Siddharth Dalmia vs Union Of India

REPORTABLE 2025 INSC 351 IN THE SUPREME COURT OF INDIA

CIVIL ORIGINAL JURISDICTION

WRIT PETITION (C) No. 337 of 2018

SIDDHARTH DALMIA & ANR. … PETITIONERS

Versus

UNION OF INDIA & ORS. … RESPONDENTS

J U D G E M E N T

SURYA KANT, J.

1. The instant Writ Petition, under Article 32 of the

Constitution, has been filed purportedly in public interest. The

petitioners seek to restrain private hospitals from compelling the

patients to purchase medicines/devices/implants/consumables from

the hospital pharmacies only, where they allegedly charge

exorbitant rates, as compared to the notified market prices of

those items.

2. The aforesaid relief has been sought in the backdrop of

an unfortunate personal experience. The mother of petitioner No.1,

who was the wife of petitioner No. 2, was diagnosed with breast

cancer in July 2017. She underwent surgery, followed by six

chemotherapies, 20 sessions of radio therapy, and 17 adjuvant Signature Not Verified Digitally signed by chemotherapies. This course of treatment was continuing when the SATISH KUMAR YADAV Date: 2025.03.17 18:35:01 IST Reason:

instant petition was filed in 2018. During the hearing, we were

informed that, Smt. Neelam Dalmia, the patient recovered and 2

fortunately, her condition has improved.

3. The petitioners claim to have realized during her

treatment that there is an organized system adopted by the private

hospitals, nursing homes, health care institutions, etc. to fleece

patients by compelling them and their attendants to buy medicines

only from the pharmacies run by such hospitals or with whom they

have some form of collaboration. It is claimed that the

medicines/treatments etc. are sold by these pharmacies at highly

inflated artificial prices, as compared to the MRP notified by the

Competent Authority.

4. The petitioners have further alleged that the Union of

India and the States have failed to take regulatory and

correctional measures as a result of which, the patients are being

exploited throughout the country.

5. Moreover, it is the case of the petitioners that the

private hospitals do not disclose the prices/MRP of medicines,

medical devices/implants, consumables, etc. to their patients, and

in the absence of any price controlling or monitoring of the

consumables which do not fall within the definition of “drugs”,

under the Drugs and Cosmetics Act, 1940, the private hospitals,

nursing homes, etc. take undue advantage of the fact that the

patients or their attendants do not have much option but to

purchase the items/medicines at inflated prices.

6. The petitioners, accordingly, seek a direction to the

private hospitals not to compel the patients to buy the medicines,

etc. from the pharmacies recommended by them. They further seek a

direction that the Union of India or the State Governments should 3

formulate a policy to prevent this form of exploitation, which, if

allowed to continue, would amount to the deprivation of their right

to a healthy life guaranteed within the framework of Article 21 of

the Constitution. It is the petitioners’ case that the States are

obligated, in terms of Articles 38, 39 and 47 of our Constitution,

where the Directive Principles of State Policy expect them to come

forward and introduce such regulatory measures as may be required

to control this menace.

7. On 14.05.2018, notice was issued in the petition, and in

response thereto, counter affidavits have been filed by the

States/Union Territories of Chandigarh, Orissa, Chhattisgarh,

Arunachal Pradesh, Manipur, Andaman and Nicobar Islands, Uttar

Pradesh, Bihar, Tamil Nadu, Kerala, Uttarakhand, Punjab, Haryana,

Rajasthan, Nagaland, Himachal Pradesh, Jammu and Kashmir, and

Gujarat.

8. The Union of India, through the Ministry of Health and

Family Welfare, has also filed a separate counter affidavit, inter

alia, pointing out that the National Council for Clinical

Establishments has issued minimum standards for the hospitals,

including for pharmaceutical services, as per which, the

availability of drugs, consumables, and medical services are

ensured in hospitals. The Union of India has further taken a stand

that there is no compulsion for the patients or their attendants to

buy medicines from the hospital’s own pharmacy.

9. The States and Union Territories, while questioning the

locus of the petitioners have, inter alia, pointed out that Jan

Aushadhi Kendras and Amrit Drug Stores have been set up in 4

Government hospitals, which are being run by public sector

undertakings, where all medicines are provided at subsidized rates.

