POINTERS OF THE DEVELOPMENT
A. Begining of the News
COVID-19 has laid more emphasis and pressure on the healthcare infrastructure. There is undoubtedly a salute to healthcare workers delivering in the moment of crisis. However, the shabby conditions of the healthcare facility in normal circumstances itself are challenging and in a pandemic, it has a lot more to narrate. Last year, the apex court took cognisance of the fire incident at a COVID hospital in Gujarat’s Rajkot in which five patients had died. The following headlines across newspaper caught attention that the Supreme Court said hospitals have become like huge real estate industries instead of serving humanity in the face of COVID-19 tragedy while directing that ‘nursing homes’ running from 2-3 room flats in residential colonies which pay little attention to fire and building safety norms should be closed. As per newspaper reports (May 5, 2021, | The Indian Express), as many as 93 people, most of them Covid-19 patients died in 24 incidents of fire in hospitals in India since last August. Why are these fires taking place regularly, despite the hospitals having passed fire checks and audits? In 13 of the 24 cases, the fire began in an ICU. These hospital ICUs did not function up to 100% capacity before the pandemic. The ventilator, equipment, air conditioners are working 24 x 7 now. It also puts pressure on the entire system.
The Gujarat government has appointed Justice D A Mehta led commission to undertake enquiry regarding fire in Shrey Hospital, Navrangpura, Ahmedabad, and enquiry into the incident of fire in Uday Shivanand Hospital, Rajkot.
The apex court questioned the Gujarat government for extending the deadline till July next year for hospitals to rectify the building by-laws violations and said the “carte blanche” notification was in teeth of its order of December 18 last year and people will continue to die in fire incidents. The court observed that the hospitals have become huge industries at the time of this tragedy and nursing homes, running from two-three room flats in a residential colony, should not be allowed to work.
“It is better that these hospitals are closed and the state should provide the necessary infrastructure. We cannot allow these hospitals and nursing homes to continue working. This is a human tragedy which is taking place,” the bench said while referring to a fire incident in Nashik, Maharashtra, where some nurses and patients were killed last year.
B. Executive Order cannot override the Supreme Court Order
It said that once a direction has been issued by the top court, “it cannot be overridden by an executive order and now you (Gujarat government) have issued a carte blanche (complete freedom to act as per your own wishes) saying the hospitals don’t have to adhere to rectifying the violations till July 2022″, and people will continue dying and getting burnt till then.
It asked Solicitor General Tushar Mehta to look into the issue of notification and take it up with the Gujarat authorities and asked the state to file a comprehensive statement explaining the notification and details of fire safety audits which were conducted pursuant to the top court’s order of last year.
The top court listed the suo motu case on the proper treatment of COVID patients after two weeks.
C. Directions of Fire Safety Audit for all the States
On December 18 last year, the top court had directed all the states to constitute a committee in each district to conduct a fire audit of COVID-19 hospitals at least once a month, inform the management of medical establishments about any deficiency and report to the government for taking follow up action.
It had said that COVID-19 hospitals, which have not obtained any objection certificate from the concerned fire department, should be asked to immediately apply for NOC and after carrying necessary inspection, a decision shall be taken in this regard.
“Those COVID hospitals who have not renewed their NOC should immediately take steps for renewal on which appropriate inspection is taken and decisions are taken. In the event, COVID hospital is found not having NOC or not having obtained renewal, appropriate action be taken by the state,” it had said.
The top court had directed that all states and Union Territories should appoint one nodal officer for each COVID hospital, if not already appointed, who shall be made responsible for ensuring compliance with all fire safety measures.
It had said that the state would extend all co-operations to the enquiry commission so that the enquiry report is submitted at an early date and the appropriate remedial action be taken by the state.
The top court noted that the Centre has also directed the states and UTs to update their respective local building bye-laws/fire services, synchronising them in line with the ‘Model Bill on maintenance of fire and emergency service, 2019′, circulated by the Ministry of Home Affairs on September 16 last year.
The issue of the Rajkot fire incident had cropped up in the top court which was hearing a suo motu case on the proper treatment of COVID-19 patients and dignified handling of bodies in hospitals.
