Ramesh Chander vs Union Of India & Ors.

S.NO.,Heads,"Allocations (in

Rs. )","Expenditure(in

Rs. )",Expenditure in %,

,,2015-16,2015-16,,

1.,GIA-SALARIES,"16,24,48,759","8,74,10,475",53.81,

2.,"GIA-OTHER THAN

SALARIES","30,93,23,871","5,52,13,090",17.85,

3.,"GIA-FOR CREATION

OF CAPITAL ASSETS","11,23,65,312","2,84,67,319",25.33,

4.,GIA-M&E,"17,04,19,071","1,81,51,336",10.65,

,Total,"75,45,57,013","18,92,42,220",,

S.No.,Category,"Number of

sanctioned

posts for 250

beds","Number of

posts filled as

on 15th July,

2017","Number of

vacancies yet

to be filled",

1.,Professor,12,NIL,12,"No

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issued so far.

2.,"Associate

Professor",14,NIL,14,"No

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issued so far.

3.,"Assistant

Professor",59,12,47,

4.,"Blood

Bank

Officer",01,01,0,

5.,"Senior

Resident",104,44,60,

6.,"Junior

Resident",48,42,6,

7.,"Medical

Officer",10,02,8,

infrastructure in the form of equipments and highly specialized diagnostic machines, etc. were procured. The acute shortage of staff in both hospitals",,,,,

has led to a woeful situation of inadequacy of services to the general public who deserve it and for whom there is a crying need for such services.,,,,,

This has translated into both severe lack of access to cheap or free medical aid to the general public and scarcity of such public resources, though",,,,,

physical infrastructure has been created. OPD footfalls are less than the expected level â€" intuitively one can infer that the OPD footfalls in both the,,,,,

institutions are less than half â€" of the capacity made available. In the case of bed utilization, the situation is far worse.",,,,,

The acute shortage of staff is attributable to the high vacancy position. During the course of hearing, it was stated that most of the posts in the",,,,,

hospitals and those advertised are not permanent or encadred but contractual or tenure posts. This appears to be an important reason why either there,,,,,

is a large proportion of vacancies or there is a considerable turnover â€" or both.,,,,,

Health care and right to wellness are an intrinsic and important component of the right to life. The Directive Principle of State Policy contained in,,,,,

Article 47 considers it the primary duty of the state to improve public health, securing of justice, humane condition of works, as well as extension of",,,,,

sickness, old age, disablement and maternity benefits.",,,,,

In several judgments, the Supreme Court explained the substantive content of the right to life, and held that the right to life included the right to live",,,,,

with human dignity including the right to good health. (Bandhua Mukti Morcha v Union of India AIR 1984 SC 812). In Consumer Education and,,,,,

Research Center v. Union of India (AIR 1995 SC 636) the Supreme Court declared that the right to health was an integral factor of a meaningful right,,,,,

to life. The court held that the right to health and medical care is a fundamental right under Article 21. Examining the issue (i.e. the constitutional right,,,,,

to health care under arts 21, 41 and 47 of the Constitution of India), the Supreme Court in State of Punjab v Ram Lubhaya Bagga, 1998(4) SCC 177",,,,,

observed that the right of one person is connected with a duty cast upon another individual, employer, government or authority. Consequently,",,,,,

citizens’ right to life under Art 21 casts obligations on the state. This obligation is underlined by Article 47. The state has to secure health to its,,,,,

citizens as its primary duty. The government strives to fulfil this obligation by setting up public healthcare facilities, government hospitals and health",,,,,

centers. They must be within the reach of its people, if they are to be effective.",,,,,

Again, in Paschim Banga Khet Mazdoor Samity v. State of West Bengal 1996 (4) SCC 37 it was held that",,,,,

It is no doubt true that financial resources are needed for providing these facilities. But at the same time it cannot be ignored that it is the",,,,,

constitutional obligation of the State to provide adequate medical services to the people. Whatever is necessary for this purpose has to be,,,,,

done. In the context of the constitutional obligation to provide free legal aid to a poor accused this Court has held that the State cannot,,,,,

avoid its constitutional obligation in that regard on account of financial constraints. The said observations would apply with equal, if not",,,,,

greater, force in the matter of discharge of constitutional obligation of the State has to be kept in view.""",,,,,

The Court made certain additional direction in respect of serious medical cases:,,,,,

“(a) Adequate facilities be provided at the public health centers where the patient can be given basic treatment and his condition,,,,,

stabilized.,,,,,

(b) Hospitals at the district and sub divisional level should be upgraded so that serious cases be treated there.,,,,,

(c) Facilities for given specialist treatment should be increased and having regard to the growing needs, it must be made available at the",,,,,

district and sub divisional level hospitals.,,,,,

(d) To ensure availability of bed in any emergency at State level hospitals, there should be a centralized communication system so that the",,,,,

patient can be sent immediately to the hospital where bed is available in respect of the treatment, which is required.",,,,,

(e) Proper arrangement of ambulance should be made for transport of a patient from the public health center to the State hospital.,,,,,

(f) Ambulance should be adequately provided with necessary equipment and medical personnel.â€​,,,,,

In these circumstances and having regard to the glaring deficiencies in the healthcare system in the two hospitals and related health care centres,,,,,

(both being superspeciality hospitals) established at great public expense, with substantial annual grants- a large part of which appears to be unutilized,",,,,,

this Court is of the opinion that the Government of NCT should take urgent steps to have both the hospitals and other such public medical institutions,,,,,

which are under its control (and are independently governed through Governing Councils, etc.), audited through a third party agency, to point out the",,,,,

deficiencies and shortcomings and suggest remedial measures to ensure availability of clinical, diagnostic and full panoply of medical services that",,,,,

each hospital was designed to cater to. A direction is issued to the Cabinet Secretary to examine the matter and with the assistance of an appropriate,,,,,

Committee, consider the feasibility of appointing an Expert Audit Committee which will go into all aspects and suggest effective reforms. The reforms",,,,,

should also consider appropriate long term measures to recruit crucial medical and para medical staff, to ensure stability in personnel availability, which",,,,,

appears to be a critical and glaring cause for the ineffectiveness of the two hospitals’ delivery system.The Committee/experts may be also tasked,,,,,

with examining the feasibility of evolving a common on-line portal, showing to the members of the public the availability of various services on a",,,,,

dynamic basis linked centrally so that the bed position in each public hospital is updated on a daily basis. Such a web portal may also display the,,,,,

relevant disciplines that each hospital would cater to the bed capacity, etc.",,,,,

Let a comprehensive affidavit be filed by the Principal Secretary, Health, Government of NCT of Delhi in the light of the above directions within 4",,,,,

weeks, after considering the above directions.",,,,,

List on 27.10.2017.,,,,,