INTRODUCTION
Recently, we all witnessed the strikes and shutdowns by private hospitals against the proposed Right to Health Act. This shutdown was followed by some government hospitals also shutting down their services to retaliate against this act. The hospitals declared this shutdown as indefinite and decided not to open the hospitals until the government removes this Act. Even though shutdowns were happening in the state, especially in the capital Jaipur, the government passed the bill into the Right to Health Act 2023. But finally, on the 4th of April 2023, a consensus was reached between the Doctors and the Government after days of talks and negotiations.[1]
RIGHT TO HEALTH
Though the right to health is not explicitly a fundamental right it has been included under Article 21 of the Constitution of India, 1950 which states that “No person shall be deprived of his life or personal liberty except according to procedures established by law”[2] and is now an inseparable part of Article 21[3].
This is a much-needed fundamental right as it was seen at the times of the pandemic when the government was finding it hard to manage the crisis and there was a lot of havoc caused to the citizens due to the lack of beds in hospitals.
WHAT IS THE RIGHT TO HEALTH ACT?
- The bill provides access to healthcare for people in the state by giving them the right to their health. This includes free health care services at any clinical establishment to residents of the state. The bill will set up Health Authorities at the state and district levels[4]. It will put certain duties on the state which will make it necessary for them to ensure the Right to Health for the citizens of the state and provide them with quality healthcare at the necessary time. The act will provide the right to emergency treatment and care without prepayment to every resident of the state. The citizens can access medical services at hospitals without the need for money at the moment.
Timeline of the bill
The bill was introduced in the Rajasthan Assembly on September 22, 2022. The bill was then referred to a select committee (Chair: Mr. Prasadi Lal Meena, the Minister of Health and Medical Services).[5]
The bill was finally passed by the state assembly on 28th March 2023 but could not be implemented due to the strikes by the doctors in opposition to this bill. However finally, on the 4th of April, a consensus was reached between the doctors and the government after which the doctors called off the strikes.[6]
KEY ISSUES OF THE BILL
- Doctors are opposing the bill as there is no provision in the bill for reimbursing private health establishments for providing free medical services. This lack of provision may make this bill unviable and violate Article 19(1)(g)[7] of the Constitution.
- Implementing this act will increase the pressure on the state finances as there are no provisions as to how the state will deal with these extra finances.
- A portal has been made for the district health authorities to submit their report on it. But, there is no mention of who will have access to this portal which can cause danger to patients’ privacy.
GOVERNMENT’S POINT
The Government wants to pass the bill so that it can provide free health care in emergencies to the needy who don’t have money at that moment. This will let them provide the citizens with their right to health of emergency treatment and medical services. The government wants that no one should suffer due to lack of treatment.
AGREEMENT BETWEEN THE GOVERNMENT AND DOCTORS
Private multispecialty hospitals having less than 50 beds will be kept out of the purview of the act in the first phase of its implementation. There will be no binding of this law on those hospitals which have not taken any concession, rebate, or help from the government in terms of land or funds.[8]
ARTICLES AND IMPORTANT CASE LAWS REGARDING THE RIGHT TO HEALTH
- State of Punjab v Mohinder Singh Chawla, Supreme Court, 1996- In 1996, the Supreme Court held that the right to life (Article 21)[9] included the right to health within its fold, and also pointed out the obligation of state governments to provide health services.[10]
- Under the Constitution of India three lists divide the power between the centre and the state and under these lists, public health and sanitation, including hospitals and dispensaries, come under the State List which obliges the state to take care of them and make policies for properly implementing them.[11]
- In 2018, the National Commission on Human Rights drafted the Charter of Patient Rights to be implemented by state governments.[12]
OTHER SCHEMES BY THE RAJASTHAN GOVERNMENT
Rajasthan runs certain schemes to ensure health coverage which include:
- Rajasthan Government Health Scheme (RGHS) – Rajasthan Government Health Scheme is a scheme taken out by the government of Rajasthan to provide health services and benefits to the beneficiaries which includes Members of Legislative Assemblies, ex-MLAs, All India Services, Government service employees who are serving or retired and State Autonomous Bodies. All the beneficiaries of this scheme will have access to the cashless medical facility.[13]
- Mukhyamantri Chiranjeevi Yojana- The state launched this health scheme under which it will provide cashless insurance of 5 lakh rupees, covering all families. Under this scheme, free-of-charge insurance is provided to all the families that come under NFSA, SECC, and several other schemes for the poor and underprivileged sections of society.[14]
SCHEMES PROVIDED BY THE CENTRAL GOVERNMENT FOR THE HEALTHCARE SECTOR IN INDIA
Health is a state subject, so the main power of making policies on this matter rests with the state but the central government supplements the efforts of the State Government in the delivery of health services through several schemes for primary, secondary, and tertiary care.
