Infant Deaths : Rajasthan HC Issues Urgent Directions To Fill Up Shortage Of Medical Staff [Read Order]

In the suo moto proceedings initiated in the wake of deaths of infants in tribal and backward areas of the state, the Rajasthan High Court on Friday issued omnibus directions to address the acute shortage of medical staff.

The division bench of Chief Justice Ravindra Bhat and Justice Dinesh Mehta directed the Government to fill up the vacancies of medical officers in primary health centres in vulnerable and backward areas of the state within four weeks.

Immediate steps for augmenting medical supplies and equipments have also been directed to be taken. The Court also directed to constitute a special District-wise team comprising a senior medical professional, district collector and a social worker to assess and report the levels of hygeine, availability of pure drinking water, toilets etc., in the area.

The suo moto proceedings were taken in 2017 based on news reports about deaths of 90 infants in M G Government Hospital at Banswara.  The Court appointed Advocate Rajvendra Saraswat as amicus curiae in the matter, who made local inspections and site visits to ascertain ground realities. The amicus highlighted that most hospitals were woefully short of staff and in many cases child births were handled by cleaning/labour staff. In many cases, infants and mothers were found to be shockingly malnourished.

The Court called for a report regarding the staff position. The Government report showed nearly 22% shortage of medical officers.

The court held that the right to public health care is an intrinsic and essential component of the right to life. The court also emphasized on Article 47, Directive Principle of State Policy, where it is the primary duty of the State to improve public health also. In support, the bench further cited the Supreme Court judgments like Bandhua Mukti Morcha v. Union of India (AIR 1995 SC 636) and State of Punjab v. Ram Lubhaya Bagga (1998 4 SCC 177). The court also mentioned Paschim Banga Khet Mazdoor Samity v. State of West Bengal (1996 4 SCC 37) where it was held that 'It is no doubt that financial resources are needed for providing these facilities. But at the same time, it cannot be ignored that it is the constitutional obligation of the State to provide adequate medical services to the people'.

The High Court has issued following directions to the Government of Rajasthan :

1. The State is directed to resort to urgent temporary basis appointment, especially in the MO cadre and wherever there is critical staff deficiency. The State should assess the need for its requirement for ensuring that posts of Medical Officer in all PHCs especially in vulnerable and tribal areas are filled at the earliest.

2. The State is also directed to ensure that its competent officials carry out inspection of all PHCs and CHCs in remote and tribal areas, especially TSP areas and based on the needs and the deficiencies noted, take immediate remedial steps towards augmenting equipment, medicines, surgical or other equipment, refrigeration of essential and critical care medication, facilities towards water and also ensuring general cleanliness to eliminate possibility of infection.

3. The above steps should be completed and an overall assessment be made based upon a team if need be many teams constituted by the State for this purpose. The assessment of every PHC's needs and deficiencies and remedial measures should be listed out and compiled in a report. The remedial steps towards ensuring that the deficiencies are removed shall be taken.

4. The Court also directs that the State should constitute Division wise teams comprising of a senior medical professional; one local Collector or some other senior official from the administration and an independent individual (connected with the health-such as doctor or someone from NGO) to inspect, in each division and prepare reports with respect to the following:-

a. Levels of hygiene;

b. Availability of water;

c. Availability of refrigeration facility for essential medication;

d. Availability of sufficient and continuous electricity supply;

e. Cleaning of toilets;

f. Nature of equipment available including medicines and the deficiencies, if any.

5. After receipt of the reports, a comprehensive action plan shall be prepared to aim at: rationalizing the issues of staffing; recruitment and deployment of personnel; optimum utilization of available equipment; allocation of resources; specific consideration of ensuring effective measures for maintaining cleanliness and proper water supply in PHCs, CHCs etc. including examining award of district-wise cleaning contracts rather than locally. The Government should aim at creating a permanent monitoring mechanism to ensure that such shortages are eliminated or minimized and wherever there is a likely vacancy or deficiency, swift and timely action is taken, to prevent tragedies in the future.

Further, the Government of Rajasthan has been directed to file an action taken the report in the form of an affidavit. The said affidavit is to be filed within eight weeks. Accordingly, the matter has been adjourned and is directed to be listed after eight weeks.

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