to a shortage of ICU/ventilator beds and malfunctioning CT scan machines

The Delhi High Court, in a suo moto petition, directed the Chief Secretary and Principal Health Secretary of GNCTD for implementation of recommendations by Dr SK Sarin committee within 30 days. The court noted that the said committee had recommended numerous immediate, short-term as well as long-term measures to improve the medical infrastructure of the state. 

The bench headed by Acting Chief Justice Manmohan and comprising Justice Manmeet PS Arora held, "The Chief Secretary and the Principal Health Secretary shall also indicate a road map as to how they intend to implement the intermediate and long term measures within the timeline stipulated by the Expert Committee. Let an action taken cum status report be filed by the Principal Health Secretary within four weeks". 

The court had initiated a suo moto petition after one incident involving the unfortunate demise of one Pramod, who was denied medical treatment by three Delhi Government hospitals, as well as a Central Government Hospital. The refusal of treatment was attributed to several factors, including the lack of available ICU/ventilator beds and malfunctioning CT scan machines.

Thereafter, the court observed minimal progress in addressing the issue and thus had established a committee comprising various members, including Dr. S.K. Sarin, Chancellor of ILBS, serving as Chairman, Dr. Nikhil Tandon, Professor & Head of the Department of Endocrinology and Metabolism at AIIMS, Dr. D.K. Sharma, MS, from Dr. R.P. Eye Centre at AIIMS, Dr. Suresh Kumar, Director of LNJP Hospital, Dr. Piyush Gupta, Professor of Paediatrics & Principal at University College of Medical Sciences, and Dr. Deepak K. Tempe, Senior Professor of Anaesthesiology and Vice-Chancellor at ILBS.

During the court session dated April 16, 2024, the committee presented a comprehensive executive summary detailing its action plan, which included:
1. Compiling issues based on available data from the Department of Health and Family Welfare, GNCTD.
2. Engaging with the Government of NCT and other relevant authorities to garner necessary support and data.
3. Soliciting information from the Directorate General of Health Services (DGHS) and Commissioner MCD.
4. Collaborating with MD, NICSI for software development and support for control room operations.
5. Conduct meetings with Medical Directors and Superintendents of Delhi hospitals to grasp the challenges they face.
6. Gathering information on manpower, equipment, and challenges encountered by government hospitals.
7. Requesting hospital heads to identify top priority areas for immediate improvement.
8. Conducting visits to Delhi government hospitals for firsthand assessment.
9. Referring to gap analysis by the Health Department, Govt. of NCT of Delhi, and conducting on-site inspections.

The committee, in its report, identified critical deficiencies in human resources, infrastructure, medical/surgical consumables, and the referral system. Recommendations were put forth to rectify these shortcomings, with a focus on enhancing emergency healthcare services. These recommendations were stratified based on immediate, short-term, intermediate-term, and long-term timelines. They encompassed measures to optimize existing resources, establish a control room for real-time information on ICU/HDU bed availability, and ensure the availability of infrastructure, medicines, and manpower in hospitals. Additionally, suggestions were made for maintaining functional medical equipment, alleviating stress on referral hospitals, ensuring an uninterrupted supply of medicines, and filling vacant positions.

Moreover, recommendations were tendered to introduce emergency services in Delhi Arogya Kosh, permit Delhi residents to utilize Aadhar cards for cashless facilities in private hospitals during emergencies, appoint a dedicated MS/Director for all hospitals, and provide telemedicine services.

Longer-term measures included NABH accreditation for all Delhi hospitals, expansion of teaching programs, augmentation of the Delhi Health budget, and facilitation of private sector involvement in healthcare provision. Additionally, the committee proposed the provision of ACLS ambulances in each district around the clock.

Court directed the Chief Secretary and Principal Health Secretary of GNCTD to implement the immediate measures within thirty days, as per the Expert Committee's timeline.

The Chief Secretary and Principal Health Secretary were also instructed to outline a plan for implementing intermediate and long-term measures within the specified timeline. The Principal Health Secretary was also instructed to submit an action taken report within four weeks. 

Case Title: Court On Its Own Motion v Union Of India And Ors