31 July 2011
The recent direction of the Supreme Court of India to government hospitals in Delhi to refer poor patients to private hospitals gains significance not only as one more pro-poor judicial pronouncement but also because it highlights one of the major contradictions in India's health care service: even as there has been a mushrooming of huge, well-equipped, multi-discipline hospitals in big cities serving the rich, thousands of rural India's poor patients have to go without even a semblance of medical care when they desperately need it.
A two-member bench of the apex court comprising Justice R.V. Raveendran and A.K. Patnayak said that private hospitals would provide the patients from the crowded government hospitals necessary treatment free of cost, pending the preparation of a scheme that would involve private hospitals in treating the poor. It is perhaps to find out how far the private hospitals are right in claiming that if they provide total free treatment to the poor they would become bankrupt. When one of the counsels of the private hospitals told the court that nobody was occupying the beds allotted for the poor, the Bench responded stating, “It means you are not welcoming anybody.”
The Bench was hearing an appeal filed by private hospitals against a 2007 judgment of the Delhi High Court, which directed the private hospitals to ensure free treatment to 10 per cent of in-patients and 25 per cent of outpatients. The High Court ruling made it mandatory for private hospitals on the ground that they had received subsidised land after giving an undertaking that the hospitals they built would provide free treatment to the economically weaker sections of the people.
The Supreme Court directed the Delhi government and the private hospitals to draw the necessary modalities for the purpose. During an earlier hearing of the appeal, the court came down heavily on the private hospitals. Stating that they behaved like “star hotels,” they were highly critical of these hospitals for collecting abnormal charges from the poor. They also took strong objection to their failure to honour their word and violation of the condition that the poor be given free treatment.
The Supreme Court's bold initiative should enthuse social activists, political parties, and the media to carry the message that there is an urgent need to strengthen the public health security system in the country so that deprived sections of the people could have greater access to medical assistance in time. Only recently Nobel laureate Amartya Sen warned that gigantic inequalities in access to healthcare would lead to poor health in general. Commending the splendid work done by human rights activist, Dr. Binayak Sen among tribal people, he said that inequality in access to healthcare was not only bad distribution of the overall health benefits; it also reduced the overall health benefit.