Author: Dr. Teena Momsia, Dr BhimRao Ambedkar Law University, Jaipur, Rajasthan
To the Point
Healthcare in India has witnessed remarkable advancements thanks to the proactive initiatives of the Indian Parliament. With the rapid transformations driven by urbanization and industrialization, the legal framework must evolve to safeguard the interests of disadvantaged groups and weaker sections. The Indian Parliament has enacted numerous social welfare legislations to enhance the social dynamics of citizens and fulfill the objectives set in the Constitution. These legislations are designed to protect various groups, including women, children, and workers, while upholding the fundamental right to health. The Constitution obliges the State to ensure the health and nutritional well-being of all individuals. Significant strides have been made in the healthcare sector since independence through diverse legislative measures, bolstering the protection of health as a human right.
Abstract
The Indian Parliament has consistently addressed the evolving needs of society by enacting social welfare legislations aimed at protecting the interests of disadvantaged groups. The rapid pace of urbanization and industrialization has necessitated modifications in the legal framework to protect these groups. The Constitution of India not only delineates the fundamental rights of its citizens but also obliges the State to ensure their health and nutritional well-being. Prior to independence, the healthcare sector faced severe challenges, including high mortality rates due to diseases. However, post-independence, there has been a significant focus on improving the healthcare sector through various legislative measures. This article examines the role of different legislations in safeguarding health as a human right in India and highlights the progress achieved in the healthcare sector since independence.
Use of Legal Jargon
The Indian Constitution contains several Articles and Provisions / Acts, that address health and related matters:
Article 14 (Right to Equality) – It guarantees equality before the law and equal protection of the laws within the territory of India. This means that every person is entitled to equal treatment under the law, and no individual can be discriminated against. In the context of healthcare, this ensures that all citizens have equal access to healthcare services without any discrimination based on gender, caste, religion, or socio-economic status.
Article 15 (Prohibition of Discrimination) – It prohibits discrimination on grounds of religion, race, caste, sex, or place of birth. This article is essential in promoting inclusivity and fairness in the provision of healthcare services. It ensures that no one is denied access to healthcare facilities and services due to their background or identity. The state is also empowered to make special provisions for women and children, which can include health-related measures.
Article 21 (Protection of Life and Personal Liberty) – It guarantees the right to life and personal liberty. The Supreme Court of India has interpreted this right to include the right to health and medical care. This means that the state has a duty to ensure that all citizens have access to healthcare services necessary for a healthy life. This interpretation has led to various judgments and directives aimed at improving public health infrastructure and services.
Article 47 (Duty of the State to Raise the Level of Nutrition and Standard of Living) – It mandates the state to regard the raising of the level of nutrition and the standard of living of its people, as well as the improvement of public health, as its primary duties. This article emphasizes the state’s responsibility to enhance public health infrastructure, ensure access to nutritious food, and create policies that improve the overall health of the population.
Article 39(a) of the Constitution of India – As one of the Directive Principles of State Policy, It mandates that the State should ensure that all citizens, both men and women, have the right to an adequate means of livelihood. It emphasizes the State’s responsibility to create policies that facilitate access to healthcare services, as an adequate means of livelihood cannot be achieved without ensuring good health.
Article 39(e) (Right to Adequate Means of Livelihood) – It directs the state to ensure that the health and strength of workers, both men and women, and children are not abused. It also aims to prevent citizens from being forced into occupations that are unsuitable due to economic necessity. This provision is related to healthcare as it seeks to protect the physical well-being of workers and children by regulating working conditions and preventing exploitation.
Article 42 (Provision for Maternity Relief) – It requires the state to make provisions for securing just and humane conditions of work and for maternity relief. This article is directly related to healthcare as it mandates the state to provide maternity benefits and ensure that working conditions do not adversely affect the health of pregnant women and new mothers.
Article 43 (Living Wage, etc., for Workers) – It mandates the state to strive to secure a living wage and decent working conditions for all workers, ensuring a standard of life that includes access to healthcare. By guaranteeing fair wages and suitable working conditions, the state helps workers maintain their health and well-being.
National Medical Commission Act, 2019 – Replaced the Indian Medical Council Act, 1956, to regulate medical education and practice in India. It aims to improve the quality of medical education and ensure ethical standards among medical professionals.
Mental Healthcare Act, 2017 -This Act provides for mental healthcare and services for persons with mental illness, aiming to protect, promote, and fulfill the rights of such persons during the delivery of mental healthcare and services.
Consumer Protection Act, 2019 – This Act includes provisions related to healthcare services under “deficiency in service” if malpractice or negligence is proven. It provides a mechanism for the redressal of consumer disputes, including those related to healthcare.
Transplantation of Human Organs and Tissues (Amendment) Act, 2011 – This amendment to the original 1994 Act aims to streamline the process of organ donation and transplantation, ensuring ethical practices and preventing commercial dealings in human organs.
Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, 1994 – This Act prohibits sex determination of fetuses to curb female feticide and regulate the use of pre-natal diagnostic techniques.
Epidemic Diseases (Amendment) Act, 2020 – This amendment to the Epidemic Diseases Act, 1897, was introduced during the COVID-19 pandemic to provide stricter enforcement measures and protect healthcare workers from violence and harassment.
Digital Information Security in Healthcare Act (DISHA Bill) – A revised draft of this bill was released in 2022 by the Ministry of Health and Family Welfare (MoHFW).
Digital Personal Data Protection Act (DPDP Act) Passed in 2023 – This act governs how personal data is handled in India. It aims to protect privacy and establish a framework for data accountability.
