Full Judgment Text
1
REPORTABLE
IN THE SUPREME COURT OF INDIA
2025 INSC 351
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
SATISH KUMAR YADAV
Date: 2025.03.17
18:35:01 IST
Reason:
chemotherapies. This course of treatment was continuing when the
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
1
life guaranteed under Article 21 of the Constitution. 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.
6
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
2
may be required, 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.
7
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.
8
REPORTABLE
IN THE SUPREME COURT OF INDIA
2025 INSC 351
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
SATISH KUMAR YADAV
Date: 2025.03.17
18:35:01 IST
Reason:
chemotherapies. This course of treatment was continuing when the
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
1
life guaranteed under Article 21 of the Constitution. 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.
6
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
2
may be required, 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.
7
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.
8