By Radhika M
Right to life is the very basic human right. Well, what is life? As it has been propounded by the Hon’ble Supreme Court through its decisions, life is something more than mere animal existence. It is living with human dignity.
The court amplified the scope of Right to Life under Article 21 of Constitution of India to recognise variety of rights deriving from it. The rights disseminating from the Article includes Right to Livelihood, Right to Shelter, Right to Privacy, Right to Environment, Right to Legal Aid, Right to Health etc. This list is not exhaustive.
Speaking about Right to Health, it is a human right. Article 25(1) of Universal Declaration of Human Rights says that,
“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”
Article 12(1) of the Covenant on Economic, Social and Cultural Rights says that,
“The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.”
Good health and wellbeing is one of the Sustainable Development Goals set out by United Nations, which they intend to achieve by 2030.
Where does India stand?
If the figures could speak, the data from National Health Profile 2019 says that we have 0.55 beds per 1000 Indians[1]. India was ranked 145th in the Healthcare Access and Quality Index among 193 nations[2]. India was far behind its neighbours.
Well, where does the problem lie? It is not a secret that, our country lacks infrastructure development when it comes to healthcare facilities. Even though majority of our population lives in rural areas, there are no adequate medical facilities there. The hospitals, wellness centres, therapeutic centres even pharmacies are concentrated on urban areas.
The only affordable health institutions at rural areas being Primary Health Centres, they lack both treatment facilities and staff. The institutions which can provide an advanced treatment and emergency treatment are inaccessible to rural India.
The distance and non-availability of transport systems are forcing them to compromise with their ailments. Even if they could reach such advanced Government Hospitals, they are too overburdened. There is lack in the human resource, treatment facilities, diagnostic facilities, pharmaceutical services etc.
All of these indicate the lack of spending by the Government in the healthcare sector. India’s healthcare sector has always been a neglected one. It does not matter who ruled, all of them equally ignored the importance of health of its own people.
It is not that the sector is not growing but it is slow paced. India’s spending on healthcare is somewhere near 1.5% of its GDP (Gross Domestic Product) where the WHO (World Health Organisation) recommends that it should be between 4-5%.
Following such events, a National Health Policy was introduced in 2017. One of the main objective or vision put forward by the policy was that right to health will be ensured as a fundamental right. Along with such an assurance, other key factors that to be noted from the policy are-
- Equity
- Affordability
- Accountability
- Patient centred and Quality Care
- Universality
- Inclusive partnership
- Pluralism
- Decentralisation
Also implementing universal health coverage and aligning the progress of private sector (in health care) with the public health goals are the ambitious projects of the Government.
The Constitutional mandates
Article 47 of the Constitution of India which is a Directive Principle casts a duty upon the state to raise the level of nutrition, standard of living and improve public health. And the Courts in India through a wide range of decisions has repeatedly held that right to health and to seek medical assistance is a part of right to life which is enshrined in Article 21.
In the case of Paschim Banga Khet Mazdoor Samity v. State of West Bengal[3] an accident victim was denied treatment in the Government hospitals in Kolkata even though his injuries were serious. The Court in the case held that the refusal officers in the Government run hospital to provide health services to the victim is violation of fundamental right guaranteed under Article 21.
The Court held that the state is duty bound to ensure the welfare of the people. Article 21 imposes a duty on the state to safeguard the life of every person. The staffs in the government hospitals are duty bound to extend the medical assistance to the needy.
Otherwise, it would be the violation of Right to Life guaranteed under Article 21. Failure of the hospitals to provide timely treatment is violation of Article 21.
In the case of Parmanand Katara v. Union of India[4] , the Supreme Court held that
“Every doctor whether at a government hospital or otherwise has the professional obligation to extend his services for protecting life. The obligation being total, absolute and paramount, laws of procedure whether in statutes or otherwise cannot be sustained and, therefore, must give way.”
In the case of CESC Ltd. v. Subhash Chandra Bose[5], the Court held that the Right to Health is not only a fundamental right conferred under Article 21 but a Directive Principle of State Policy as well as a part of the international covenants that India is a party to.
Again, in the case of State of Punjab & Ors v Ram Lubhaya Bagga[6] , the Court observed that one’s right corelates to the duty of another. When a person is provided with a right, it corelates to the duty casted upon the government or employer or authority or any similar institution.
So, when the citizen is conferred the right to live, the state is under a duty to sustain the same. Article 47 imposes duty on the state to secure the health of its citizens. The state is already doing it by running Government hospitals. But to make it more effective, such facilities should be within reach of people and the queue in waiting lists should be reduced.
In the case of Regional Director, E.S.I Corporation v. Francis De Costa[7] , the Court while commenting upon Employee’s State Insurance Act observed that:
Article 39(e) enjoins the State to protect the health of the workers under Article 41 to secure sickness and disablement benefits and Article 43 accords decent standard of life.
