New Delhi : The Supreme Court on Tuesday flagged the ground reality regarding the lack of institutional safety standards in health care establishments, while constituting a nine-member national task force (NTF) to formulate effective recommendations to remedy the issues of concern pertaining to safety, working conditions and well-being of medical professionals.
A three-judge bench led by Chief Justice of India D Y Chandrachud said medical professionals who are posted for night-duties are not provided adequate resting spaces. “More often, doctors rest in the patients’ room or in available public spaces. Duty rooms are scant. Separate duty rooms for male and female medical professionals are conspicuous by their absence in most health care establishments”, said the bench, also comprising justices J B Pardiwala and Manoj Misra.
The bench said interns, residents and senior residents are made to perform thirty-six hour shifts in conditions where even basic needs of sanitation, nutrition, hygiene and rest are lacking and there is an absence of uniformity in terms of a standard national protocol. “The fear of retribution prevents most health care professionals from questioning the absence of facilities for basic well-being…Lack of security personnel in medical care units is more of a norm than an exception. More often than not, medical professionals, which includes young resident doctors, interns and nurses are left to handle unruly attenders”, said the bench.
The bench noted that medical care facilities do not have sufficient toilets and most often there is only one common toilet for medical professionals in one department.
The bench said there is an absence or lack of properly functioning CCTV cameras to monitor ingress and egress to the hospital and to control access to sensitive areas. “The patients and their attendants have unrestricted access to all places within the hospital, including Intensive Care Units and the doctors resting rooms…Medical professionals have to shoulder the responsibility of being both medical and ‘emotional’ caregivers to patients and their relatives. There are no supportive facilities and no training in communication skills”, said the bench.
The bench said certain spaces within hospitals such as the intensive care unit (ICU) and the emergency wards are prone to a greater risk of violence because of the severity of medical conditions of patients in these departments.
Against this backdrop, the bench said a national consensus must be evolved - after due consultation with all stake-holders - on the urgent need to formulate protocols governing the issues above-described.
The apex court constituted a nine-member task force consisting: Surgeon Vice Admiral Arti Sarin, AVSM, VSM, Director General, Medical Services (Navy); Dr D Nageshwar Reddy, Chairman and Managing Director, Asian Institute of Gastroenterology and AIG Hospitals, Hyderabad; Dr M Srinivas, Director, AIIMS, Delhi; Dr Pratima Murthy, Director, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru; Dr Goverdhan Dutt Puri, Executive Director, All India Institute of Medical Sciences, Jodhpur; Dr Saumitra Rawat, Chairperson, Institute of Surgical Gastroenterology, GI and HPB Onco-Surgery and Liver Transplantation; Professor Anita Saxena, Vice-Chancellor, Pandit B D Sharma Medical University, Rohtak; Dr Pallavi Saple, Dean, Grant Medical College and Sir JJ Group of Hospitals, Mumbai; and, Dr Padma Srivastava, formerly Professor at the Department of Neurology, AIIMS Delhi.
The ex-officio members of the NTF will be: Cabinet Secretary, Government of India; Home Secretary, Government of India; Secretary, Ministry of Health and Family Welfare, Government of India; Chairperson, National Medical Commission; and President, National Board of Examinations.
The apex court, in its order, said: “The NTF shall formulate effective recommendations to remedy the issues of concern pertaining to safety, working conditions and well-being of medical professionals and other cognate matters….The NTF shall while doing so, consider the following aspects to prepare an action-plan. The action plan may be categorized under two heads: (I) Preventing violence, including gender-based violence against medical professionals; and (II) Providing an enforceable national protocol for dignified and safe working conditions for interns, residents, senior residents, doctors, nurses and all medical professionals”.
The apex court said NTF shall be at liberty to make recommendations on all aspects of the action-plan and any other aspects which the members seek to cover. “They are at liberty to make additional suggestions, where appropriate. The NTF shall also suggest appropriate timelines by which the recommendations could be implemented based on the existing facilities in hospitals….The NTF is requested to submit an interim report within three weeks and the final report within two months from the date of this order”, said the apex court, in its order.
The apex court said the Central Bureau of Investigation should submit a status report to it by 22 August 2024 on the progress in the investigation of the crime at RG Kar Medical College Hospital. “The State of West Bengal shall also file a status report by 22 August 2024 on the progress of the investigation on the acts of vandalism which took place at the Hospital in the aftermath of the incident”, said the bench, scheduling the matter for hearing on August 22.
