Maharashtra hospital deaths: State cannot shift public health burden to private hospitals, says Bombay High Court

The Bombay High Court on Friday emphasized that the State government cannot shift the burden of ensuring public health care on to private hospitals..The Court made the observation in response to concerns raised by Advocate General Dr. Birendra Saraf that the burden on State-run hospitals is often increased due to referrals from private hospitals and smaller hospitals.."Patients are brought to public hospitals in an extremely critical situation. There have been 11 to 20 deaths in a day in these hospitals before too. Public hospitals cannot ask people to go away. They try to accommodate everyone. Heavy inflow of patients from private and government hospitals. Private hospitals are not following norms in terms of patient referral. There is burden," Advocate General submitted..The Court, however, that the State government cannot shift its burden to private players."There cannot be a shift of burden on private players. You are the State after all," the Court said..A division bench of Chief Justice Devendra Kumar Upadhyaya and Justice Arif Doctor made the observation while hearing a suo motu public interest litigation initiated in the wake of recent patient deaths in government hospitals at Nanded and Chhatrapati Sambhaji Nagar..The Advocate General today submitted that all medicines and medical equipment required by hospitals had been made available to the patients and had been administered as per protocol. There was no gross negligence that could have lead to the patient deaths, he maintained. "There are issues. There is no denying that. However, it seems that there was no gross negligence by the hospitals. Of course, it is sad what has happened. People have died. Every death is unfortunate," Saraf said..The Court responded by noting that while everything may be available on paper, it was important that everything works, on the ground level."How to strengthen it? Everything is in place on paper. But if it is not there on the ground ... It is about the general condition of healthcare in the State." the Court said..The Court proceeded to peruse preliminary reports submitted by the State government, which indicated that there were vacancies in the post of medical officer. The Court has called for the filling of these vacant posts. "As against 325 sanctioned posts for junior doctors, 273 posts were filled in. As for senior posts, the report also mentions that as against 97 sanctioned posts, only 49 are filled in. For hospitals associated with colleges, the senior and junior residents have responsibilities, and even one empty post cannot be accepted in any situation," the Court recorded in its order. .It also noted that there had been a reduction in the budgetary allocations for public health and medical education. "The decline in the percentage of allocation by State to these departments is visible. AG states that some additional budgetary allocation will be made in supplementary demands," the Court observed. .The Court further expressed concern that the State government had not yet appointed a Chief Executive Officer (CEO) for the authority under the Maharashtra Medical Goods Procurement Authority Act. The judges opined that having a person hold an "additional" charge of CEO is not enough and directed for a regular appointment to be made in two weeks time. "Having regard to the nature of functions the authority is to perform and the functions assigned, we have no hesitation to observe that giving an additional charge of CEO doesn’t meet the requirement in terms of the scheme of the Act. Thus there appears to be burden for want of a full-fledged CEO which we expect shall be done in 2 weeks," the Court ordered.. .The Court also directed the principal secretary of the State Department of Public Health and the Department of Medical Education to file an affidavit setting out details regarding vacancies in hospitals.