Right to medical and disability benefits are fundamental human rights under Article 25(2) of Universal Declaration of Human Rights and Article 7(b) of International Convention of Economic, Social and Cultural Rights. Right to health, a fundamental human right stands enshrined in socio-economic justice of our constitution and the Universal Declaration of Human Rights.
Concomitantly right to medical benefit to a workman is his/her fundamental right. The Act (Employee’s State Insurance Act) seeks to succour the maintenance of health of an ensured workman.
The court in the case of Navtej Singh Johar v. Union of India[8] observed that
“In the evolution of its jurisprudence on the constitutional right to life under Article 21, this Court has consistently held that the right to life is meaningless unless accompanied by the guarantee of certain concomitant rights including, but not limited to, the right to health.245 The right to health is understood to be indispensable to a life of dignity and well- being, and includes, for instance, the right to emergency medical care and the right to the maintenance and improvement of public health.”
The court while taking Suo motu notice of the death of Amarnath Yatrees due to overcrowding and lack of medical assistance, observed in the case of Court on Its Own Motion vs Union Of India[9] that,
“Article 25(2) of the UDHR ensures right to standard of adequate living for health and well-being of an individual including housing and medical care and the right to security in the event of sickness, disability etc. The expression ‘life’ enshrined in Article 21 of the Constitution does not connote mere animal existence or continued drudgery through life.”
Then the court set out a long guideline to be followed by Union and State Government for ensuring the safety of Amarnath Yatrees. This included establishing of health centres all along the way to the temple, designated health officers to be appointed, rescue team etc.
In the case of Devika Biswas v. Union of India[10], the Court held that the significance of having well equipped Primary Health Centres across the country cannot be overemphasised. It directed the Union of India to ensure that people have access to Primary Health Centres.
And it also observed that Union Government and State Governments should work together to strengthen Primary Health Centres. Right to Health is an integral facet of Right guaranteed under Article 21.
Recently taking Suo motu notice of the unfortunate events evolved during the covid 19 pandemic, the Supreme Court In Re: The proper treatment of covid 19 patients and dignified handling of dead bodies in the hospitals etc[11] observed:
“Right to health is a fundamental right guaranteed under Article 21 of the Constitution of India. Right to health includes affordable treatment. Therefore, it is the duty upon the State to make provisions for affordable treatment and more and more provisions in the hospitals to be run by the State and/or local administration are made. It cannot be disputed that for whatever reasons the treatment has become costlier and costlier and it is not affordable to the common people at all. Even if one survives from COVID-19, many times financially and economically he is finished. Therefore, either more and more provisions are to be made by the State Government and the local administration or there shall be cap on the fees charged by the private hospitals, which can be in exercise of the powers under the Disaster Management Act.”
Conclusion
Even though it is a very established principle that right to health and right to get medical assistance is a human right, like many other basic human rights we are miserably failing to ensure the same. Nobody should be deprived of his right to live which in course propounds that nobody should be denied medical assistance because he is poor.
It is a shame to the humankind that our fellow beings are dying and are holding up their pain because they are poor. And in India even though we are one of the most populated nations in the world, we do not have proper healthcare facilities corresponding to the number.
And when other nations funded the healthcare institutions through insurance coverage, we are taking the baby steps here. Even if we are trying to provide insurance coverage, they are limited to the people who belong to the lower strata of the society.
When the data itself shows that the people who belong to lower income group are not adequately represented in the BPL (Below Poverty Line) and their numbers could be high, we should not be biased against providing free treatment facilities based on their showed income.
Such healthcare programmes should be universal. The assurance that ‘Right to health’ will be a ‘Fundamental Right’ shall not merely be allowed to sit in the papers, but rather should be brought into action.
Reference
- Constitution of India, 1950
- Universal Declaration of Human Rights
- International Covenant on Economic, Social and Cultural Rights
- Sustainable Development Goals
- National Health Profile, 2019
- National Health Policy 2017
- National Health Profile, 2019 ↑
- Health Care Access and Quality index, 2016 ↑
- Paschim Banga Khet Mazdoor Samity v. State of West Bengal 1996 SCC (4) 37, JT 1996 (6) 43 ↑
- Parmanand Katara v. Union of India (AIR 1989 SC 2039), ↑
- CESC Ltd. v. Subhash Chandra Bose 1992 AIR 573, 1991 SCR Supl. (2) 267 ↑
- State of Punjab & Ors v Ram Lubhaya Bagga (1998) 4 SCC 117 ↑
- Regional Director, E.S.I Corporation v. Francis De Costa 1992 SCR (3) 23, 1993 SCC Supl. (4) 100 ↑
- Navtej Singh Johar v. Union of India (2018) 10 SCC 1 ↑
- Court On Its Own Motion vs Union Of India SUO MOTU WRIT PETITION (CIVIL) NO. 284 OF 2012 ↑
- Devika Biswas v. Union of India (2016) 10 SCC 726 ↑
- In Re: The proper treatment of covid 19 patients and dignified handling of dead bodies in the hospitals etc SUO MOTU WRIT PETITION (CIVIL) NO.7 OF 2020 ↑