They rely upon the Drug Price Control Order, 2013, issued by the

Central Government under the Essential Commodities Act, 1955

whereunder the prices of the essential drugs are fixed to ensure

their availability at a reasonable rate. Like the Union of India,

most of the States have also referred to the National

Pharmaceutical Pricing Authority (NPPA), under the Ministry of

Chemicals and Fertilizers, which, according to them, has the

mandate to fix/revise the prices of controlled bulk drugs and

formulations to enforce prices and availability of the medicines in

the country.

10. We may hasten to add that most of the States have also

highlighted State-run-schemes, which are meant to ensure the

availability of drugs, consumables, and medical services to the

patients and their attendants at affordable prices. Some States

have introduced cashless treatment schemes, especially to provide

medical facilities to specially-abled persons, widows, and BPL

card-holders.

11. We have heard learned counsel for the petitioners as well

the counsels for the Union of India and other States.

12. The issues that fall for consideration are: (i) whether

the affairs of the private hospitals, nursing homes, medical

institutes, etc. with reference to the fixation of prices of drugs,

equipment, or other accessories sold from the pharmacies run by

them and/or with whom they have some commercial agreement, can be

regulated through administrative or legislative measures? (ii) If 5

so, what can be the extent of such measures? and (iii) What is the

mechanism to enforce such measures and to whom such task can be

entrusted?

13. There can be no doubt that the provision of medical

facilities to one and all is an essential component of the right to

life guaranteed under Article 21 of the Constitution.1 The States

have, therefore, committed themselves to provide medical facilities

to the people in furtherance of the duty and vision enshrined in

Part IV of the Constitution. It is also a matter of record that in

proportion to the population of this country, the States have not

been able to develop the requisite medical infrastructure to cater

to the needs of all kinds of patients. The States have, therefore,

facilitated and promoted private entities to come forward in the

medical field as a result of which, numerous renowned private

hospitals, well-known for their specialties, and which are

comparable to any other hospital around the globe, have been set up

throughout the country. It, therefore, must be acknowledged that

not only the people, even the States look towards these private

entities to provide basic and specialized medical facilities to the

public at large.

14. In this backdrop, would it be prudent for the Union of

India or the States to introduce a policy which regulates each and

every activity within the compound of these private hospitals?

Will such a policy discourage persons to come forward and invest in

the health industry throughout the country? Most importantly, why

1 State of Punjab v. Ram Lubhaya Bagga, (1998) 4 SCC 117; Paschim Banga Khet Mazdoor Samity v. State of W.B., (1996) 4 SCC 37; Vincent Panikurlangara v. Union of India, (1987) 2 SCC 165.

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should the States not adopt such economic policies whereunder they

ensure dedicated apportionments towards the development of basic

infrastructure, including institutions for health services; and

till such time the States are able to do so, whether stringent

measures which would stall private entities from coming forward,

should be allowed to be introduced?

15. All these issues are undoubtedly of paramount public

importance. It, however, seems to us that such issues primarily

involve policy decisions, for which the policy-makers are the best

equipped to take a holistic view and formulate the guidelines as

may be required,2 to safeguard the patients or their attendants

from exploitation while simultaneously, ensuring that there is no

discouragement and unreasonable restriction on private entities

from entering the health sector.

16. It may be noticed that the subject of public health and

sanitation, hospitals, and dispensaries falls under List-II – the

State List – and, therefore, any such measure, as illustrated

above, must be taken by the State Governments, keeping their local

conditions in mind.

17. To sum up, it may not be advisable for this Court to

issue mandatory directions which may hamper the growth of hospitals

in the private sector; but parallelly, it is necessary to sensitize

the State Governments re: the problem of unreasonable charges and

exploitation of patients in private hospitals.

2 In Re : Section 6A of the Citizenship Act 1955, 2024 SCC OnLine SC 2880; Suman Kumar v. Union of India, 2023 SCC OnLine SC 1750; Transport & Dock Workers Union v. Mumbai Port Trust, (2011) 2 SCC 575; Govt. of A.P. v. N. Subbarayudu, (2008) 14 SCC 702.

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18. Consequently, we dispose of this Writ Petition with a

direction to all the State Governments to consider this issue and

take appropriate policy decisions as they may deem fit.

19. It is clarified that we have not expressed any opinion on

the merits of the case. We have only briefly explained the plight

of the public at large, who comprise a huge class of consumers of

health services, alongwith the constitutional framework within

which such policy decisions are required to be taken to redress

their grievances.

20. As a result, the pending interlocutory applications, if

any, also stand disposed of.

....................…….....J. (SURYA KANT)

..............……......………...J. (NONGMEIKAPAM KOTISWAR SINGH)

NEW DELHI;

MARCH 04, 2025.

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