- The Government of India is planning to increase health expenditure to 2.5% of the Gross Domestic Product by the year 2025.[15]
- The Government has launched a National Health Mission which has two sub-missions, The National Rural Health Mission (NRHM) and The National Urban Health Mission (NUHM). It envisages that every citizen has access to quality and affordable healthcare and medical services.[16]
- PMJAY – The Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana is the world’s largest healthcare program financed by the government. This scheme provides financial help to the poorer sections of society especially the lower half of the citizens.[17]
CONCLUSION
With the passage of this act, Rajasthan has become the first state in India to pass such an act. As envisaged this act will help all the needy in their tough times of emergency where they can avail of its benefits without the need for money at that moment. Fortunately, a consensus has been reached by the government and doctors which will let the doctors restart their work and also would not affect their practice. Now this act can also be implemented into force. This act would help Rajasthan to become a state where due to lack of money no one gets denied their right to health and can help save a lot of lives. This act will help bring a lot of change in the medical services provided by the state.
Author(s) Name: Anushk Garg (Dr. Ram Manohar Lohiya National Law University)
References:
[1] Rajesh Asnani, ‘ Rajasthan doctors call off strike against right to health bill ’ (The new Indian Express, 5 April 2023) < https://www.newindianexpress.com/nation/2023/apr/05/rajasthan-doctors-calloff-strike-againstright-to-health-bill-2562818.html > accessed 13 April, 2023
[2]Constitution of India,1950, art 21
[3] Constitution of India,1950, art 21
[4] Right to Health Act, 2023, Acts of Rajasthan State Legislature, 2023 (India)
[5] PRS legislative research, https://prsindia.org/bills/state-legislative-briefs/the-rajasthan-right-to-health-bill-2022 (last visited April 21, 2023)
[6] Rajesh Asnani, ‘ Rajasthan doctors call off strike against right to health bill ’ (The new Indian Express, 5 April 2023) < https://www.newindianexpress.com/nation/2023/apr/05/rajasthan-doctors-calloff-strike-againstright-to-health-bill-2562818.html > accessed 13 April, 2023
[7] The Constitution of India, 1950, Article 19(1)(g)
[8] Press release, ‘Agreement between government and doctors on right to health doctors agreeing on public welfare law a good sign’ (Chief Minister’s Office, 4 April 2023) < https://cmo.rajasthan.gov.in/pressreleasedetail/85601 > accessed 13 April 2023
[9] The Constitution of India, 1950, Article 21
[10] State of Punjab & Ors. v Mohinder Singh Chawla, 1996, (1996) 113 PLR 499
[11] The Constitution of India, 1950, Entry 6, List II, State List, Seventh Schedule
[12] Charter of Patient Rights, Ministry of Health and Family Welfare, 2018
[13] Rajasthan Government Health Scheme, < https://rghs.rajasthan.gov.in/RGHS/home/ > (last visited 13 April, 2023)
[14] Chiranjeevi.rajasthan.gov.in, <https://chiranjeevi.rajasthan.gov.in> (last visited 13 April, 2023)
[15] Press Information Bureau, <\ https://www.pib.gov.in > (last visited 13 April, 2023)
[16] National Health Mission, < https://nhm.gov.in/ > (last visited 13 April, 2023)
[17]National Health Authority, < https://nha.gov.in/PM-JAY.html > (last visited 13 April, 2023)