D. Laws governing the Commissioning of the Hospital
1. The Society Registration Act of 1960
2. The Companies Act 2013
3. The Urban Land Act 1976
4. The National Building Code, 2005
5. A building permit from the municipality
6. The Fire safety rules 1987
7. The Electricity Rules 1956
8. The Radiation Protection certificate for radiology dept from BARC
9. The Atomic Energy (safe disposal of radioactive waste) Rules 1987
10. The Indian Telegraph Act of 1885.
11. The Clinical Establishments Bill, 2010
12. The Registration Act, 1908
13. The Government Buildings Act, 1899
14. The Red Cross Society (Allocation of Property) Act, 1936
15. The St. John Ambulance Association (India) Transfer of Funds Act, 1956
Laws governing the qualifications/practice and conduct of professionals
1. The Indian Medical Council Act 1956
2. The Indian Medical Degrees Act
3. The Registration of Medical Practitioners with State Medical Councils
4. The Indian Nursing Council Act 1947
5. The Dentists Act 1948
6. The Dental Council of India regulations 2006
7. The AICTE rules of physiotherapy rules
8. The All India Council for Technical Education ACT, 1987
9. The Apprenticeship Act 1961
10. The Rehabilitation Council of India Act, 1992
Law governing storage/sale of drugs and safe medication
These laws include:
1. The Drugs and Cosmetic Act 1940
2. The drugs control Act of 1950
3. The Pharmacy Act 1948
4. The Central excise Act 1944 ( for a permit to use and store spirit)
5. The Retail Drug License
6. The Sales of good Act 1930
7. The Blood bank regulations under Drugs and cosmetic (2nd amendment) rules, 1999.
8. The Homoeopathy Central Council (Amendment) Act, 2002
10. Homoeopathy Central Council Act, 1973
Law governing the management of patients
These laws include:
1. The Drugs and Magic Remedies (objectionable) Advertisements Act 1954
2. The MTP Act 1997
3. The Transplantation of Human Organ Act 1994
4. The Transplantation of human organ Rule 1995
5. The Rules for insurance cover the sterilization cases
6. The Birth and death and Marriage Registration Act 1886
7. The Indian Lunacy Act of 1912
8. The Epidemic Disease Act of 1897
9. The Lepers Act
10. The Guardians and Wards Act of 1890
11. The Mental Health Act of 1987
12. The Indian Evidence Act (disclosure of privileged/confidential patient-related information before a court of law – under protest)
14. The Consumer Protection Act of 1986
15. Protection of human rights Act
Law governing environmental protection
These laws include:
1. The Biomedical medical waste management handling rules 1998 (Amended in 2000)
2. The Water ( prevention and control of pollution ) Act 1974
3. The Noise Pollution (Regulation and Control) (Amendment) Rules, 2006.
4. The Rules regarding the safe discharge of effluents in the public sewers/drains
5. The DMC sanitation and public health Bye-laws, 1959
6. The Air (Prevention and Control of Pollution) Rules, 1982
7. The Environment Protection Act of 1986
8. The Noise pollution control Rules 2000
Laws governing the employment of manpower in Hospital
These laws include:
1. The Child Labour Act
2. The Citizenship Act of 1955
3. The Employees provident fund and miscellaneous provision Act 1952
4. The Employment exchange (compulsory notification of vacancies) Act 1959
5. Equal Remuneration Act of 1976
6. The Minimum Wedge Act of 1948
7. The Payment of Bonus Act 1965
8. The Payment of Gratuity Act 1972
9. TDS Act
10. Maternity Benefit (Amendment) Act, 2008
11. The Workmen’s Compensation Act, 1923
12. The Persons with Disabilities Act 1995
13. The SC and ST Act of 1989
14. The Weekly Holidays Act, 1942
Regulations governing the business aspects of the hospital
These laws include:
1. The Charitable and Religious Trust Act of 1920
2. The Contract Act, 1982
3. The Customs Act of 1962
4. Rules for the display of Red Cross Insignia
5. The Wireless operation certificate from post and telegraphs
Photo by Piron Guillaume on Unsplash
