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Synopsis

The Delhi High Court, recently, ordered the director of All India Medical Sciences (AIIMS) Prof M Srinivas to implement the recommendations of the Sarin Committee promptly.

“There is far too much to ‘n’ fro of communications between GNCTD and Director, AIIMS which is delaying the implementation of the recommendations and valuable time is being lost”, the bench of Chief Justice Manmohan and Justice Manmeet PS Arora held. 

The observations were made in a suo moto petition that was initiated following numerous news reports regarding increased verbal and physical violence against doctors, particularly in the Emergency and casualty departments. The court also noted that the Resident Doctors had initiated self-defense classes. 

However, the court remarked that resorting to violence, even for self-defense, would not be a viable solution. The court recognized two issues: a). the grievance of patients/attendants of what is perceived as a delay in receiving medical attention and b). doctors being grossly overworked. 

Furthermore, the court highlighted that “since the time hospitals were constructed and commenced operations, patient loads have grossly increased. There is no evidence at all of any change in the numbers of medical experts put in place by those in authority to man these hospitals and provide patient care. It is evident therefore that the problem of doctors facing violence as well as availability of adequate medical attention to the patients have to be considered in tandem”. 

The court also noted the status report by the Director of AIIMS dated September 25, 2024. The director recommended that vacant positions be filled on an outsourcing or contractual basis within one to two months to alleviate the interim crisis. Additionally, the commissioning of essential diagnostic equipment, such as ultrasound, CT scan, and MRI machines, was suggested through Public-Private Partnerships (PPP) or alternative means.

The report also noted that officials from the Government of the National Capital Territory of Delhi (GNCTD) who attended meetings with the AIIMS team lacked decision-making authority and comprehensive information, causing delays in prompt action.

To expedite decision-making, the court directed that the next meeting would involve the Chief Secretary of Delhi and other senior officials. Meanwhile, AIIMS explored Corporate Social Responsibility (CSR) support from various companies to establish a Clinical Decision Command Centre to assist GNCTD doctors in managing emergency and ICU patients more effectively.

On September 27, 2024, a separate report was submitted on behalf of the Government of NCT of Delhi and was added to the record. Upon reviewing both reports, the court expressed dissatisfaction with the delays in implementing the Expert Committee's recommendations.

“The issues sought to be tackled in this matter pertains to availability of critical medical care to the residents of Delhi and the said objective ought to be kept in mind and bureaucratic obstacles in implementation of the recommendations shall not be countenanced by the Court”, the court emphasized in an order dated September 30, 2024. The court stated that no further delays or attempts to obstruct the implementation would be tolerated

In the recent court hearing, Advocate VSR Krishna for AIIMS informed the court that AIIMS, led by its Director, Prof. M. Srinivas, had made progress in implementing the recommendations of the Sarin Committee. The Director confirmed that cooperation from GNCTD had improved and that further review meetings would take place within three weeks to assess the implementation steps taken.

The court was informed that certain pending issues from the status report were addressed by the Health Minister. Further, the Minister assured the court of full support for implementing the Sarin Committee's recommendations and emphasized collaboration with the AIIMS Director, who retained the final authority on the measures to be adopted.

The court reviewed an affidavit filed by the GNCTD’s Deputy Secretary, dated October 11, 2024, which indicated that significant progress had been made in constructing three hospitals, with 96% completion reported for ongoing projects. 

The bench directed GNCTD to complete the construction of Guru Gobind Singh Hospital, Sanjay Gandhi Memorial Hospital, and Acharya Shree Bhikshu Government Hospital by the end of the current financial year. Additionally, the court ordered the creation of new staff positions for these hospitals within 15 days and mandated the Finance Department to ensure prompt approval of necessary financial allocations. 

GNCTD was also instructed to present a comprehensive proposal at the next hearing to complete the other hospital projects, where progress ranged from 74% to 87%. The court expressed concern over potential financial waste if these projects were not finished promptly. 

The next meeting to review progress was scheduled for November 8, 2024. Therefore, the court listed the matter on November 13, 2024, with an expectation that tangible results would be presented. 

Case Title: Court On Its Own Motion v Union Of India & Ors (W.P.(C) 3903/2017