Full Judgment Text
REPORTABLE
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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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.
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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
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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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