In Re The Proper Treatment Of Covid 19 ... vs Unknown

IN THE SUPREME COURT OF INDIA CIVIL ORIGINAL JURISDICTION

SUO MOTU WRIT PETITION (CIVIL) No.7/2020

IN RE : THE PROPER TREATMENT OF COVID 19 PATIENTS AND DIGNIFIED HANDLING OF DEAD BODIES IN THE HOSPITALS ETC.

O R D E R

1. This Court issued notice on 12.06.2020 in this

Suo Motu writ petition with object to notice

deficiencies, shortcomings and lapses in patient care

of Covid-19 in different hospitals in National

Capital Territory of Delhi and other States. The

object was to take remedial action by all concerned

to redeem the plight of patients and other persons

who needs medical care.

2. In response to notice dated 12.06.2020, Union of

India, Delhi Government and other States have filed

their affidavits. Several applications for

intervention have also been filed by different

individuals, organisations highlighting one or other

aspects of the issue.

Signature Not Verified Digitally signed by ARJUN BISHT Date: 2020.06.19 17:51:59 IST Reason: 3. The Union of India in its affidavit after

1 noticing the aberration, which were highlighted by

the Court in its order, have brought on the record

remedial steps taken by Union of India. The affidavit

mentions that on 14.06.2020, a high-level meeting was

held by Hon’ble Home Minister with Lieutenant

Governor of Delhi, Chief Minister of Delhi, Union

Health Minister, Health Minister of Delhi, Mayors and

Commissioners of Delhi’s three Municipal Corporations

to strengthen the strategy to fight the coronavirus.

The affidavit enumerates certain action points which

have emerged in the deliberation. In paragraph 13 of

the affidavit, decision taken by the Union of India

have been referred to. We may notice only few of such

decisions which need to be specifically noticed. In

paragraph 13(ii), following has been stated:-

“13. (ii) It has been further decided that a team of senior doctors from Central Government Hospitals in Delhi, GNCTD Hospitals, Municipal Hospitals and AIIMS shall visit all hospitals in Delhi, within 2 days, to study the arrangements made for patient care and treatment and suggest improvements to be done. The responsibility for implementation of the said decision has been given to the Union Health Secretary to coordinate with Chief Secretary, GNCTD and Director, AIIMS, who would ensure implementation of the said decision.”

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4. In paragraph 13(iv), decision regarding increase

of the testing per day in NCT of Delhi has been

mentioned. It has been stated that by 20.06.2020, the

tests shall be increased up to 18,000 per day. The

decision also refers to the constitution of the

Committee of Dr. V.K. Paul, Member, NITI Aayog,

representative of the AIIMS and representative of

GNCTD who has to report regarding reasonable rates of

various covid related facilities/tests etc. for

private hospitals, labs.

5. We have come to know that the rates of the tests

to be conducted in the private labs is substantially

reduced by the Government of India for which orders

have also been issued. The affidavit also gives

details of guidelines framed by the Union of India to

ensure proper treatment of Covid-19 patients and

dignified handling of the dead bodies in the

hospitals as well as the guidelines framed by the

Union of India pertaining to Covid-19 hospital

management.

6. In paragraph 18, it has been stated that strict

observance and adherence of guidelines shall be

3 ensured. One of the guidelines, whose adherence was

to be ensured, was that the patients are provided

with the bed and are permitted to have one attendant

and the attendant can remain in the hospital premises

in the area earmarked by the hospital and no

suspected Covid-19 patients shall be turned away from

the hospital and details of indoor facilities and

advisory for OPD has also been noticed.

7. The Government of NCT, Delhi has also filed

affidavit of Smt. Padmini Singla, Secretary, Health

and Family Welfare, Government of NCT of Delhi.

Although affidavit gives the details of the

Government hospitals of Delhi, Government designated

Covid hospitals, name of an IAS officer who was

deployed as a nodal officer in all Covid designated

hospitals to monitor and supervise various aspects

and functioning of the hospitals, providing for 24x7

Help desk at each hospital along with display

board/LED Screen to inform the availability of beds

to the general public, details of available manpower

in LNJP hospital, details of public sector labs and

private sector labs. The affidavit also noticed the

decision taken in the meeting chaired by Hon’ble Home

4 Minister on 14.06.2020 to increase the testing

facility in Delhi.

8. We, however, 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. Every organisation, every

individual should be more than ready to know about

shortcomings, lapses and it is only after knowing

one’s shortcomings and deficiencies, remedial actions

can be taken.

