TMI Blog1998 (2) TMI 585X X X X Extracts X X X X X X X X Extracts X X X X ..... 97 (2) SCC 83. Consequent to the effect of the said and other decisions and their resultant impact on the State exchequer and other actors led the State Government to reconsider its old policy of 1991 by making necessary modifications, deletionsa through order dated 9.9.94 till it was substituted through a new policy dated 13th February, 1995. All the earlier rulings were based on the aforesaid old policy including the clarification dated 8th October, 1991. The same was partially withdrawn on 9th September, 1994 followed by placing the new policy on 13th February, 1995. In short respondents grievance, is the claim which was allowed by this Court earlier when such employees were admitted for heart ailment in escorts a non- governmental hospital, is now being declined which was allowed by this Court earlier when such employees were admitted for heart ailment in Escorts a non-governmental hospital, is now being declined which is in contradiction to the said rulings of this Court. In short in SLP (C) No. 13167 respondent is said have suffered a severe heart attack on 13th March, Research Center in an emergency. On 27th March, 1995 and was taken to the Escorts Hearts Institute and Re ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... everything crumbles. This Court has time and again emphasised to the Government and other authorities for focussing and giving priority and other authorities for focussing and giving priority to the health of its, citizen, which not only makes one's life meaningful, improves one's efficiency, but in turn gives optimum out put. Further to secure protection of one's life is one of the foremost obligation of the State, it is not merely a right enshrined under Article 21 but an obligation cast on the State to provide this both under Article 21 and under Article 47 of the Constitution. The obligation includes improvement of public health as its primary duty. Learned counsel for the appellant on the other hand does not deny such a right but urges that the same can be placed within permissible limits by rules and policies laid down. The right claimed may be sacrosanct, which has to be given, but the same can be put within reasonable limits, under a policy which is framed after taking into consideration various factors. Thus the only question is, whether the new policy is arbitrary, unreasonable violative of any law or principle to be struck down. Of corse it has to stand to ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... he Government in the welfare State. The Government discharges this obligation by running hospitals and health centers which provide medical care to the person seeking to avail of those facilities. Article 21 imposes an obligation on the State to safeguard the right to life of every person. Preservation of human life is thus of paramount importance. The government hospitals run by the State and the medical officers employed therein are duty bound to extend medical assistance for preserving human life. Failure on the part of a government hospital to provide timely medical treatment to a person in need of such treatment results in violation of his right to life guaranteed under Article 21. In Paschim Banga Khet Mazdoor Samity Vs. State of West Bengal, 1996 (4) SCC 36; Para 16- It is no doubt true that financial resources are needed for providing these facilities. But at the same time it cannot be ignored that it is the constitutional obligation of the State to provide adequate medical services to the people. Whatever is necessary for this purpose has to be done. In the context of the constitutional obligation to provide free legal aid to a poor accused this Court has held that ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... red on treatment taken abroad or in a hospital other than the hospitals of the Government of Punjab (both outside and in the State of Punjab). Relevant portion of the same is quoted hereunder: The person who is in need of medical treatment outside India or in any hospital outside and in the State of Punjab) as the case may be may make an application for getting treatment in these hospitals directly to the Director, Health and Family Welfare, 2 months in advance, duly recommended by the CMO/Medical Superintendent indicating that the treatment for the disease mentioned is not available in the hospital of the Government of Punjab. In case of emergency duly authenticated by CMO/Medical Superintendent the application can be made 15 days in advance. Director, Health and Family Welfare, Punjab will place the application of the employee concerned before the Medical Board within 15 days on the receipt of application. In case of emergency, if immediate meeting of Medical Board cannot be convened, such application may be circulated to all the members of the Medical Board and decision taken thereof. Thereafter on 8th October, 1991, the policy was further clarified so far as the choic ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... tember, 1994 on the advice of the Finance Department the aforesaid 1991 policy was again modified by withdrawing the clarification dated 8th October, 1991 wherein private hospitals in the State and outside were recognised for treatment. hence the benefit of the designated hospitals was no longer available to an employee for being reimbursed towards his medical expenses. it is in this background present that the new policy dated 5th October, 1995 has come in to force. The relevant portion of the Said State Policy is reproduced below:- As per instructions issued vide Punjab Government letter No. 7/7/85 - 5HBV/2498, dated 25.1.1991 the policy regarding reimbursement of medical emphases incurred on medical treatment taken abroad an din hospitals other than the hospitals of the Government of Punjab (both outside and inside the State of Punjab) was laid down. The Government has reviewed the decisions taken in the aforesaid letter and it has now been decided as under:- TREATMENT AT AIIMS District Civil Surgeons shall be competent to permit treatment of a particular disease at AIIMS, New Delhi on the basis of recommendations of the District level Standing Medical Board provid ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... of