Provide Free Medical Treatment To Poor In Kausa-Mumbra Even Without Yellow & Orange Ration Cards: Bombay High Court To Thane Municipal Corp

In a significant order the Bombay High Court directed the Thane Municipal Corporation to ensure free treatment for all poor patients even if they don't have yellow and orange ration cards at its newly built 100-bed Hakim Ajmal Khan Hospital in Kausa-Mumbra.

A division bench comprising Justices Devendra Kumar Upadhyay and Arif Doctor observed that people living in that locality were “disadvantaged” and came from economically weak backgrounds, making it the court's duty to ensure they enjoy the facility of affordable public health services so that their right to life with dignity can be ensured.

“Thus, it is now well settled that duty of the State as cast by Article 47 of the Constitution of India has to be taken aid of for giving full meaning to right to life enshrined as fundamental right under Article 21 of the Constitution of India. Right to life does not mean mere animal existence, it will encompass in it the right to live with dignity and if any citizen is deprived of affordable public health services, right to life with dignity cannot be ensured, it will rather be compromised.”

The court disposed of a clutch of PILs filed by the Association for Protection of Civil Rights and others, seeking the court's intervention to ensure completion and proper functioning of the hospital project pending for over 15 years.

According to the civic body citizens with yellow ration card, Annapurna ration card and orange ration card shall not be charged any amount. However, citizens who do not fall in these categories would be charged as per the Mahatma Jyotiba Phule Jan Arogya Yojna, and those not covered will be charged 79% of the Government Health Services scheme rates.

The petitioners also alleged that the civic body was going to run the hospital on a Public Private Partnership Model. This meant the hospital would eventually be privatized and deny free treatment.

The court, however, refrained from interfering with the civic body's decision to run the hospital under a Public-Private Partnership model, calling it a "policy matter" falling within the executive domain.

However, it took note of the Municipal Corporation's resolution dated 3rd March 2022 on providing free treatment even to those without yellow and orange ration cards.

"…it is incumbent upon the Corporation to translate the aforesaid Resolution into action. This would therefore necessarily mean that the Corporation would have to ensure that any medical facility and/or public health-care system which is to be evolved by the Municipal Corporation is to necessarily provide free medical aid/treatment for the poor within the Thane Municipal Corporation limits."

The court noted that the entire hospital was built on public funds. Moreover, the Resolution itself mentioned that the civic body would reimburse the private partner as per the fixed rate ascertained by the Municipal Committee.

"Any Agreement entered into by the Respondent – Corporation to run the Hospital on a PPP model would therefore necessarily have to be in conformity with Resolution No. 750 dated 3rd March 2022 to the extent that the same would inter alia require free medical services to be given to the poor and those who do not have yellow and orange cards and other patients."

Significantly, the court noted that Part IX-A in the Constitution of India gave Municipalities or the Urban Local Governance bodies in the country constitutional status and responsibilities. Article 243-W empowers civic bodies to formulate guidelines for the State, including for matters mentioned in the Twelfth Schedule.

One of the functions enlisted in Twelfth Schedule is “Public Health, sanitization conservancy and solid waste management”.

“Thus, it becomes a constitutional function and duty of every Municipality to implement the schemes entrusted to it including the schemes in relation to the public health as well.”

“The provisions of Article 243-W read with Twelfth Schedule and Article 21 read with Article 47 (Duty of the State to…improve public health) of the Constitution of India and various other provisions contained in MMC Act, thus, cast a duty on the municipality i.e. Thane Municipal Corporation to provide public health-care system in a way which is affordable and accessible to all irrespective of their socio-economic condition.”

Regarding allegations of malpractice and cost escalation over the years, the Bombay High Court directed the petitioners to make a representation before the State first.

Case No- PUBLIC INTEREST LITIGATION NO. 24 OF 2022

Case Title - Association for Protection of Civil Rights (APCR) & othrs vs The Municipal Commissioner

Appearances – Senior Advocate Yusuf Mucchala along with advocate Karim Pathan

Senior advocate Ram Apte for TMC

GP PP Kakade

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