9. We impress upon Government of NCT of Delhi to be

more vigilant in knowing about the deficiency and

lapses in functioning of the hospitals and patients

5 care and take immediate & remedial steps to redeem

the miseries of patients, the public who needs

medical care and help.

10. 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. 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. The most important aspect is

continuous supervision and monitoring of Government

hospital in Government of NCT of Delhi and other

States.

11. As noted above, in the meeting dated 14.06.2020

chaired by Hon’ble Home Minister, one of the

decisions taken was that a team of senior doctors

from Central Government hospitals in Delhi, GNCTD

hospitals, Municipal hospitals and AIIMS shall visit

all hospitals in Delhi. One visit in all hospitals of

Delhi is not enough. There has to be constant

6 monitoring, supervision and management.

12. We with the object of continuous supervision and

monitoring of government hospitals, Covid dedicated

hospitals and other hospitals taking care of covid

management issue following directions Nos.(I) to

(IV):-

(I) 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.

(II) 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

7 Covid patients; The Expert Committees shall

ensure that at least one visit in each

hospital be done weekly.

(III) 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.

(IV) We further direct that all 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.

13. An affidavit has also been filed by Director,

LNJP hospital, Government of NCT of Delhi, where in

paragraph 4, it has been stated that CCTV Cameras

have been installed in all the wards. The

installation of CCTV Cameras in all the wards is a

welcome step which shall not only help the hospital

management to immediately find out the requirement of

proper care with regard to patients admitted in the

wards but also ensure transparency in the patients

care in the hospital. In this regard, we issue

following directions as direction Nos. (V) to (VII):

(V) 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.

(VI) In Government hospitals of GNCT, Delhi

which are Covid dedicated hospitals, where

CCTV cameras have not been installed, steps

9 shall be taken to install CCTV Cameras in the

wards.

(VII) The Chief Secretaries of other States

shall also 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.

14. We have noticed above that one of the guidelines

by the Union of India is to permit one attendant of

covid-19 patient. In this regard, we issue following

directions as direction No. (VIII) and (IX):-

(VIII) 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.

(IX) 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.

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15. In the supplementary affidavit dated 17.06.2020

filed on behalf of the Union of India, details of

Covid-19 patients discharge policy of Union of India

has been given. Copy of the revised discharge policy

for Covid-19 dated 08.05.2020 has also been brought

on the record. The revised policy dated 08.05.2020

brought on record does not indicate that necessary

directions have been issued to all States/Union

Territories to communicate it to the concerned

dedicated Covid hospitals and other hospitals to

uniformly follow the discharge policy. We are of the

view that discharge policy framed by the Union of

India has to be followed by all States/Union

Territories uniformly to ensure discharge of the

Covid patients uniformly and to achieve clarity in

the minds of all concerned. We, thus, issue

following direction in this regard:-

(X) 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

11 dated 08.05.2020 with regard to discharge of

different categories of patients as

categorised in the revised discharge policy.

16. We, in our order dated 12.06.2020 has observed:-

“We impress upon the States to ensure that there should be steep increase in the testing both by Government hospitals and private labs and whosoever desires for testing should not be denied on any technical ground or any other ground…………….”

17. We have also noticed in this order that Union of

India has constituted a Committee of Dr. V.K. Paul,

Member, NITI Aayog, representative of the AIIMS and

representative of GNCTD who has to report regarding

reasonable rates of various Covid related

facilities/tests etc. Government of India on the

basis of a report from the said Committee has already

taken a decision for reducing the amount of test in

the NCT Delhi. The Union of India may consider

issuing uniform directions to all the States and

Union Territories with regard to reasonable rates of

various Covid related facilities/test for private

hospitals/labs, which may be made applicable across

the country. If any variations to be made with

regard to any particular State/Union Territory, the

12 same shall be specifically provided for in the

guidelines. We, thus, issue following direction in

this regard:-

(XI) The Union of India may 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.

I.A Nos.55935 & 55936 of 2020

18. Learned counsel for the applicant submits that the

State of Maharashtra has issued an order that a positive

report of the patient shall not be given to the patient

or the relatives of the patient.

19. Mr. Tushar Mehta, learned Solicitor General conceded

that when a report of the patient is positive, the same

shall be given to the patient or his relatives.

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20. We have no doubt that the States and all concerned

shall supply a copy of the report of the patient to him

or his relatives and the hospital.

21. A copy of the applications may also be given to the

learned Solicitor General as well as learned counsel for

the State of Maharashtra.

