U.P Hospitals ‘Ram Bharose’ – Allahabad High Court

(PIL No. 574 of 2020) briefing by Manvee & Rajanish Kumar

A Public Interest Litigation (PIL No. 574 of 2020) has been filed in Allahabad High Court regarding Inhuman Condition at Quarantine Centres & For Providing Better Treatment to Corona Positive which states that –

In its last order it directed the respondent which is State of Uttar Pradesh to appoint a 3-member Pandemic Public Grievance Committee in each district of the state which will look after the grievances of individuals and resolve them. A government order dated 13.05.2021 which stated the same for which the order has been complied but, in the order, it has not been stated that how and in what manner Public Grievance Committee would redress the problems or grievances of individuals.

The PIL No. 574 of 2020 directs the respondent state that for resolving all the complaints a District Nodal Officer will be appointed in every district by the State Government & the Officer will discuss the complaints with the Committee. The Officer needs to ensure that every grievance is resolved in next 24-48 hours after reporting. Moreover, the committee will also look after the complaints of Supply of Oxygen to people who are in Nursing Homes, Private Hospitals and in the Home Isolation as well of the concerned district.

After fetching the details of the 5 districts of the state regarding the availability of medical facilities, it was observed that the health facility is insufficient in these cities in order to meet the requirement of its population and for the rural areas the Community Health Centres lack life saving gadgets. In most of the districts Level – 3 Hospital Facilities were lacking.

The PIL cited the example of one of the 5 districts which was Bijnor in order to test the overall healthcare facilities in the district. In this district as per 2011 census the urban population is 9,25,312 & undoubtedly in 2021 it went upto 25% more. Surprisingly there is no Level – 3 hospital in this district. There are only 3 government hospitals having total of 150 beds only, whereas there were only total of 5 BIPAP machines and 2 High Flow Nasal Canula which are most important life saving devices amidst the pandemic are negligible in number. As per the census of 2011 the population in the Tehsils is approximately 27,55,000 which must have increased by 25% as of now. Assuming the present population to be approx. 32 lacks in rural areas then there are only 10 Community Healthcare Centres, which clearly means that 1 CHC has a workload of 3 lakhs people & against these 3 Lakhs people there are only 30 beds, which is clear indication that CHC can only look after the 0.01% of the population. Life saving medical devices such as BIPAP machines and  High Flow Nasal Canula are not available in these Community Healthcare Centres. In these CHC’s only 17 Oxygen Concentrators with 250 Oxygen Cylinders are available against 300 beds. It is also unknown that what is the capacity of the Oxygen cylinders and whether the medical staff is trained to operate these medical equipment’s or not. All of these information reports were given by the District Magistrate of the Bijnor to the Honourable Court. Moreover, it was also submitted that there is no increment in supply of life saving gadgets from 1^st of covid-19 and the situations of the healthcare facilities remain stagnant. So, this is a clear indication that facts are opposing the claims of the government.

The number of testing in the Urban and Rural areas are way less than what is required to be. In urban areas till date 26,245 people have been tested since 31.03.201 till 12.05.2021, whereas in rural areas the number is 65,491 for the same time period. The District Magistrate of Bijnor informed the court that the testing was done in the ratio of 60:40 in both the methods i.e. RTPCR & rapid antigen kit. In the population of 32 lakhs where robust testing of 4000 to 5000 per day needs to be done in order to avoid 3^rd wave of coronavirus there testing is done only 1200 per day that also in a ratio of 60:40 and all the tests need to be done in RTPCR mode. But from the statement of District Magistrate of Bijnor we aren’t seeing any robust testing in upcoming days which is a clear indication of 3^rd wave of pandemic.

There was one viral news where an 64 years old aged person named Santosh Kumar succumbed due to the negligence and mismanagement of the hospital authorities. He was admitted in Medical College, Meerut on 21.04.2021, he was referred by District Hospital, Ghaziabad. The patient was covid positive and was in isolation ward, On the night of 22^nd April 2021 the patient went to washroom and fainted there & later on when he was brought upon stretcher, efforts were made to save him but he died by that time. One of the Doctor got the corpse of the deceased removed from the hospital and at last he was unable to be identified and this case became a case of Unidentified body. From the narration of facts and inquiries this is a clear case of Carelessness & Medical Negligence. If this is the state of affairs of treatment at medical College in the city like Meerut then the entire medical system of the State pertaining to the smaller cities and villages can only be taken to be like a famous Hindi saying ‘Ram Bharose’.

The state needs to take strict action against those who are responsible for the death of Santosh Kumar and should compensate the dependents of the deceased who are suffering from the irreplaceable loss.

In view of the above discussions and the fact that the people of this State have faced the pandemic for over last three months and are under serious threat of its third wave, two things become very clear:

(i) We need to vaccinate each and every individual in the country; and

(ii) We need to have an excellent medical infrastructure.

Recommendations Provided in the PIL (547 of 2020)

• All nursing homes should have an oxygen facility on every bed.
• Every nursing home/ hospital which has more than 20 beds should have at least 40 per cent beds as Intensive Care Units.
• Of the designated 40 per cent; 25 per cent should have ventilators, 25 per cent should have High Flow Nasal Cannula and 50 per cent of the 40 per cent reserved beds should have BIPAP machines. This should be made compulsorily for all the nursing homes/ hospitals in the State of Uttar Pradesh.
• Every nursing home/ hospital which has more than 30 beds should compulsorily have an oxygen production plant.
• So far as the villages and small urban areas are concerned, they should be given all kinds of pathology facilities and treatments should be made available in Community Health Centres which are at par to the treatment given by Level-2 hospitals in bigger cities.
• If a patient however becomes serious in the rural areas or in small towns then ambulances with all kinds of Intensive Care Unit facilities should be provided so that the patient can be brought to a hospital which has proper medical facilities in a bigger town.
• Every B Grade and C Grade town of the State of Uttar Pradesh should be provided with at least 20 ambulances.
• Every village should be provided with at least 2 ambulances having Intensive Care Unit facilities.
• Ambulances should be made available within a period of one month. With these ambulances’ patients from smaller towns and villages can be brought to bigger hospitals in bigger towns.