In March 21, 2023, Rajasthan became the first state to pass the Right to Health Bill in the state assembly. The Bill entitles every resident of the state to avail free of cost Out Patient Department (OPD) and In Patient Department (IPD) services in all public health facilities. Along with this, similar health services will be provided free of cost at selected private hospitals.

Responding to a debate on the Bill, state health minister Parsadi Lal Meena said the government is committed to provide health facilities to the people of the state and the Bill is in public interest. The minister said that complaints have been received that despite having the Chiranjeevi card, some private hospitals do not treat patients under the Chiranjeevi Health Insurance Scheme, and hence the Bill is being brought. 

The Bill was introduced in the assembly in September last year, but was sent to a select committee. The committee gave its report, and accordingly the Bill was amended and passed on March 21. 

The law states that a patient during emergency treatment such as accidents, or any other emergency decided by the state health authority, will be treated without prepayment of requisite fee. Any person who knowingly contravenes any provision of the law, or any rule made thereunder, shall be punishable with a fine of up to Rs 10,000 for the first contravention and Rs 25,000 for subsequent contraventions.

In this law, the state aims to provide protection and fulfil rights and equity in health and well-being under Article 47 of the Constitution as well as secure the right to health as per the expanded definition of Article 21 in the Constitution. The law also ensures free access to as well as equality in healthcare for all residents of the state, with a gradual reduction in expenditure incurred in seeking, accessing or receiving healthcare.

The Rajasthan model of public health may push the state into an era of improved public health, as every resident of the state is entitled to enjoy the highest attainable standards of physical, mental, intellectual and social wellbeing, which is conducive to living a life of dignity. The right to health is an inclusive right, extending not only to timely healthcare, but also to the underlying socio-economic, cultural and environmental wellbeing.

According to the law, every person in Rajasthan shall have the following rights:

(a) to have adequate, relevant information about the nature, cause of illness, proposed investigations and care, expected results of treatment, possible complications and expected costs.

(b) to avail free OPD services, IPD services consultation, drugs, diagnostics, emergency transport, procedure and emergency care provided by all public health institutions according to their level of healthcare as may be prescribed by rules made under this law.

(c) to have emergency treatment and care under any emergent circumstances, without prepayment of requisite fee or charges, including prompt and necessary emergency medical treatment and critical care, emergency obstetric treatment and care by any healthcare provider, establishment or facility, including private provider, establishment or facility, qualified to provide such care or treatment without delay, and in a case of medico-legal nature, no healthcare provider or healthcare establishment shall delay treatment merely on the grounds of receiving police clearance or a police report.

As per the law, the State Health Authority shall carry out the following functions:

(a) to advise the government on any matter concerning public health, including preventive, promotive, curative and rehabilitative aspects of health and occupational, environmental, and socio-economic determinants of health;

(b) to formulate state health goals and get these included in the mandate of Panchayati Raj Institutions and urban local bodies;

(c) to formulate state level strategic plans for implementation of right to health as provided under this law, including action on the determinants of healthy food, water and sanitation.

The law also deals with meetings of the State Health Authority. It says:

(1) The State Health Authority shall meet at least once in six months, by giving such reasonable advance notice to its members and shall observe such rules of procedure regarding the transaction of business at its meetings as may be prescribed by rules made under this law—provided that if, in the opinion of the chairperson, any business of an urgent nature is to be transacted, he may convene a meeting of the Authority at such time as he thinks fit.

(2) The meetings of the Authority and the mode of transaction of business at such meetings, including quorum, etc., shall be governed by such regulations as may be prescribed by rules made under this law.

The state government shall constitute an independent body such as District Health Authority, within one month from the date of constitution of the State Health Authority. The District Health Authority shall carry out the following functions:

(a) ensure implementation of the policies, recommendations and directions of the State Health Authority;

(b) formulate and implement strategies and plans of action for the determinants of health, especially food, water, sanitation, and environment;

(c) formulate a comprehensive written plan for prevention, tracking, mitigation, and control of a “public health emergency”, as well as situations of “outbreak” or “potential outbreak” in the district based on state’s plan;

(d) coordinate with the relevant government departments and agencies to ensure availability and access to adequate and safe food, water and sanitation throughout the district;

(e) organize hearing of the beneficiaries coming to the hospital once in three months with a view to improve the healthcare services.

