Making Medical Facilities Available In Govt Hospital Is State's Constitutional Duty, Court Can Issue Directions If It Is Neglected: Madras HC

The bench of Justice MS Ramesh and Justice AD Maria Clete noted that when the constitutional obligation was neglected, the court was within its powers under Article 226 of the Constitution to issue positive directions.

“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,” the court said.

The court was hearing public interest litigations regarding absence of guidelines in respect of standards of medical and infrastructural facilities available in the Government Hospitals and for the establishment of Bone Marrow Transplantation facilities in government hospitals.

The petitioners informed the court that apart from the Rajiv Gandhi General Hospital, Chennai, and the Institute of Child Health and Hospital for Children in Egmore, and the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), no other government hospitals in the state had facilities for free bone marrow transplant. Highlighting the importance of the Bone Marrow Transplant procedure for treating rare medical conditions, the petitioners submitted that the procedure involved a huge expenditure, and since the facilities were available only in Chennai, people from the southern districts of the State were put to great hardship.

The Additional Advocate General drew the court's attention to the status report filed by the Directorate of Medical Examination which said that the total estimated cost for Civil Structure, Equipment, Staff Sanctioning would be Rs.13,52,76,000/- and the Annual Expenditure for the medical and non-medical staff would be an additional sum of Rs.3,63,76,000/-. It was further informed that the equipment for blood bank, oncopathology etc would cost Rs.4,99,00,000/-. The AAG also informed that the medical officers were also deputed from Dindigul and Madurai for a three month training programme.

It was also submitted that the estimated cost was subject to approval from the Government. Further, since it was a policy decision of the Government, a time limit also could not be given.

The court noted that though the status report begins with a positive note, the rider that the proposals as well as time limit is the policy decision of the government was not appreciable.

The court added that the facility of bone marrow transplant should be extended to at least one General Hospital in each district. The court added that the Government should take into consideration all imminent and crucial medical procedures which have been deprived to the poor and underprivileged section of the public and endeavour to extend such facilities at the earliest.

The court also directed the State to allocate funds as per the for civil structure, equipments and human resource for establishment of BMT facility at Government Rajaji Hospital in Madurai within three months and to ensure that the facility is established within 6 months.

The court also gave liberty to the petitioners to make appropriate representation to the respondents for framing guidelines in respect of the standards of medical and infrastructural facilities in all Government Hospitals in the State of Tamil Nadu.

Counsel for the Petitioner: Mr. S. Venkatesh for Mr. S. Ramesh, Mr. R. Alagumani

Counsel for the Respondent: Mr. J. Ravindran, Additional Advocate General, assisted by Mr. P. Thilak Kumar, Government Pleader

Case Title: Dr. S. Gurushankar v. The Chief Secretary to Government of TN

Citation: 2025 LiveLaw (Mad) 153

Case No: W.P.(MD) Nos.11886 of 2019 & 19218 of 2024