The Maharashtra government cannot escape its responsibility and shift the same to private players regarding the recent deaths of several patients at government run hospitals at Nanded and Chhatrapati Sambhajinagar, observed the Bombay High Court on Friday.
“You cannot escape by saying there is a burden. You are the state. You cannot shift the responsibility to the private player. See the general condition of the health care in the state,” said a division bench of Chief Justice DK Upadhyaya and Justice Aruf Doctor.
The bench said the state had things on paper on how to strengthen healthcare the system but it was not trickling down.
“How to strengthen it? Everything is there on paper, but if it is not trickling down then there is no point. This is not just about procurement (of medicines and equipment) but the general state of healthcare in Maharashtra,” said the CJ.
The high court’s remake came after Maharashtra Advocate General Birendra Saraf told the bench that the recent deaths at the hospitals do not seem like gross negligence. “It does not seem like there was any gross negligence by the hospitals. Of course, it is sad what has happened, people have died,” Saraf said.
Thirteen one patients, including many infants, died at the Dr Shankarrao Chavan Government Medical College and Hospital in Nanded in 48 hours since September 30, while the death of 18 patients was recorded at the Government Medical College and Hospital at Chhatrapati Sambhajinagar, earlier known as Aurangabad, between October 2 and 3.
The high court, on October 4, took suo motu (on its own) cognisance of the deaths.
Saraf told the court that all medicines and other equipment required at the hospitals for the management of patients were available and administered as per protocol. The patients who died had been brought in critical condition from other hospitals.
“Doctors, medical staff at the hospitals are burdened”
“There are issues. There is no denying that. But it does not seem like there was any gross negligence by the hospitals,” Saraf said, adding that the doctors and medical staff at the hospitals were burdened.
Inquiring about the cause of deaths in the hospitals in Nanded and Chhatrapati Sambhajinagar, the court asked: “How did the situation come to this? What happened?”
Saraf explained that smaller and private hospitals refer patients to public hospitals when their condition becomes critical. “Most of the patients (who died in Nanded and Chhatrapati Sambhajinagar state hospitals) were referred to these hospitals when their condition was severely critical. Most of them died within a day...this includes infants,” he said.
He claimed that earlier too there had been 11 to 20 deaths in a day in these hospitals.
He added: “Public hospitals cannot ask people to go away. They try to accommodate everyone. At Nanded, there were 12 cases of infant deaths. Of this, only three were born at the government hospital. The remaining were brought in extremely critical condition from other hospitals.”
Maha govt forms committee to probe the matter
The AG said that the government has formed a three-member committee which will visit all government hospitals and submit reports.
The bench noted that there was a decline in budgetary allocation for public healthcare in Maharashtra in the last three years. “As per the report submitted by the government, in 2020- 21, 4.78 per cent of the total budget was allocated to public health. In 2021-22, it was 5.09 per cent, in 2022-23 it was 4.24 percent and now in 2023-24 it is 4.01 per cent. The decline is thus visible,” the HC underlined.
Displeasure over vacancies in government hospitals
The court expressed displeasure over the vacancies in government hospitals. “See the vacancy for senior residents. Out of 97 posts for senior residents, only 49 posts are filled. 50 per cent vacancy...is this justifiable? How do you (government) justify this?”
Saraf pointed out that additional posts were created in January this year due to which there were substantial vacancies. He said the posts would be filled soon.
The HC has directed the Principal Secretaries of the Public Health Department and the Medical Education and Drugs Department to file affidavits giving details of sanctioned posts in all government hospitals and the vacancies against such posts. The affidavits shall give details of the steps taken in the last six months to ensure the vacancies are filled.
The affidavits shall also disclose demands for medicines, medical goods and equipment made by the hospitals in Nanded and Chhatrapati Sambhajinagar in the last year and supplies made against such demands.
Pulling up the government for failing to appoint a full-fledged Chief Executive Officer (CEO) for the Maharashtra Medicines Procurement Authority set up in May this year, the HC directed that the CEO be appointed within two weeks.
In a detailed order, the court noted that the incident has brought to the fore certain issues with regard to the state healthcare system that needs to be addressed by the Maharashtra government. These include crucial problems faced by the hospitals such as vacancies, procurement of medicines and medical goods and equipment
The court has kept the matter for hearing on October 30.