Himachal Pradesh High Court: A Division Bench of Tarlok Singh Chauhan and Chander Bhusan Barowalia, JJ passed directions against the respondents in addition to the directions already passed in CWPIL No. 11 of 2020.
The instant petition was filed as a pro bono publico for grant of appropriate directions to ensure that all the Covid patients are provided adequate medical facilities including beds, medicines and ventilators at the Dr. Y.S. Parmar Medical College and that the Covid patients at Nahan Government Hospital are properly and regularly attended to and treated by the doctors and not be left at the mercy of the medical support staff and to further ensure immediate installation and functioning of the ventilators already supplied and available in the Hospital and that every doctor at the hospital may kindly be made personally responsible and liable to ensure that the critical Covid patients requiring oxygen are put on ventilators forthwith in order to prevent further loss of life and to complete the installation and functioning of the existing oxygen manufacturing plant in the Nahan Medical College premises forthwith from its emergency fund without waiting for the resolution of the dispute with the supplier of the said oxygen plant and machinery. An appropriate direction is also requested as the nodal agency to execute and monitor the financial obligations of the State under the Disaster Management Act, 2005 and lastly to designate the Nahan Medical College as Covid 19 dedicated hospital for the district.
The main issue is about lack of oxygen facilities at Dr. Y. S. Parmar Government Medical College, Nahan and non-functioning of 25 ventilators which have been given to the Medical College under the HIM Care Scheme in July, 2020.
Counsel for the petitioners submitted that in view of the surge of Covid cases, the hospital at Nahan is far too small to handle Covid cases as it has only 20 Covid ICU beds and additional 10 beds which are being maintained through ‘D’ type oxygen cylinders to deal with the Covid patients. Whereas, taking into consideration the sudden surge in the Covid positive patients, the facility for atleast 500 persons should be made available by the Government.
The Court laid directions due to drastic surge in the Covid-19 positive cases and as the fatality in the State are highest in the Country. The directions are:
- Increase the number of authorized laboratories/clinics/hospitals which can carry on the testing for a larger percentage of population
- Increase the number of testing being done in the bigger towns of the State. The State Government should consider the use of other kits, besides the Rapid Antigen Kit, or the RT PCR tests, for increasing the tests being carried out on daily basis.
- In order to increase the testing facilities in the hill districts of the State, the State Government should consider sending of ‘mobile vans’ which are fully equipped for carrying out the testing of COVID-19 virus.
- The State should increase the number of dedicated COVID-19 Hospitals. For, merely having few dedicated COVID-19 hospitals, is too little to tackle the menace, especially when the pandemic is likely to spread and increase throughout the State in the coming months.
- The State is also directed to consider the feasibility of establishing temporary hospitals with the help of any other Central agency.
- The State is directed to increase the number of beds available in the hospitals. It shall ensure that the majority of the beds are equipped with Oxygen tank and sufficient numbers of bed are equipped with ventilators. If necessary, the number of ICUs in the hospitals should be increased. This is essential as it is claimed that the second strain directly affects the lungs of the patient. Therefore, the patient needs to be given intensive care, and may require to be put on ventilator immediately.
- The State Government is directed to ensure that the PPE kits and other protective gears, such as gloves, masks, and sanitizer are provided to all the medical staff, especially to the Doctors, Nurses, Ward Boys to look after the COVID-19 patients. Until and unless our front line worriers are protected from COVID-19 virus, it will be impossible for us to win the battle against the COVID-19 virus.
- The State Government is directed to publish the names and locations of the testing centres, and the names and locations of Hospitals/Dedicated COVID-19 Health Care Centres in the media bulletin on a daily basis. The media bulletin should clearly indicate the total number of beds available in each hospital/Dedicated COVID- 19 Health Care Centres, and the number of vacant beds available in each hospital. It should also indicate the class of the beds i.e. the number of beds attached with ventilators, number of beds attached with Oxygen cylinders and the number of beds without any Oxygen tank/ Cylinder.
- We make it absolutely clear that in case the private hospitals refuse to cooperate or reluctant to provide Covid test and covid facilities, then the State Government shall forthwith resort to coercive steps as provided under the Disaster Management Act and also Essential Services Maintenance Act. In addition thereto, wherever private hospitals have been granted incentives like plots on concessional rates etc. etc. The State Government shall be free to withdraw the incentive/ recover the amounts etc. Lastly, the State may proceed to take any other coercive or punitive step as may be warranted and otherwise permissible under the law.
