The Madras High Court has asked the Tamil Nadu government to think of out-of-the-box solutions when it comes to ensuring appropriate healthcare facilities, especially for those who cannot afford private medical care and those who don’t have insurance.
The Division Bench of Chief Justice Sanjib Banerjee and Justice Senthilkumar Ramamoorthy made the observation on Friday while holding that the system came up short during the Covid-19 pandemic, particularly for the poor. The bench was hearing a petitioner who alleged the quality of food supplied in government hospitals was and continues to remain abysmal, and short on nutrition and awfully inadequate for recuperating patients.
The bench held that apart from the fact that the healthcare system requires improvement, the diet at government hospitals leave a lot to be desired. There are the usual suspicions that are aroused pertaining to the award of contracts for supply of food, whether cooked or uncooked, to government hospitals. Sometimes the rates are abysmally low and contractors use their access to hospitals and exploit the same by quoting lower rates than the calorific content of the diet would warrant.
“The problem may also arise because public health and sanitation, including hospitals and dispensaries, are included in Entry 6 of the State List in the Seventh Schedule to the Constitution and uniform guidelines and measures cannot be adopted across the country, though the sufferings appear to be somewhat similar across the country.”
The bench sought a clarification from the government as to the extent of government presence in the health sector, the desirability and parameters of private participation therein, the cost of healthcare and, generally, the state of the healthcare facilities across the state.
“Despite the superior healthcare facilities in this state, the Covid-19 deaths were quite alarming. It is possible that the worst may have been averted and the dedication of doctors, nurses and other healthcare workers, both in the private and the public sectors, helped arrest the second surge and the casualties, but there is no doubt that a clear policy in such regard requires to be spelt out,” said the Bench.
The Court said that even though healthcare facilities are inadequate, the number of doctors produced in the country every year keeps on increasing, while the attendant infrastructure necessary for doctors to function effectively remains stagnant. A comprehensive study needs to be undertaken to ascertain what would be the adequate number of beds across the State and across districts, whether private participation can be invited with the state overseeing the same.
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It was pointed out by the Court that there are various systems which exist and the systems differ from State to State. There may be fewer beds in government hospitals in Kerala and Punjab than in private healthcare facilities in such states, whereas other states have an overwhelming number of government beds without adequate infrastructure and little by way of private healthcare facilities. International models may also be looked into. It appears that Germany does not have government hospitals and all beds in such country are under the private healthcare system, but the overall system is monitored and checks and balances are put in place.
“The object of the exercise is to ensure that people from the various strata of society have access to healthcare and that the better facilities are not reserved only for the rich sick,” clarified the Court.
“At any rate, what requires immediate attention is the qualitative improvement of the diet served at government hospitals. While the first aspect of the matter requires more time and study; the State must report on the second aspect of the matter and how it proposes to deal with the same when this petition appears next four weeks hence,” the order said.