The Supreme Court of India has recently annulled a 2018 directive issued by the Allahabad High Court mandating that government officials in Uttar Pradesh exclusively seek medical care from state-run healthcare institutions.
The High Court had initially promulgated a series of directives aimed at ameliorating deficiencies within the state’s public healthcare system, among which was the now-nullified provision.
However, a judicial bench comprising Chief Justice of India (CJI) Sanjiv Khanna and Justice Sanjay Kumar adjudicated that such compulsory mandates encroach upon the domain of policy formulation and impinge upon individual autonomy in medical decision-making.
During the deliberations, the bench scrutinized the legitimacy of constraining government employees’ access to diverse healthcare providers. “How can the High Court dictate policy decisions determining where a person must or must not seek treatment? While the intention to improve hospital conditions is commendable, such directives cannot override individual choice,” observed CJI Khanna.
The court’s analysis concentrated on Direction No. 11 of the High Court’s order, which stipulated that government employees and public sector personnel avail themselves exclusively of medical services from government hospitals.
Furthermore, the directive precluded reimbursement for medical expenses incurred at private healthcare facilities, except in cases where state-run institutions were demonstrably incapable of providing requisite treatment.
Expressing reservations about the potential ramifications of this directive, the CJI underscored that prioritizing government employees within public healthcare institutions could inadvertently engender systemic inequities, ultimately disadvantaging the general populace.
The bench reaffirmed that policy-making prerogatives reside within the executive domain and emphasized the necessity of maintaining constitutional boundaries to prevent judicial overreach.
While rescinding the aforementioned directive, the Supreme Court conferred upon petitioners the liberty to reapproach the High Court with substantiated data and empirical evidence supporting their claims.
The genesis of this litigation was a public interest litigation (PIL) initiated by a working-class woman who had endured severe postnatal complications, allegedly due to medical negligence at a government hospital, compelling her to resort to prohibitively expensive private healthcare services. Her case underscored the broader deficiencies within the public healthcare framework of Uttar Pradesh.
In response to these systemic concerns, the Allahabad High Court had promulgated 21 directives, encompassing measures to address the chronic dearth of medical personnel in government hospitals. The court had further directed the authorities to ensure the consistent availability of high-quality pharmaceuticals and medical apparatus within public healthcare facilities. Additionally, it underscored the necessity of fortifying maternal healthcare services through the recruitment of female physicians and paramedical professionals.
Another pivotal directive mandated an audit, to be conducted under the auspices of the Comptroller and Auditor General (CAG), to investigate allegations of fiscal mismanagement and administrative inefficiencies within public hospitals.
Although the Supreme Court invalidated the High Court’s specific mandate compelling exclusive reliance on government healthcare facilities, it acknowledged the overarching concerns regarding public health infrastructure in Uttar Pradesh, thereby leaving room for continued legal examination of the broader systemic deficiencies.
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