- The State should also consider the purchasing of additional CT Scan Machines in the State as it is learnt that this machine is essential to detect the presence of the second strain of Covid-19 virus.
The Court further directed to furnish the following informations:
i) Available bed capacity exclusively for Covid-19 facilities in the State both in Government and private hospitals alongwith the details of the availability of oxygen (high flow or otherwise).
ii) State shall give the details of the steps taken and proposed to augment the availability of oxygen meeting both the current and projected requirements.
iii) Place on record the plan prepared by the State Government under the Disaster Management Act to tackle the Covid-19 cases.
iv) Steps taken to ensure the availability of essential drugs including Remdesivir, Favipiravir and Tocilizumab amongst other prescribed drugs and the modalities which have been set up for controlling the essential drugs for preventing hoarding and ensuring the proper communication of the requirement at the level of each Districts by the District Health Authorities or the Collectors of the Health Department of the State.
v) The details of the steps taken by the Government to comply with the judgment of the Hon’ble Supreme Court in suo motu Writ Petition (Civil) No. 3 of 2021 in Re: Distribution of Essential Supplies and Services during pandemic, dated 30.04.2021.
vi) Furnish the details of the staff alongwith their designation who have been deputed in the Covid hospitals, both Government and Private.
vii) Respondent No.4 shall furnish the details with regard to distribution of Remdesivir, Favipiravir and Tocilizumab from the Central Government to the State Government up-to-date and why the State of Himachal Pradesh has been discriminated while making allocations of Tocilizumab vide letter dated 27.04.2021 and why allocation of only 3000 Remdesivir vials was made to the State of Himachal Pradesh in comparison to the States with lesser population and with far lesser Covid- infections.
viii) The State shall provide details along with data with regard to distribution of the oxygen and further the details proposed to augment the supply of oxygen.
ix) The State shall furnish the data and also give the data-wise demand and supply of oxygen for the last two weeks as well as future projected demand and the measures taken for meeting such demand.
x) The State shall ensure the uploading of real time data about the availability of beds in each hospital of the State for Covid-19 patients on its Web Portals and also on the Web Portals of all the Hospitals and also physically display the data outside each hospital on daily basis .
xi) As regards the availability of beds in hospital, the following parameters of information must be placed in the public domain by the State Government for all Covid designated hospitals in the State, both public and private through dedicated website and physically outside the hospital.
(a) Name and address of hospital;
(b) Total number of designated Covid-19 beds;
(c) Total number of available designated Covid-19 beds;
(d) Number of beds available in ICUs with ventilators.
(e) Number of beds in ICUs without ventilators;
(f) Number of general hospital beds available with oxygen;
(g) Number of general beds available without oxygen facility.
(h) Date and time when this information was last updated;
(I) Name and mobile number of the Nodal Officers for admission to the hospital;
(j) Link to GPS location of the hospital (only for website).
Such information must be updated once every eight hours and it must be ensured that the site is not password protected and does not require any login credentials to view this information.
(xii) The State shall also furnish the steps taken regarding the availability of oxygen for those all the Covid-19 patients, who though may in home isolation but require oxygen.
xiii) Experts speculate a third wave and, therefore, the State shall disclose its road-map in case third wave strikes.
(xiv) The State has not carried out any Vaccination Programme for those aged between 18 to 44 on the pretext of non-availability of vaccine. Therefore, the State Government is directed to disclose clearly as to from which date, it shall commence the vaccination for the age group as aforesaid.
(xv) The State shall furnish its stand regarding the importance (if any) of the ventilators in treatment of Covid and how it proposes to put to use the ventilators that are lying idle with the State in various hospitals.
(xvi) The State is directed to furnish the complete details regarding the availability of essential medicines required for the treatment of Covid-19 patients, more particularly, the availability of Remdesivir, Favipiravir and Tocilizumab and in case of short-fall, the steps taken in this regard.
(xvii) In the meanwhile, respondent No.4 is directed to ensure the adequate availability of the essential drugs, more particularly, the life saving drugs to the State of Himachal Pradesh and enumerate in detail the steps taken in this regard on or before the next date of hearing.
[Ashutosh Gupta v. State of HP, 2021 SCC OnLine HP 4555, decided on 06-05-2021]
Arunima Bose, Editorial Assistant has put this report together
Counsel for petitioners: Mr. B.N. Misra and Ms. Vandana Misra.
Counsel for the State: Mr. Ashok Sharma and Mr. Ajay Vaidya
Counsel for respondent 4: Mr. Balram Sharma