22. Learned counsel for the State of Maharashtra submits

that the State of Maharashtra has already fixed the rate

of testing as Rs.2200/- and Rs.2800/-, which we feel is

welcome to step-up the number of testing in the State of

Maharashtra. He further submits that every day more than

16000 tests are conducted in the State of Maharashtra.

Learned counsel for the State of Maharashtra submits that

he shall obtain instructions regarding non-giving of the

report to the patient or his relatives. He shall advise

the State to issue an appropriate order permitting

handing of the report to the patient or his relatives and

the hospital.

23. Learned counsel for various intervenors have

submitted that their several suggestions have been

included in the intervention applications. Learned

counsel appearing for the intervenors may give a copy of

the suggestions in writing to the learned Solicitor

14 General as well as to learned counsel for the respective

States for appropriate consideration.

24. A question was posed to Shri Sanjay Jain, learned

Additional Solicitor General appearing for the Delhi

Government about the status of construction of second

trauma centre at Dwarka out of Rupees Sixty Crores

deposited as a fine by the Ansal Brothers (Rupees Thirty

Crores each) in Uphaar Cinema fire tragedy case –

Criminal Appeal No. 597-598 of 2010 vide this Court’s

order dated 22.09.2015. Shri Sanjay Jain submitted that

he will get back on this on the next date of hearing.

25. List the matter in third week of July, 2020.

...................J. [ASHOK BHUSHAN]

...................J. [SANJAY KISHAN KAUL]

...................J. [M.R. SHAH] NEW DELHI;

JUNE 19,2020.

15 ITEM NO.303 Virtual Court 5 SECTION PIL-W

S U P R E M E C O U R T O F I N D I A RECORD OF PROCEEDINGS

SMW(C) No(s).7/2020

IN RE THE PROPER TREATMENT OF COVID 19 PATIENTS AND DIGNIFIED HANDLING OF DEAD BODIES IN THE HOSPITALS ETC. Petitioner(s)

Date : 19-06-2020 This petition was called on for hearing today.

CORAM :

HON'BLE MR. JUSTICE ASHOK BHUSHAN HON'BLE MR. JUSTICE SANJAY KISHAN KAUL HON'BLE MR. JUSTICE M.R. SHAH

Counsel for the parties:

By Courts Motion, AOR

Mr. Tushar Mehta, SG Mr. K.M. Nataraj, ASG Ms. Manisha Lavkumar, Sr. Adv. Mr. Rajat Nair, Adv.

Mr. Kanu Agrawal, Adv.

Mr. Saurab Mishra, Adv.

Mr. B.V. Balram Das, AOR Mr. Gurmeet Singh Makker, AOR Mr. Aniruddha P. Mayee, AOR

Mr. Pukhrambam Ramesh Kumar, Adv. Ms. Anupama Ngangom, Adv. Mr. Karun Sharma, Adv.

Mr. Jayanth Muthuraj, AAG Mr. M. Yogesh Kanna, AOR

Mr. Shivam, Adv.

Mr. Talha Abdul Rahman, AOR

Mr. Anish Kumar Gupta, AOR Ms. Archana Preeti Gupta, Adv. Mr. Chandra Shekhar Suman, Adv. Mr. Avdhesh Kumar Singh, Adv.

Mr. Suhaan Mukerji, Adv. Mr. Vishaal Prasad, Adv. Mr. Amit Verma, Adv.

M/S. Plr Chambers And Co., AOR

16 Mr. Sanjay Jain, ASG Mr. Gurukrishna Kumar, Sr. Adv. Mr. Chirag M. Shroff, AOR

Mr. Sachin Patil, AOR Mr. Rahul Chitnis, Adv.

Applicant-in-person, AOR

Mr. Abhimanyu Tewari, AOR Ms. Eliza Bar, Adv.

Mr. Subhash Chandran K.R., Adv. Mr. Biju P Raman, AOR

Mr. Shashank Deo Sudhi, Adv.

Mr. Udian Sharma, Applicant-in-person

UPON hearing the counsel the Court made the following O R D E R

We have heard Mr. Tushar Mehta, learned Solicitor General,

Mr. Sanjay Jain, learned senior counsel appearing for the NCT of

Delhi, Mr. Sachin Patil, learned counsel appearing for the State of

Maharashtra and learned counsel appearing for the intervenors.

The Hon'ble Court issued certain directions in terms of the

signed reportable order.

List in the third week of July, 2020.

(ARJUN BISHT) (RENU KAPOOR) COURT MASTER (SH) BRANCH OFFICER

(signed reportable order is placed on the file)

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