A. Narayanan v. Mr. D. Sreenivasan

In the High Court of Judicature at MadrasDated: 20 - 2 – 2008Coram:The Honourable Mr.Justice S.J.MukhopadhayaandThe Honourable Mr.Justice M.VenugopalWrit Petition No.3920 of 2008& M.P.No.1 of 2008A.Narayanan.. Petitionervs.State represented byThe Secretary to Government,Health & Family Welfare Department,Secretariat, Chennai. .. RespondentWrit Petition filed under Article 226 of the Constitutionof India, praying for issuance of a Writ of Mandamus, as statedtherein.For petitioner : Mr.A.Narayanan, Petitioner-in-personFor respondent: Mr.D.Sreenivasan, Addl.G.P.OrderS.J.Mukhopadhaya,JThis Writ Petition in public interest, has been preferredby the petitioner-in-person to direct the respondent todiscontinue the system of pay wards in the Government Hospitalsat Chennai.2. The petitioner is the Managing Director of a firm,manufacturing scientific instruments used for research anddevelopment. He claims to be the Founder Trustee and Convenor ofone or other non-government organisation for the benefit ofpublic in general.3. On appearance, the petitioner-in-person delivered longlecture on the sufferings of poor and their treatment in theGovernment Hospitals, and then attacked the Government's policyto have the pay wards in the Government Hospitals at Chennai. Itis informed that in January 2008, the Department of Health and https://hcservices.ecourts.gov.in/hcservices/ Family Welfare of the Government of Tamil Nadu opened specialpay wards in the General Hospitals and operating such wards inGastroenterology Department in Government Stanley Hospital,Chennai, Special Class Maternity Wards in Government Women andChildren Hospital, Egmore, Chennai and Kasturibai GandhiGovernment Hospital, Triplicane, Chennai for the past few years.Against such a decision, the petitioner claims to have expressedhis opinion through Media, mentioning the harm being caused tothe under-privileged and poor sections of the Society.4. It was also submitted by the petitioner that India beinga poorest nation in the World, is burdened with innumerablecommunicable and non-communicable diseases and nutritionaldeficiencies and our public health delivery system has not beenable to deliver the quality and efficient service to the poorand marginalised persons. The track record of the Government, interms of a providing quality medical, primary health care andeducation is extremely poor in comparison with the developingnations in the World. It was further submitted that India is oneof the lowest Governmental investment nations in primary healthand indoor-patient medical care compared with all otherdeveloping countries and some of the poorest nations. It is anuphill task to catch-up the countries with China, Brazil etc. Ofthe total population, only 3.5% who are the Government staff andindustrial workers, is covered by the health insurance. 5. In the Writ Petition, certain data are not supported byany evidence. According to the petitioner, more than 34% of ourpopulation is below-poverty-line (BPL) who are suffering fromdeprivation and the Central Government has still managed toprovide a budget of Rs.96,000 crores in the current financialyear for Defence; but only a sum of Rs.15,000 crores for Health.As per the Website of the Tamil Nadu Government, the totalnumber of beds in the Government Hospitals put together is21,285. If approximate population of the State is taken as 6.2crores, 3.4% beds are available for 10,000 population. It wassubmitted that the poor will suffer and marginalised will beleft to the mercy of private medical practitioners and privatehospitals, whose motive is commerce first and service theleast/last. 6. It was further submitted that the Government has triedto justify the special pay wards on the ground that they willprovide quality treatment on par with the private hospitals likeAppollo Hospitals, etc., at half a cost of it. According to thepetitioner, there are basic flaws in this approach as poor andthe middle class cannot pay for even such cost, withoutresorting to borrowing and selling of assets. https://hcservices.ecourts.gov.in/hcservices/

7. In the typed set of papers filed along with the WritPetition, while reports of the newspapers published in the NewIndian Express, the Hindu etc., have been extracted, a copy ofthe Government Notification regarding the pay wards has not beenenclosed therein, except a Government Order of the year 2003, inG.O.Ms.No.94, Health and Family Welfare (E1) Department, dated14.5.2003, indicating the ratification and revision of the ratesof one Hospital or the other. In the absence of any suchGovernment decision in the form of Notification of the year 2008regarding the starting of special pay wards, it is not possibleto determine whether such a decision will go against the poor orit will go in favour of some advantageous class. 8. Learned counsel appearing for the respondent-Statesubmitted that no definite answer can be given in regard to paywards without any instructions from the State and further statedthat no case of public interest is made out.9. We have heard the petitioner-in-person and learnedcounsel appearing for the respondent-State and also perused theaverments made in the affidavit filed in support of the WritPetition and the other records.10. From the averments, it would be evident that merecertain statements have been made which are not based on anyrecords/evidence. It is also not clear whether they are meresubmissions of the petitioner before the Court and/or true tothe knowledge of the petitioner or true to the informationderived from the records.11. As pointed out by the learned counsel appearing for therespondent-State, the Government Notification regarding thespecial pay wards of the year 2008, has not been enclosed andtherefore, it is not possible to decide whether suchNotification is issued by the State constituting the special paywards for one or other Department of the Government Hospitals atChennai is proper or not. 12. It cannot also be presumed that only in the GovernmentHospitals, poor are treated and no affluent persons goes to theGovernment Hospitals or that the affluent person only goes toprivate hospitals such as Appollo Hospitals etc.; on the otherhand, the presumption will be that persons irrespective of theirstatus go and avail the benefits of the Government Hospitals, iftreatment is given without any cost. Those who are Governmentemployees, generally, as per their service conditions, aresupposed to be treated in the Government Hospitals and only inappropriate cases, the matter may be referred by the Doctor or https://hcservices.ecourts.gov.in/hcservices/ Board of Doctors for treatment in a private hospital. In such asituation, as the presumption is that both the affluent and thepoor persons are treated alike in Government Hospitals, if theGovernment intends to charge certain cost/fee from those who areaffluent and the ones who have some benefit of Governmenttreatment, it cannot be held to be arbitrary or the policyagainst the poor. Mere constitution of special pay wards doesnot amount to a Government Policy to charge anything from poor,nor can it be presumed that it will go against the poorpatients. Thus, in the absence of any policy decision of theGovernment, it cannot be presumed that the poorer patients willsuffer due to denial of such treatment to them without anyfee/cost. 13. This Court specifically asked the petitioner as to whatsort of business he is doing, as in paragraph 2 of the affidavitfiled in support of the Writ Petition, he has stated that he isa resident of Chennai and is the Managing Director of a firm,manufacturing scientific instruments. We also wanted to know asto how he could get certain information, as orally thepetitioner was making various statements with regard to one orother Hospital. The petitioner specifically informed the Courtthat he is manufacturing scientific instruments useful forresearch and development, as stated in paragraph 2 of theaffidavit and he is also supplying such scientific instrumentsto the Government Hospitals at Chennai. 14. Apart from the aforesaid fact that no case is made outby the petitioner, as was stated by the learned counselappearing for the respondent-State, we also find that somepersonal interest of the petitioner is involved in the matter,as he is one of the suppliers of the scientific instruments tothe Government Hospitals at Chennai.15. We find no merits in this public interest litigation,which is accordingly dismissed. But in the facts andcircumstances, there shall be no order as to costs. TheMiscellaneous Petition is closed.CsSd/Asst.Registrar/true copy/Sub Asst.Registrar https://hcservices.ecourts.gov.in/hcservices/ ToThe Secretary to Government,Health & Family Welfare Department,Secretariat, Chennai. + 1 cc to the Government Pleader, High Court, Madras SR No.9163Orderin W.P.No.3920 of 2008 KA(CO)SR/25.2.2008