The law also says that the state government shall prescribe a Grievances Redressal Mechanism, within six months from the date of commencement of this law. The powers of the State Health Authority and District Health Authority are:

(1) For purposes of carrying out the inquiry under this law, the State Health Authority or District Health Authority, as the case may be, may nominate one or more persons or committees, in the prescribed manner, for the efficient discharge of its functions.

(2) The State Health Authority or District Health Authority, as the case may be, shall have the power to require any person to furnish information on such matters as may the subject matter of the inquiry and any person so required shall be legally bound to furnish such information.

(3) The State Health Authority or District Health Authority, as the case may be, or any other officer authorized in this behalf by the State Health Authority or District Health Authority, as the case may be, enter in any building or place where the State Health Authority or District Health Authority, as the case may be, has reason to believe that any document relating to the subject matter of an inquiry may be found in such building or place and may seize any such document or take extracts or copies thereof:

Provided that the State Health Authority, District Health Authority or any officers authorized by it, as the case may be, shall follow the provisions of Section 100 of the Code of Criminal Procedure, 1973, while acting under this subsection.

Regarding appeal, any person aggrieved by an order of the District Health Authority passed under the provisions of this law may file an appeal in the prescribed manner to the State Health Authority within 30 days from the date of the order.

As regards jurisdiction, no civil court shall have the jurisdiction to entertain any suit or proceeding in respect of any matter which the State Health Authority or District Health Authority, as the case may be, constituted under this law is empowered by or under this law to determine.

The law also deals with the power of state government to make rules. It says:

(1) The State Government may, by notification in the Official Gazette, make rules to carry out the provisions of this law.

(2) Every rule made under this law shall be laid, as soon as may be after it is so made, before the House of the State Legislature, while it is in session, for a period of not less than fourteen days which may be comprised in one session or in two or more successive sessions and if before the expiry of the session in which it is so laid or of the sessions immediately following, the House of the State Legislature makes any modification in the rule or resolves that the rule should not be made, the rule shall thereafter have effect only in such modified form or be of no effect, as the case may be, so, however, that any such modification or annulment shall be without prejudice to the validity of anything previously done thereunder. 

Health is defined as a condition of complete physical, mental and social prosperity and not only the occurrence of disease. In several cases, courts have accentuated health inside the ambit of life and freedom under Article 21 of the Constitution. The Constitution expects states to make every possible effort, within available resources, to realize the right to health. Human rights are interdependent, indivisible and interrelated and thus, violating the right to health may often impair the enjoyment of other human rights, such as the rights to education or work.

Although, Rajasthan is running popular schemes like Mukhyamantri Chiranjeevi Swasthya Bima Yojana, Rajasthan Government Health Scheme, apart from regular budget allocated to run medical colleges, associate hospitals, district and sub-district hospital, community health centres, primary health centres and sub-centres, the government desires to establish legal rights of citizens of the state to avail best of health services.

Therefore, to enhance effectiveness and implementation of the Rajasthan model of public health, the state government proactively decided to bring a legislation to safeguard the right to health. The law ensures duties of residents and also provides for a strong grievance redressal mechanism. 

—By Adarsh Kumar and India Legal Bureau

The Delhi High Court on Monday sought response from the North Delhi Municipal Corporation upon a plea alleging erection of Fixed Compactor Transfer Station (FCTS) for installation of garbage compactors within the premises of a school situated in Delhi’s Jahangir Puri.

The Division Bench comprising Acting Chief Justice Vipin Sanghi and Justice Navin Chawla while issuing notice in the matter, directed the Corporation to neither setup nor operate the FCTS within the premises of the school located in Block J, Jahangir Puri.

The Bench noted that: 

“It goes without saying that any such exercise within the school premises would be contrary to the permitted use of the area as also be a cause for hazard to the children studying in the school.”

The matter is slated for further hearing on September 2, 2022.
The instant public interest litigation has been filed by Advocate Mahavir Sharma, on behalf of local residents of the Block J, Jahangir Puri.

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The petitioners have approached the High Court being aggrieved by the construction of FCTS for installation and use of garbage compactors within the playground of Municipal Primary School situated in the area.

The plea averred that the alleged act is against the welfare of children inasmuch as the same will expose them to toxic waste and harmful gases which will be released from such garbage compactors and is likely to impact the health as well as the life span of children studying in the said school.