The Proof
1. Judicial Precedents –
Paschim Banga Khet Mazdoor Samity v. State of West Bengal – This significant case saw the Supreme Court of India assert that the right to life, guaranteed by Article 21 of the Constitution, encompasses the right to prompt medical treatment in government hospitals. The case was initiated when a worker, having sustained injuries, was denied treatment by multiple government hospitals citing inadequate facilities. The court ruled that the State is obligated to provide sufficient medical facilities and ensure that no individual is refused medical treatment due to lack of resources. This ruling substantially emphasized the State’s duty to offer healthcare services, setting a vital precedent for healthcare rights in India.
2. Legislative Measures –
National Medical Commission (NMC) Act, 2019 – This Act superseded the Indian Medical Council Act, 1956, aiming to enhance the quality of medical education and uphold ethical standards within the medical profession. The NMC Act established the National Medical Commission to supervise medical education and practice, ensuring that medical institutions comply with established standards, promoting transparency, and maintaining accountability. This legislative measure ensures that medical professionals receive proper training and that the healthcare system functions with integrity and efficacy.
3. Statistical Data and Reports –
Data from various government reports have shown notable advancements in healthcare access and quality over the years. For instance, the National Family Health Survey (NFHS) offers extensive data on health indicators like maternal and child health, nutrition, and disease prevalence. According to NFHS-5 (2019-21), there have been substantial improvements in critical health indicators, such as a reduction in infant mortality rates, an increase in institutional births, and better vaccination coverage. These improvements highlight the positive impact of healthcare policies and legislation on public health.
4. Historical Context –
Evolution of Healthcare Policies: Historical evidence indicates that since gaining independence, India has made dedicated efforts to enhance its healthcare system. The implementation of various health missions, such as the National Health Mission (NHM), has focused on providing comprehensive healthcare services to all citizens, particularly in rural and underserved regions. NHM initiatives, including the Janani Suraksha Yojana (JSY) for promoting safe motherhood and the Ayushman Bharat scheme for universal health coverage, have significantly improved healthcare access and quality.
Case Laws
In the landmark case of “Vincent Panikulangara v. Union of India”, The Supreme Court of India addressed the abecedarian issue of access to essential drugs and medicines, affirming it as a abecedarian aspect of the right to life under Composition 21 of the Constitution. The petitioner, Vincent Panikulangara, argued that the absence of regulatory measures to control the quality and distribution of essential medicines was a violation of the fundamental right to life. The Court recognized that access to life-saving drugs and medicines is essential for preserving human life and health, and thus falls within the purview of the right to life. This judgment underscored the State’s obligation to ensure the availability and accessibility of essential medicines and drugs, reinforcing the principle that healthcare is a fundamental right that must be protected and upheld by the government.
In the landmark case of “Consumer Education and Research Center v. Union of India. The Supreme Court of India affirmed that the right to health and medical care is a abecedarian right defended under Article 21 of the Constitution. The case centered on the health and safety of workers in the asbestos industry, where the petitioner highlighted the detrimental health impacts caused by asbestos exposure. The Court ruled that the right to life extends beyond mere survival and includes the right to live with human dignity, which necessitates access to healthcare and medical facilities. The judgment emphasized that the State and employers have a duty to ensure safe working conditions, provide adequate healthcare facilities, and protect the health and well-being of workers. This case set a significant precedent by explicitly recognizing that the right to health and medical care is intrinsic to the right to life, thereby mandating proactive measures to safeguard public health.
Conclusion
India’s healthcare legal framework is complex and multifaceted, incorporating constitutional provisions, statutory laws, judicial interpretations, and regulatory bodies to ensure equitable healthcare access and uphold public health standards. Constitutional articles such as 21, 14, 15, 39(a), and 47, along with laws like the Clinical Establishments (Registration and Regulation) Act, 2010, and the Mental Healthcare Act, 2017, form the foundation of the right to health. Landmark judicial rulings, including Paschim Banga Khet Mazdoor Samity v. State of West Bengal and Consumer Education and Research Center v. Union of India, underline the State’s duty to provide adequate medical facilities and recognize health as a fundamental right under Article 21. Regulatory bodies, such as the National Medical Commission (NMC), play a crucial role in ensuring compliance and maintaining healthcare standards. Understanding this legal framework is essential for healthcare professionals, organizations, and policymakers to navigate healthcare complexities, ensure legal compliance, and advocate for patient rights, striving toward a robust and equitable healthcare system for all citizens.
FAQS
Q.1. What constitutional articles relate to health in India?
A.1. Articles 21, 14, 15, 39(a), and 47 are key constitutional provisions that relate to health in India.
Q.2. How does Article 21 ensure the right to health?
A.2. Article 21 guarantees the right to life and personal liberty, which the Supreme Court has interpreted to include the right to health and medical care.
Q.3. What are some key healthcare legislations in India?
A.3. Key healthcare legislations include the Clinical Establishments (Registration and Regulation) Act, 2010, the Mental Healthcare Act, 2017, and the Transplantation of Human Organs Act, 1994.
Q.4. Why are case laws important in healthcare?
A.4. Case laws provide judicial interpretations and precedents that clarify and enforce the right to health, shaping the legal landscape and ensuring State accountability.
Q.5. What is the role of Article 47 in public health?
A.5. Article 47 mandates the State to improve public health and raise the level of nutrition and standard of living as primary duties, guiding policies and legislative measures to enhance health outcomes.
