It Is The Centre’s Duty To Provide Special Health Packages To All Hilly States: Uttarakhand HC

The Uttarakhand High Court on Friday issued a slew of directions for improvement of medical facilities in the State.

In doing so, the Bench comprising Justice Rajiv Sharma and Justice Lok Pal Singh asserted that it is the Centre’s duty to provide special health packages to all hilly States, observing, “We are not oblivious of the financial crunch faced by the State of Uttarakhand. It is the duty of the The Court can take judicial notice of the fact that Central Govt. to provide special health package to all the hilly states to maintain and improve public health. We would like to mention at this stage that all the schemes announced, launched must be completed in a time bound manner to save public money. The Union of India was added as party at the subsequent stage, since the State Govt. has stated in its one of the affidavits that it has sent the proposal to the Central Govt. to release the sufficient funds.”

The Court was hearing a petition filed by one Mr. Deepak Ruwali, highlighting the shortage of doctors and paramedical staff at three Government Hospitals in Nainital— B.D. Pandey (Male) District Hospital, B.D. Pandey (Female) District Hospital and G.B. Pant Hospital. Mr. Ruwali had alleged several other deficiencies in the hospitals too, including inadequate space and lack of basic equipment.

Over several hearings, the Court examined the shortcomings in the three hospitals, and constituted a five-member committee, with the Chief Secretary, Government of Uttarakhand as its Chairperson. Based on the report submitted by the committee, and  the submissions by the parties, the Court issued the following directions:

State to start multi-speciality hospital within 6 months

• The State Govt. is directed to start Multi-Speciality Hospital at Bhowali T.B. Sanatorium within a period of six months from today, as per the norms of Medical Council of India and Indian Public Health Standards issued from time to time, as per decision dated 13.06.2017. 


• The State Govt. is directed to construct the new buildings for Multi-Speciality Hospital as per the norms of Indian Public Health Standards by initiating the tender process after completing all the codal formalities i.e. DPR, building plans etc., within a period three months from today. 


• The State Govt. is also directed to release sufficient funds for the treatment of patients admitted in T.B. Sanatorium, Bhowali, within a period of seven days’ from today. 


• The State Govt. is also directed to undertake minor repairs of buildings at Bhowali T.B. Sanatorium on urgent basis and to make it functional for establishment of Multi-Speciality Hospital within a period of two weeks from today. 

Establishment of Cardiac Care Unit and Geriatric Ward

The State Govt. is also directed to setup/establish Cardiac Care Unit and Geriatric Ward at B.D. Pandey District Hospital, within a period of three months from today. Cardiologist and Gynaecologist be appointed within two weeks from today. 

Vacant posts to be filled within 3 months

All the vacant posts of doctors, paramedical staff and ministerial staff in B.D. Pandey (Male) District Hospital, B.D. Pandey (Female) District Hospital and G.B. Pant Hospital be filled up within a period of three months from today, if necessary by holding walk-in- interview on urgent basis. 

Central heating in all 3 hospitals

The State Govt. is also directed to make provision for Central heating in all the three hospitals i.e. B.D. Pandey (Male) District Hospital, B.D. Pandey (Female) District Hospital and G.B. Pant Hospital, Nainital before the onset of winter season.

Generators in every district for uninterrupted power supply

The State Govt. is further directed to install generators in every district hospital to provide uninterrupted power supply.

Ensuring constant availability of all doctors 

The State Govt. is also directed to ensure that all the doctors posted at a particular place/station remain available around the clock, failing which, disciplinary proceedings be initiated against them.

Ensuring compliance with Indian Public Health Standards

• The State Govt. is directed to appoint doctors, nurses, para-medical staff, administrators etc. and to provide equipment as per Indian Public Health Standards within a period of six months from today at the secondary level/tertiary level hospitals.


• The State Govt. is also directed to appoint doctors, nurses, para-medical staff, administrators etc. in all the sub-district/sub-divisional hospitals, Special Centres, Primary Health Centres (PHCs’), Community Health Centres as per the norms of Indian Public Health Standards and Medical Council of India, within a period of six months from today. 


• The State Govt. is also directed to comply with all the norms of Indian Public Health Standards issued from time-to-time in the Multi-Speciality Hospital to be opened/ established in T.B. Sanatorium, Bhowali including doctors, nurses, para-medical staff, administrators and equipment. 

Trauma Centres in every district hospital

The State Govt. is directed to establish trauma centres with following essential equipments in every district hospital, within three months from today, as per the norms prescribed by the Indian Public Health Standards:- 

• 24 x 7 operational emergency with dedicated emergency room shall be available  with adequate man power. 


• It should preferably have a distinct entry independent of OPD main entry so that  a very minimum time is lost in giving immediate treatment to casualties arriving in  the hospital. There should be an easy ambulance approach with adequate space  for free passage of vehicles and covered area for alighting patients. 


• Lay out shall follow the functional flow.


• Signage of emergency shall be displayed at the entry of the hospital with  directional signage at key points.


• Emergency shall have dedicated triage, resuscitation and observation area.  Screens shall be available for privacy.


• Separate provision for examination of rape/sexual assault victim should be made  available in the emergency as per guidelines of the Supreme Court.


• Emergency should have mobile X-ray/ laboratory, side labs/plaster room/and  minor OT facilities. Separate emergency beds may be provided. Duty rooms for  Doctors/nurses/ paramedical staff and medico legal cases. Sufficient separate  waiting areas and public amenities for patients and relatives and located in such a  way which does not disturb functioning of emergency services. 


• Emergency block to have ECG, Pulse Oxymeter, Cardiac Monitor with  Defibrillator, Multi-parameter Monitor, Ventilator also. 


• Stretcher, wheelchair and trolley shall be available at the entrance of the emergency at designated area.

Treatment of accident victims without insisting on registration of FIR

There shall be a direction to all the sub-district/sub-divisional hospitals, Special Centres, Primary Health Centres (PHCs’), Community Health Centres, District Hospital, tertiary hospitals to treat the accident victims and other emergency cases without insisting for registration of FIR. We also direct that Army Hospitals and Private Hospitals, Private Clinics shall also render medical assistance to the accident victims /emergency cases as per their Constitutional duty. 

Centre to release special health packages to hill stations

We request the Ministry of Health & Family Welfare, Govt. of India to release the special health package to the hill states to maintain and improve the public health in a phased manner.