The plea stated that the petitioners have made a representation to the sitting Councilor in March, 2022, seeking a restraint on the construction of FCTS in the school premises, however no action has been taken upon the representation.
Seeking a direction to the Corporation to stop the construction of alleged garbage compactor in the school premises, the plea averred thus-

“Right to Health is an inherent and inescapable part of a dignified life and depriving the future of India of good hygiene conditions and fresh air, these children are being deprived of the fundamental right to life.”

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A Public Interest Litigation (PIL) has been filed in the Supreme Court seeking direction to the Central Government to frame stringent and effective rules regulations and guidelines to control population explosion in order to secure the important fundamental rights viz. right to clean air, right to clean water, right to health, right to peaceful sleep, right to shelter, right to livelihood, right to education, and right to dignity.  

The PIL filed by Social Activist Amber Zaidi through Advocate Ashwani Kumar Dubey also seeks direction to the Center to ascertain the feasibility of making Two-Child Norm as a mandatory criterion for government jobs, aids, subsidies, right to vote, right to contest, and right to free shelter, etc and to declare First Sunday of every month as ‘ Population Control Day in place of ‘ Polio Day ‘ to spread awareness on population explosion and provide contraceptive pill, condoms, vaccines, etc. to EWS and BPL families, with polio vaccines.  

In the alternative, the PIL seeks direction from the Law Commission of India to examine population control laws and policies of the developed countries and prepare a comprehensive report within three months.

According to the Petition,  on 12.12.2020   in a written reply in Top Court, Health Ministry said that the Center is against forcing family planning and won’t take coercion action. It is necessary to state that “Population Control and Family Planning” is part of List – III of Seventh Schedule ( Entry 20A ) hence Center can make stringent rules – regulations to control population explosion but it has not taken appropriate steps to enact a stringent law till date.  

The Petitioner submitted that the injury caused to citizens’ particularly women is extremely large.  The perils of population explosion on the economy and its ramifications are often discussed.  But, the impact that repeated childbearing has on a woman is seldom highlighted outside the niche areas.  

“Incidence of grand multiparity, which is defined as more than 4 viable births, in developing countries like India is 20 % while it is only 2 % in developed countries.  The ill effects of repeated pregnancies both on the women and the newborns are devastating.  In India, malnutrition – anemia is rampant in expecting mothers. This becomes worse with repeated pregnancies jeopardizing their health and leading to further adverse pregnancy outcomes.  There is an increased risk of abortions also in such mothers.  Mothers become more prone to infections with repeated pregnancies”, the Petition alleged.

It is argued that the risk of complications during delivery such as cord prolapse, post-dated pregnancy, labor induction, instrumental deliveries, assisted vaginal deliveries and cesarean sections are also higher.  Grand multiparity is itself a risk factor both for antepartum hemorrhage that is bleeding before the onset of labor and postpartum hemorrhage, which is increased bleeding after childbirth.

The Petition stated that such women also suffer from more genital tract injuries including rupture of the uterus sometimes leading to hysterectomy ( surgical removal of the womb ).  Overall it results in mothers having a longer stay in the hospital, more blood transfusions, more frequent admissions to Intensive care units ( ICU ), and even increased deaths.  The harmful effects of multiple pregnancies are seen not only in mothers but also in babies who are born to such mothers.  These babies may be premature, or of low birth weight ( < 2.5 kg ), and may have poor outcomes as indicated by low “Appearance, Pulse, Grimace Activity, and Respiration.” (APGAR0  score.  

“Sometimes they have a large fetal size that leads to increased birth trauma.  There is also an increased incidence of congenital anomalies in such babies.  More newborns need admissions to ICU arising due to fetal distress, abnormal CTG, or sometimes even stillbirths and increased perinatal mortality “, said the Petition

It is highlighted in the PIL that the deleterious effects of multiple pregnancies are not only limited to the said medical conditions.  These women spend the most productive – active years of their lives performing the task of childbearing and breastfeeding.  With a lesser number of children, they can pursue their hobbies, dreams and may be able to move towards a better quality of life.  A decreased pregnancy load would not only help them achieve their full potential but can also lead to the upliftment of their families.  

