Supreme Court: The 3-judge bench of Ashok Bhushan, SK Kaul and MR Shah, JJ has issued detailed directions in the matter relating to deficiencies, shortcomings and lapses in patient care of Covid-19 in different hospitals in National Capital Territory of Delhi and other States where the Court had taken suo motu cognizance on the basis of media reports and programmes aired in several channels presenting horrific scenes from LNJP hospital, which is a COVID-19 dedicated hospital.

The Court had, on June 12, 2020, issued notice to all States and Union Territories seeking Status report with regard to Government hospitals, patient care and the details of the staff, infrastructure, etc.

On the affidavit filed by Delhi Government, the Court noticed that in the entire affidavit, apart from general statement that all steps are being taken, the affidavit does not indicate any mechanism for proper supervision of the functioning of the hospital and steps for improvement. The affidavit tries to give an impression to the Court that everything in the Government hospital in NCT, Delhi is well and all steps are being taken by the Government of NCT of Delhi.

“When the Government does not endeavour to know any shortcomings or lapses in its hospitals and patient care, the chances of remedial action and improvement becomes dim.”

The Court further, said that the necessary guidelines on all aspects of patients’ care, hospital management, testing, infrastructure are in place as has been highlighted by Union of India in its affidavit. However, the main concern is the faithful and strict implementation of the said guidelines which can be only ensured by constant supervision, monitoring and taking remedial steps with regard to improvement of infrastructure, staff, facilities, etc.

DIRECTIONS ISSUED

On reasonable rates for COVID related facilities/test etc

  • Centre should issue appropriate guidelines/directions to all the States/Union Territories with regard to prescribing reasonable rates of various COVID related facilities/test etc., which need to be uniformly followed by all concerned. In case, with regard to any particular State/Union Territory, there is any difference, the same may be specifically noticed and directed accordingly.

On continuous supervision and monitoring of government hospitals, Covid dedicated hospitals and other hospitals taking care of covid management

  • The Ministry of Health and Family Welfare, Union of India, shall constitute Expert Committees consisting of

a) Senior Doctors from Central Government hospitals in Delhi,

b) Doctors from GNCTD hospitals or other hospitals of Delhi Government,

c) Doctors from All India Institute of Medical Sciences, d) Responsible officer from Ministry of Health and Family Welfare.

  • The Expert Committee shall inspect, supervise and issue necessary directions to all Government hospitals, Covid hospitals and other hospitals in NCT of Delhi taking care of Covid patients. The Expert Committees shall ensure that at least one visit in each hospital be done weekly.
  • The above team may in addition to normal inspection shall also conduct surprise visits to assess the preparedness of the hospitals. The expert team as indicated above after visiting may issue necessary instructions for improvement to the hospital concerned and also forward its report to the Government of NCT of Delhi and the Union of India, Ministry of Health and Family Welfare.
  • States shall also constitute an expert team of Doctors and other experts for inspection, supervision and guidance of Government hospitals and other hospitals dedicated to Covid-19 in each State who may inspect, supervise the hospitals in the State and issue necessary directions for the improvement to the concerned hospital and report to the Government. Chief Secretary of each State shall ensure that such Committees are immediately constituted and start their 8 works within a period of seven days.

On transparency in patient care

  • Footage from the CCTV Cameras shall be made available by the hospitals in NCT of Delhi to the inspecting/supervising expert team or to any other authority or body as per directions of the Union of India, Ministry of Health and Family Welfare for screening the footage and issuing necessary directions thereon.
  • The Chief Secretaries of all States shall take steps regarding installation of CCTV Cameras in COVID dedicated hospitals where COVID patients are taking treatment to facilitate the management of such patients and for the screening of the footage by designated authorities or bodies so that remedial action may be suggested and ensured.

On permitting attendant for COVID-19 Patient

  • All COVID-dedicated hospitals shall permit one willing attendant of the patient in the hospital premise, who can remain in an area earmarked by the hospital
  • All COVID dedicated hospitals shall create a helpdesk accessible physically as well as by telephone from where well-being of patients admitted in the hospitals can be enquired.

On Discharge Policy

  • The Union of India, Ministry of Home Affairs may issue appropriate directions in exercise of power under Disaster Management Act, 2005 to all States/Union Territories to uniformly follow the revised discharge policy dated 08.05.2020 with regard to discharge of different categories of patients as categorised in the revised discharge policy.

The Court will now take up the matter in the third week of July.

[IN RE THE PROPER TREATMENT OF COVID 19 PATIENTS AND DIGNIFIED HANDLING OF DEAD BODIES IN THE HOSPITALS ETC, 2020 SCC OnLine SC 530 , order dated 19.06.2020]

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