expenses incurred at Escorts on the basis of the alleged new policy. The decision under the new policy to reimburse expenses only on the basis of the rates at the AIIMS, it is contended illegal. Everyone in order to protect his life has to go wherever best possible treatment is available. If respondent went to Escorts which was once a designated hospital. The refusal now to reimburse expenses incurred at Escort has no justifiable ground to stand. Having heard learned counsel for the parties at length, we find the Surjit Singh's case admittedly was based on the old policy. There the medical reimbursement claim, was admissible at the rate admissible in Escort's, as Escorts's was one of the designated hospitals. In that case denial of such rate was therefore rightly rejected. However, strong reliance has been placed by the respondent on the following paragraphs of surjit Singh vs. State of Punjab (1996 (2) SCC 336 ) which is as under: Para 9 - The Policy, providing recognition for treatment of open heart surgery in the escorts, specifically came to be examined by a Division bench of the Punjab and Haryana High Court at Chandigarh titled as Sadhu R. Pail vs. State ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... very employee to undertake treatment in any private hospital of his own choice any where in the country. The only clog is that the reimbursement would be to the level of expenditure as per rates which are fixed by the Director, Health and Family Welfare, Punjab for a similar package treatment or actual expenditure which ever is less. Such rate for a particular treatment will be included in the advice issued by the District/State Medical Board for fixing this. Under the said policy a Committee of Technical Experts is constituted by the Director to finalize the rates of various treatment packages and such rate list shall be made available to the offices of the Civil surgeons of the State. Under this new policy, it is clear that none has to wait in a queue. One can avail and go to any private hospital anywhere in India. Hence the objection that, even under the new policy in emergency one has to wait in a queue as a argued in Surjit Singh case (supra) does not hold good. In this regard Mr. Sodhi appearing for the State of Punjab has specifically stated that as per the Director's decision under the new policy, the present rate admissible to any employee is the same as prevalent i ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... ue of waiting lists, and it has to provide all facilities for which an employee looks for at another hospital. Its up-keep; maintenance and cleanliness has to be beyond aspersion. To employ best of talents and tone up its administration to give effective contribution. Also bring in awareness in welfare of hospital staff for their dedicated service, give them periodical, medico-ethical and service oriented training, not only at then try point but also during the whole tenure of their service. Since it is one of the most sacrosanct and a valuable rights of a citizen and equally sacrosanct sacred obligation of the State, every citizen of this welfare State looks towards the State for it to perform its this obligation with top priority including by way allocation of sufficient funds. This in turn will not only secure the right of its citizen to the best of their satisfaction but in turn will benefit the State in achieving its social, political and economical goal. for every return there has to be investment. Investment needs resources and finances. So even to protect this sacrosanct right finances are an inherent requirement. Harnessing such resources needs top priority. Coming back ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... policy by the State by deleting its earlier decision of permitting reimbursement at the Escort and other designated hospital's rate is justified or not? This of course will depend on the facts and circumstances. We have already held that this court would not interfere with any opinion formed by the government if it is based on relevant facts and circumstances or based on expert advice. Any State endeavor for giving best possible health facility has direct co-relation with finances. Every State for discharging its obligation to provide some projects to its subject requires finances. Article 41 of the Constitution gives recognition to this aspect. 'Article 41: Right to work, to educate and to public assistance in certain cases: The State shall, within the limits of its economic capacity and development, make effective provisions for securing the right to work, to education and to public assistance in cases of unemployment, old age sickness and disablement, and in other cases of undeserved want.' It is submitted by the appellants that earlier under the 1991 policy, for bringing in some of the designated Hospital for treatment, sanction from Finance department was obtai ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... lies when there is any constraint on the health budget on account of financial stringencies. But we do hope that government will give due consideration and priority to the health budget in future and render what is best possible. For the aforesaid reasons and findings we uphold governments new policy dated 13th February, 1995 and further hold it not to be violative of Article 21 of the Constitution of India. In the Civil Appeals arising out of SLP(C) Nos. 13167/97 and 12418/97, the surgery at Escorts was after the introduction of the new policy and therefore the extent of medical reimbursement can be only according to the rates prescribed by AIIMS. However, the respondents therein are not entitled to the full expenditure that was incurred at Escorts. We therefore, allow the appeals in part and direct that the respondents are entitled to reimburse only at AIIMS rate. The appellant will therefore reimburse the respondents to the extent within one month from today. The appeals arising out of SLP (C) No. 12143/97 and 12144/97 though the treatment at Escorts was after the new policy the amount as claimed has already been paid at Escorts rates. On the facts and circumstances of ..... X X X X Extracts X X X X X X X X Extracts X X X X
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