The Petitioner mentioned that In order to maintain a higher standard of living people prefer to have a small family.  According to the survey, those who earn less than Rs.  100 per month have on average a reproduction rate of 4 children and those earning more than Rs.  300 per month have a reproduction rate of 3 children._Self – control is the best powerful method to control the population.  It is an ideal and healthy approach and people should be encouraged to follow._It helps in reducing the birth rate.  This method implies family by choice and not by 1 chance.  By applying preventive measures, people can regulate the birth rate.  This method is being used extensively;  The success of this method depends on the availability of cheap contraceptive devices for birth control.  The birth rate will likely to fall if there are different recreational facilities – cinema;  theater, sports, dance, etc. are available to people.

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“It is indeed heartening that India’s population growth has come down.  However, a strong and effective population control law on the lines of China is the need of the hour.  More emphasis needs to be laid on women’s education and health.  They are the foundation for future generations.  If they are physical – mentally fit, confident independent, they can bring a paradigm change in the society”, read the Petition.

It is pertinent to note that in June last this year a Public Interest Litigation has been filed in the Apex Court by Firoz Bakht Ahmed, Chancellor of Maulana Azad National Urdu University, seeking direction to the Union of India to frame effective rules regulations, and guidelines to control population explosion and to ascertain the feasibility of making Two-Child Law as a criterion for government jobs, aids and subsidies, right to vote, right to contest, right to property, right to free shelter, etc.

Earlier, the Supreme Court has allowed a plea to make the Ministry of Health and Family Welfare a party to a PIL that has sought certain steps, including the two-child norm, to control the country’s growing population. A bench of Justice Sanjiv Khanna passed the directions on May 7 on the plea filed by BJP leader and lawyer Ashwini Kumar Upadhyay.

The Delhi High Court on Wednesday issued notice to the Centre and Delhi Government on a plea seeking directions to treat all persons with disabilities that qualify as per the Rights of Persons with Disabilities Act, 2016 on priority basis for administering Covid-19 vaccine irrespective of their age.

A division bench of Chief Justice D.N. Patel and Justice Jasmeet Singh issued notice to the Government of NCT of Delhi in the petition filed by the petitioner as a Public Interest Litigation seeking directions to the Respondents to treat persons with disabilities on priority basis and to make special provisions for them for administering the vaccine for Covid-19, in terms of the mandate under Section 25 (1) and Section 8 of the Rights of Persons with Disabilities (“RPWD”) Act, 2016.

This petition is filed by two petitioners with physical disability. They submitted that it is a well-established principle that the right to life under Article 21 of the Constitution of India includes the right to health. And according to Article 14, treating persons with disabilities at par with persons without disabilities is a violation of the right to equality as well as right to life of persons with disabilities.

The counsel for these petitioners has submitted before the Court that persons with disabilities are more vulnerable to contracting the virus, as they are unable to follow measures such as social distancing, if they need care-takers, or wearing a mask, such as for persons with cerebral palsy, autism or any developmental disability.

The petitioners submitted that persons with disabilities face more severe symptoms and a higher mortality rate due to Covid-19 compared to other persons.

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They drew the attention of the bench on the issue that the persons with disabilities depend upon medical assistance which has been strained during the pandemic and therefore they suffer from poorer health during the pandemic, whether or not they are infected with Covid-19. The Court will hear the matter on May 24.

New Delhi: The Supreme Court today dismissed a plea challenging the CBSE’s decision to hold compartment exams for class X and XII students amid the COVID 19 pandemic.

A three-judge bench of Justices A.M. Khanwilkar, Dinesh Maheshwari and Sanjiv Khanna was hearing a petition filed by 808 students who had submitted that the decision to conduct the compartment exam is in sheer violation of the Right to Health which is part of Right to Life enshrined in the Constitution of India, as it fails to consider the principles of health, safety, fair and equal opportunity for students.

The petitioners further pointed out “that in view of unprecedented health emergency and rising numbers of the COVID 19 cases in the country, the conduct of compartment examination will expose the examinees to a great risk and will undeniably sacrifice basic principle of integrity by neglecting equal basis and treatment to all examinees.”

It had also been submitted that the conduct of compartment examinations will also expose lakhs of students across the country to the exponential risk of being exposed to the virus.

The petitioners further submitted that the decision taken by CBSE is itself flawed and is in complete disregard to the MHA guidelines of July 29.

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The petitioners also prayed for alternatives system of evaluation to be formulated so as to exclude possibility of discrimination, disadvantage and risk of life.

– India Legal Bureau