New Delhi: The Gujarat High Court came down heavily on the state government for the “pathetic” condition of the Civil Hospital in Ahmedabad, calling it “as good as a dungeon, may be even worse”. The hospital is the main government Covid-19 facility in the state.
Hearing a suo motu PIL Friday, the bench comprising Justice J.B. Pardiwala and Justice Ilesh J. Vora lambasted Additional Chief Secretary Pankaj Kumar, Secretary Milind Torwane and Principal Secretary, Health and Family Welfare, Jayanti Ravi, who had been placed in charge of the Civil Hospital.
The court noted that out of total 625 deaths in Gujarat, 570 had been recorded until 20 May in Ahmedabad city alone. Out of these 570 deaths, 351 were recorded in the Civil Hospital.
“The Civil Hospital contributes to 62 per cent of the total deaths,” the high court said.
It then asked if Gujarat Health Minister Nitin Patel and Chief Secretary Anil Mukim had “any idea” about the problems faced by patients and staff.
The court also asked if the government was aware “of the hard fact that the patients at the Civil Hospital are dying because of lack of adequate number of ventilators”.
Several directions were issued to the state government by the court, which also asked authorities to revert to the bench with “some positive feedback”. The court has warned that it would conduct a video conference with doctors at the facility if it finds the state’s response unsatisfactory.
Additionally, the court urged the state government to start taking help from “trustworthy” NGOs, volunteers and charitable institutions in battling the pandemic.
The court also addressed the issue of migrant labourers and directed railway authorities to either waive off one-way train fare or let the state government bear the charges.
The matter has been posted for next hearing on 29 May, with a direction to the state government to file an “exhaustive report” by 28 May, on the directions and suggestions given by the bench.
Action against private hospitals
The high court rapped private facilities which had refused to admit Covid-19 positive patients, despite an understanding with the state government to do so.
It has directed the state government to initiate legal proceedings against private/corporate hospitals “who are not ready and willing to honour the understanding arrived at with regard to treating the Covid-19 patients, including those who are not agreeable or willing to cooperate and enter into an MoU”.
The bench asked the state government to initiate prosecution against all these hospitals under Section 188 (disobeying public servant’s order) of the Indian Penal Code and provisions of the Disaster Management Act.
The court directed the state government to take 50 per cent beds in all multi-specialty private and corporate hospitals in and around the city, so that Covid-19 patients can get better treatment and ventilator support.
The government has also been asked to negotiate the rates for treatment of Covid-19 patients with private hospitals, noting that their charges were “on a higher side”.
Taking note of the Ayushman Bharat scheme, it also ordered the state government to explore the possibility of extending it to private hospitals “after taking care that there is no undue benefit or malpractice”.
“We do not want the government to now plead before such private / corporate hospitals with folded hands,” it observed.
The court asserted that it would be “utterly shameful” on the part of such private hospitals “to shy away from this responsibility at this point in time, when the country and its people need them the most”.
“At least in times like these when men and women and children are dying alone, we expect the private hospitals to be the giver of life and not the harbinger of death. We expected them to open their doors graciously for the people of their city and provide the best possible treatment at a reasonable price in this time of crisis,” it observed.
The bench also made a reference to the movie Titanic, saying that “in these unprecedented times of chaos, uncertainty and extreme stress”, we should be like Carpathia, the ship that rescued 750 passengers from the ill-fated RMS Titanic which sank in the North Atlantic Ocean in 1912.
The court’s directions came after it was informed by the state government that several private hospitals have not complied with the requisition order passed by the municipal corporation for treating Covid-19 patients and the MoU entered with them, leading to 19 such hospitals being issued a notice on 19 May.
A list of designated Covid-19 hospitals in Ahmedabad was issued by the corporation. While this included over 40 hospitals, the court noted that some of these hospitals have not yet begun treating Covid-19 patients by citing the fact that they were treating non-coronavirus patients.
The court also asked why eight hospitals like Apollo, Zydus, and Asia Colombia in a few areas in Ahmedabad were not in this list. It sought to know whether any talks were initiated with them.
“The management of all these hospitals should have come forward on their own to render treatment to the Covid-19 patients in this critical hour of crisis,” it said.
The court then asserted that the state government should initiate talks with these hospitals, as they are capable of admitting thousands of patients.
“In such circumstances, all the eight hospitals named above are not only morally responsible, but are also legally obliged to agree to reserve 60 per cent beds for the treatment of Covid-19 patients,” it added.
Covid-19 control centre, tests for healthcare workers
In another set of directions, the court ordered the government to set up a computerised Covid-19 control centre “on war footing” to collate real time information on each medical facility.
This centre should be accessible to the public, so that people can contact it for any assistance and don’t have to run from one hospital to the other for admission.
It also directed the state government to make sure that all private clinics, hospitals and nursing homes which had been shut by their owners during the lockdown should now begin functioning to provide medical facilities to non-coronavirus patients.
Private hospitals have been asked to not demand fees in advance from patients and recover the amount later if her or his PAN card details reveal that the patient is capable of making the payment.
The state government has been directed to immediately procure testing kits so that labs in private hospitals can carry out Covid-19 tests at government rates.
The government has further been asked to provide high quality N95 masks, sanitisers, sterile and non-sterile gloves, PPE kits, ventury and high flow oxygen masks, ventilator tubings, filters and similar items to all the Covid-19 facilities at its own expense.
Besides, all healthcare workers are to be tested at regular intervals. “The society is safe only if they are safe,” it said.
A doctor’s ‘anonymous letter’
The court also took note of an “anonymous letter” from a resident doctor at the Civil Hospital which had highlighted “mismanagement” at the facility. The physician, in the letter, claimed to have tested Covid-19 positive earlier this month, but had a negative report after a few days of isolation.
He alleged that despite him and a few others testing positive, their contacts weren’t traced and they were instead “criticised” for getting their tests done.
The letter pointed out other lapses in the hospital’s functioning and their management of Covid-19 patients. It said if the situation remains the same, “doctors working here will be super spreaders of Covid-19”.
The court therefore directed improvement of the working conditions of resident doctors, increase in the number of ventilators and oxygen beds, and fixation of accountability of senior officers “who have failed to improve the healthcare” in the Civil Hospital.
The court also referred to a report prepared by a medical officer of the Civil Hospital, which lists down issues with Covid-19 hospitals in Ahmedabad and proposes solutions for these grievances too.
The court clarified that it wasn’t aware of the authenticity of the claims in this report, but constituted a committee of three doctors to look into the issues.