On Monday, March 27, thousands of doctors protesting against the newly-passed Rajasthan Right to Heath Bill participated in a rally in Jaipur as part of a nationwide stir called by the Indian Medical Association (IMA).
This was the biggest demonstration against the law since the passage of the Bill in the state Assembly on March 21. The landmark legislation makes Rajasthan the first state in India to make access to healthcare a legal entitlement of every citizen of the state.
What is Right to Health Act
Under the law, every resident has the right to avail free of cost treatment along with ‘emergency treatment’ without prepayment at any health institution in the state.
Neither government nor private hospitals nor doctors can refuse a person seeking emergency treatment.
The Bill provides for residents of Rajasthan to avail free health services in any clinical establishment. Any person in the state can avail free outdoor and indoor patient department services, consultations, medicines, and diagnostics in public health institutions; emergency treatment and care at all healthcare providers without prepayment; and access to referral transport by all healthcare establishments. Residents can also avail free transportation, free treatment, and free insurance coverage against road accidents at all healthcare establishments. However, this raises a few issues.
Violation of Article 19(1)(g)
Analysis by non-profit PRS Legislative Research notes that the Bill does not specify if the state will reimburse private clinical establishments for providing such free services. ”This may violate Article 19(1)(g) of the Constitution, which guarantees the right to practice any profession or carry on any occupation, trade or business,” the analysis states.
An obligation on the private sector to provide free services to residents implies that no resident will pay any charges. “If the government does not reimburse the cost, the private establishments will have no revenue, and would likely shut down,” it observes.
The District Health Authority is required to upload an action taken report on the web portal for complaints. “The Bill does not specify who will have access to the report on the web portal. This may infringe on the patient’s right to privacy in medical cases,” it adds.
Implementing the Right to Health Act may increase the financial obligation of the state. However, the Bill does not provide for such additional costs.
Doctors feel vulnerable
Several doctor groups in the state fear that the law can do harm to medical professionals, particularly private practitioners, while critics claim that it ignores advice from medical professionals, is ill-prepared, and fails to take into account the practical realities of the system.
The doctors also believe that once implemented, the law will result in increased bureaucratic interference in their functioning.
The protesting doctors consider the bill’s implementation to be an impractical approach to healthcare and a potential burden on private hospitals, adding that it will bring little benefit to the people of the state.
Also, for any violation under the law, a hospital or doctor will be liable to pay a fine of Rs 10,000, which goes up to to Rs 25,000 for subsequent violations.
Protest to intensify
On Sunday evening, a delegation of doctors met Chief Secretary Usha Sharma, Additional Chief Secretary (Finance) Akhil Arora, Principal Secretary (Health) T Ravikant, Finance (Expenditure) Secretary Naresh Thakral and District Collector (Jaipur) Prakash Rajpurohit to resolve issues.
But the meeting remained inconclusive as the doctors have only one agenda – roll back the RTH Act. The medical professionals threatened to intensify their protest in the coming days if the Bill is not withdrawn.
State Health minister Parsadi Lal Meena on Monday said that the government would not withdraw the bill at any cost.
“If there’s any problem with the bill, then we are ready to hold a discussion but the bill won’t be taken back at any cost,” Meena said while talking to ANI.
He added that Chief Minister Ashok Gehlot has appealed to the protesting doctors to come back to work but they are taking “undue advantage”.
“After a lot of discussions, the Right to Health bill was passed by our government, ” he further said.
Right to Life
In 1996, the Supreme Court held that the right to life (Article 21) included the right to health within its fold, and also pointed out the obligation of state governments to provide health services. Under the Constitution, public health and sanitation, including hospitals and dispensaries, come under the State List.
In 2018, the National Commission on Human Rights (NHRC) drafted the Charter of Patient Rights to be implemented by state governments. Rajasthan runs certain schemes to ensure health coverage, including the Mukhyamantri Chiranjeevi Swasthya Bima Yojana, under which health coverage is provided in over 1,550 private and public hospitals across the state. Under the yojana, insurance coverage is also provided for certain types of treatment.
The Rajasthan Right to Health Bill, 2022, was introduced in the Rajasthan Assembly on September 22, 2022. The Bill was referred to a Select Committee headed by the Minister of Health and Medical Services, Parsadi Lal Meena.
Meanwhile, most private hospitals and nursing homes across the state have been shut for several days which has led to massive overburden of patients at government hospitals. In a show of solidarity with the protesting private practitioners, doctors at government hospitals also boycotted work.