The Bombay High Court directed the Thane Municipal Corporation to provide free medical services to the underprivileged residents of Kausa-Mumbra without the requirement of holding yellow or orange ration cards.

The Court disposed of a Public Interest Litigation (PIL) seeking directions against the Municipal Commissioner for the timely completion of a hospital in Kausa-Mumbra within the municipal limits of the Thane Municipal Corporation.

The Court noted that with the addition of Part IX-A in the Constitution, Urban Local Bodies have increased responsibilities, including the obligation outlined in Article 243-W and the Twelfth Schedule, which casts a duty to provide the facilities of public health as well.

The Bench headed by Chief Justice Devendra Kumar Upadhyaya and comprising Justice Arif S. Doctor observed, “any Agreement entered into by the Respondent – Corporation to run the Hospital on a PPP model would therefore necessarily have to be in conformity with Resolution No. 750 dated 3rd March 2022 to the extent that the same would inter alia require free medical services to be given to the poor and those who do not have yellow and orange cards and other patients”.

Senior Advocate Yusuf Mucchala appeared for the Petitioner, Senior Advocate Ram Apte appeared for the Thane Municipal Corporation and Government Pleader P. P. Kakade with Additional Government Pleaders O. A. Chandurkar and R. A. Salunkhe appeared for the State.

A PIL was filed before the High Court seeking intervention and issuing directions to the Respondents for the timely completion of a hospital in Kausa-Mumbra within the municipal limits of the Thane Municipal Corporation. Additionally, the Petition sought an inquiry into the causes of delay and alleged excess expenditure in the project, with a demand for appropriate action against responsible officers, purportedly incurred without legal sanction.

The Court observed that the issue concerning the incomplete hospital project was initially addressed. The Respondents were directed to take necessary steps to make the hospital functional, serving the public health needs of the Kausa-Mumbra population. The Court referenced a 2014 study by the Tata Institute of Social Sciences (TISS), revealing the urban paradox in Kausa-Mumbra, where economic prosperity coexisted with sub-standard housing and inadequate amenities, negatively impacting residents' well-being.

The Court emphasized the study's findings indicating poorer health conditions in urban slums and emphasized the weak state of health services in Kausa-Mumbra. With the incorporation of Part IX-A in the Constitution, the Court noted the constitutional status bestowed upon Municipalities, including specific responsibilities, such as public health-related schemes outlined in the Twelfth Schedule.

Thus, it is now well settled that duty of the State as cast by Article 47 of the Constitution of India has to be taken aid of for giving full meaning to right to life enshrined as fundamental right under Article 21 of the Constitution of India. Right to life does not mean mere animal existence, it will encompass in it the right to live with dignity and if any citizen is deprived of affordable public health services, the right to life with dignity cannot be ensured, it will rather be compromised”, the Bench noted.

The Court emphasized, “the provisions of Article 243-W read with Twelfth Schedule and Article 21 read with Article 47 of the Constitution of India and various other provisions contained in MMC Act, thus, cast a duty on the municipality i.e. Thane Municipal Corporation to provide public health-care system in a way which is affordable and accessible to all irrespective of their socio-economic condition”.

The Bench emphasized that the decision made in 2008 to construct a 100-bed hospital in Kausa-Mumbra, yet, even after 15 years, had not become fully operational. Alleged irregularities in the construction process were mentioned, including budget discrepancies. In response, the Court initiated a PIL Petition on September 27, 2023, appointing a Commission to assess the hospital's status. The Commission's report stated the completion of the hospital's construction in December 2022 but highlighted its non-functionality. The report detailed ongoing developments, including the award of a PPP model tender and the relocation of healthcare facilities. However, the Commission concluded that the hospital was not fully operational.

Concerns were raised about the PPP model, with the petitioners advocating for free healthcare services akin to Chhatrapati Shivaji Maharaj Hospital. The Corporation defended its decision due to funding constraints and presented a fee structure in response to accessibility concerns. The petitioners urged the court to follow the model of Chhatrapati Shivaji Maharaj Hospital, emphasizing constitutional obligations to enhance public health.

The Court, expressing concern over the delayed functionality and potential financial burdens, noted the socio-economic conditions in Kausa-Mumbra requiring an effective public health system.

The Corporation would have to ensure that any medical facility and/or public health-care system which is to be evolved by the Municipal Corporation is to necessarily provide free medical aid/treatment for the poor within the Thane Municipal Corporation limits”, the Bench added.

In light of constitutional provisions, the Court emphasized the duty of Urban Local Bodies to provide public health facilities. Article 47 obligated the State to improve public health, with the judiciary interpreting the Constitution's conscience. The right to health, integral to the right to life, was stressed, and the absence of affordable public health services compromised the right to life with dignity, necessitating state intervention.

Considering the disadvantaged population in Kausa-Mumbra, the Court recognized the duty to ensure affordable public health services. The Court referred to TISS's study, emphasizing the Corporation's constitutional obligation and its commitment to providing free medical services. The decision to run the hospital on a PPP model was considered a policy matter within the executive realm, not subject to court interference.

Accordingly, the Court disposed of the PIL with the following directives:

a) The Respondent Corporation must operate the hospital, ensuring compliance with its Resolution No. 750 dated March 3, 2022.

b) Any PPP agreement for the hospital must align with Resolution No. 750, requiring free medical services for the poor and those without yellow or orange cards.

c) The Petitioners have permission to submit an application to the State Government regarding alleged irregularities in the hospital construction process, leading to cost escalation and favouritism, for the State Government's discretionary consideration and decision.

Cause Title: Association for Protection of Civil Rights v The Municipal Commissioner (2024:BHC-AS:4153-DB)

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