While observing that making provision of a medical facility in the Government Hospitals is a constitutional obligation of the State, the Madras High Court has directed the State to allocate funds and establish a Bone Marrow Transplantation facility at Government Rajaji Hospital in Madurai.

The Public Interest Litigation was filed seeking framing of guidelines in respect of the standards of medical and infrastructural facilities to be made available in all the Government Hospitals in the State of Tamil Nadu in general and for the establishment of Bone Marrow Transplantation (BMT) facilities in the Government Hospitals.

The Division Bench of Justice M.S.Ramesh and Justice A.D.Maria Clete said, “On an overall appraisal of all the decisions of the Hon'ble Supreme Court, we have no difficulty in holding that the provision of a medical facility in the Government Hospitals, so as to reach the poor, downtrodden and underprivileged citizens of the society, is a constitutional obligation of the State and when such facilities are neglected by the State Government, this Court would be well within its powers under Article 226 of the Constitution of India to issue positive directions for such provisions.”

Advocate S. Venkatesh represented the Petitioner, while Additional Advocate General J. Ravindran represented the Respondent.

Factual Background

The Court was informed by both parties that BMT surgery is an important procedure for the treatment of rare medical conditions, which procedure involves a huge expenditure in a Private Hospital, which the affluent alone can afford. Since these facilities are not available anywhere else in the State of Tamil Nadu except Chennai, the patients in and around the District of Madurai are put to great hardship. It is in light of such circumstances that a direction was sought for the establishment of the facility of BMT in the Government Rajaji Hospital.

Reasoning

At the outset, the Bench explained that a BMT, also known as a stem cell transplant, is a medical procedure that replaces damaged or diseased bone marrow with healthy blood-forming stem cells. This treatment is crucial for patients whose bone marrow is not producing sufficient healthy blood cells due to conditions such as Leukaemia, Lymphoma, Aplastic anaemia or certain genetic disorders. By restoring healthy bone marrow, BMT can reestablish normal blood cell production and improve immune system function.

The Bench also took note of the fact that the cost involved in undergoing a BMT procedure runs to several lakhs in the private hospitals, which amount cannot be afforded by the poor and underprivileged section of the public. Moreover, in order to avail the free facilities of BMT at Chennai, the underprivileged people from the remote districts of Kanyakumari, Ramanathapuram, Tirunelveli, etc. are required to travel hundreds of kilometres to avail the benefit, apart from spending months at the Government Hospital in Chennai.

Considering this pitiable and distressing situation, which these people in the southern districts of the State are pushed into, the Bench said, “...State cannot avoid its constitutional obligation to provide free legal aid to the poor and depressed class, on account of its financial constraints, which proposition of law is well setted by the Hon'ble Supreme Court.”

It was further noticed that the proposal for civil structure, equipments and human resource for the establishment of BMT in Government Rajaji Hospital, Madurai has been estimated at Rs. 13.53 crores. As per the Bench, the facility of BMT is required to be extended to at least one General Hospital in each district, taking into account the unavailability of such a facility in any of the districts, except Chennai.

Thus, the High Court ordered, “...the respondents shall allocate the necessary funds for civil structure, equipment and human resource for establishment of BMT facility at Government Rajaji Hospital, Madurai, within a period of three months from the date of receipt of a copy of this order. On such allocation of funds, the respondents shall ensure that the facility of BMT is established at Government Rajaji Hospital, Madurai, within a period of six months from the date of allocation of the funds.”

The petition was disposed of by granting liberty to the petitioners to make an appropriate representation to the respondents, seeking for framing of suitable guidelines, in respect of the standards of medical and infrastructural facilities in all the Government Hospitals in the State of Tamil Nadu. “...on receipt of the same, the Principal Secretary, Health and Family Welfare Department, Government of Tamil Nadu, shall consider it and pass suitable orders in accordance with law, within a period of three months from the date of receipt of such representation”, it concluded.

Cause Title: Dr. S. Gurushankar v. The Chief Secretary to the Government of Tamil Nadu & Ors. (Case No.: W.P.(MD) Nos. 11886 of 2019)

Appearance:

Petitioner: Advocates S. Venkatesh, S. Ramesh

Respondents: Additional Advocate General J. Ravindran, Government Pleader P. Thilak Kumar

Click here to read/download Order


Madras High CourtJustice M.S. RameshJustice AD Maria Clete

Tulip Kanth

Assistant Editor

Tulip Kanth is an Assistant Editor at Verdictum having over 5 years of experience in the field of legal journalism and editing. She extensively covers judgments of the Supreme Court, High Courts as well as Tribunals. She has previously worked with a legal publishing website where she oversaw the work of other editors and has also created updates on notifications of different Government Ministries. She holds an English Honours Degree from SGTB Khalsa College, Delhi University and has completed her LLB course with specialisation in Corporate Law from Amity University.