By: Jay Nayan Mopur
[2/3 Pendekanti Law College]
[Indonesian Illustrator/DSI]
Introduction
Human culture is erected upon the expression of values that form the base of an ethical society, honesty, integrity, respect, pursuit of excellence, social duty, accountability, and steadfastness. Since the dawn of civilization, by trial or error, it has been established that a society and more so its medical profession, a public oriented and noble profession, can survive and thrive only by observance and practice of certain rules of conduct guided by ethical, moral, legal, and social values of the land. Healthcare in India features a universal healthcare system run by the constituent states and union territories. The Constitution charges every state with raising the nutrition levels and the standard of living of its people and enhancement of public health as one of its primary duties. Law is an obligation on the part of society imposed by the competent authority, and disobedience may lead to penalty in the form of fine or imprisonment or both.
Evolution of Healthcare in India from the Ancient to Modern Period
Healthcare in India dates to ancient times, with traditional healthcare practices like Ayurveda. The practice is believed to have begun nearly 3000 years ago, and it continues to flourish even today. Likewise, the practice of Unani that was introduced by the Arabs and Persians also thrived. Medicinal stalwarts like Charaka and Patanjali played an important part in paving the path for contemporary healthcare. The first medical institutions established in India during British rule they brought modern healthcare to the country with them. The establishment of institutions like the All India Institute of Medical Sciences (AIIMS) in 1956 marked a turning point in India’s healthcare system. AIIMS has since been a premier medical institution, known for its high standards of education, research and patient care. Today, India boasts a strong healthcare framework with many AIIMS premises across the country and a growing medico-legal professional pool.Constitution of India and Healthcare
The Constitution incorporates provisions guaranteeing that everyone has right to be the best possible physical and mental health. Article 21 of the Constitution guarantees protection of life to every citizen. The Supreme Court has held that the right to live with dignity, enshrined in Article 21, is derived from the Directive Principles of State Policy and thus includes protection of health. It has also held that the right to health is a crucial part of the right to life, and the government is obliged to provide health facilities. Failure of a government hospital to provide a patient with the required healthcare violates the patient’s right to life. Similarly, the Court has upheld the state’s obligation to maintain health services.
Article 38 is an imposition of liability on state that the State will secure a social order for the promotion of welfare of the people including public health because without public health, welfare of people has no meaning.
Article 39(e) of the Indian Constitution protects workers, regardless of age or gender, from being exploited or forced into jobs that are harmful to their health or unsuitable for their physical capabilities due to economic pressure.
Article 41 deals with right to work, education and assisting the public in certain cases and thus imposes a duty on the State to basically assist those who are old, sick, and disabled. The implications in relation to health in this Article are obvious.
Article 42 intends to protect the health of infants and mothers by providing maternity benefit.
Article 47 places a duty on the State to prioritize the well-being of its citizens. It mandates the improvement of public health, including raising the nutrition levels and standard of living. It also includes a directive for the prohibition of intoxicating drinks and drugs, unless they are for medicinal purposes.
Some Health Legislations in India
The Maternity Benefit Act, 1961 regulates the employment of women in certain establishments before and after childbirth and provides for maternity and other benefits. The Act ensures that eligible women receive their full wages during maternity leave, and in cases of miscarriage or medical termination, they are entitled to leave with wages.
The Medical Termination of Pregnancy Act, 1971 legalizes the termination of certain pregnancies by registered medical practitioners under certain circumstances. It legalized abortion under specified conditions, including risk to the woman's life or health, preventing serious fetal abnormalities.
The Food Safety and Standards Act, 2006 provides for the protection of human health and the promotion of safe and wholesome food. It safeguards public health by promoting and regulating safe food practices.
The Rights of Persons with Disabilities Act, 2016 provides for public assistance and support for persons with disabilities. The Act is built on principles of individual autonomy, non-discrimination, full participation and inclusion, respect for human diversity, equality, and the evolving rights of children with disabilities. Specific conditions like acid attack victims, hemophilia, and sickle cell anemia were included within the scope of the law.
The Reality of Healthcare
Success
India has progressed on maternal and child health. Mortality rates have come down, institutional deliveries and immunization coverage etc., have increased. The reports of the World Health Organization show reduction in the rates of malaria, leprosy etc. Some states have implemented good schemes, such as Odisha’s “Biju Swasthya Kalyan Yojana,” “Mo Hospital” programme, expansion of medical colleges in the state, etc.
Criticism
Many government health centers lack basic amenities, diagnostics, sanitation, equipment, adequate medicines. There exists very low spending on public health, i.e., less than 2 % of GDP. The private sector has approximately 11,85,242 beds while public sector has roughly 7,13,986 beds. This leaves India with an average of less than 1.4 beds for every 1000 people, significantly lower than the WHO suggested norm of 3.5 beds for every 1000 people. Laws like the Maternity Benefit Act cover only the formal sector; most women do not receive benefits because they work informally. Medical errors are not uncommon; patient safety measures are weak in smaller/rural hospitals.
The Way Forward.....
India must convert its constitutional and legal commitments into sustained public investment and practical reforms to build a resilient, rights-based health system. For instance, we must increase public health spending, strengthen primary and community health centers with diagnostics, medicines and utilities, expand public bed capacity and medical/nursing training in underserved areas etc. Healthcare must be made affordable for informal workers through targeted cash/insurance schemes. There must exist a clear medico-legal civil as well as criminal liability
