SC: Safety Norms at Medical Establishments

Case Description:

In Re: Alleged Rape and Murder Incident of a Trainee Doctor in R.G. Kar Medical College and Hospital, Kolkata and Related Issues

Supreme Court of India

Case Type: Suo Moto Writ Petition

Case No.: SMW (Crl) No 2 of 2024

Date of Order: 20.08.2024

Bench: D. Y. Chandrachud, CJI., J. B. Pardiwala, J., Manoj Misra, J.

Facts

On 9^th August 2024, a post graduate doctor, who was on a 36-hour duty shift, was found murdered and allegedly raped in the seminar hall of RG Kar Medical College Hospital. The horrific details of the incident, including name of the victim and the graphic details of the brutal sexual assault, circulated on social media without regard to the victim’s privacy or dignity.

A writ petition then emerged before the Calcutta High Court, seeking a court-monitored investigation of the crime and conduct of the hospital authorities post the incident, including role of the principal and officials of the special investigation team.

The deceased’s parents alleged that the hospital initially informed them that their daughter had committed suicide; they were only permitted to see the dead body after hours and the police belatedly registered their first information report after several hours.

The High Court transferred the investigation to Central Bureau of Investigation (“CBI”) by an order on 13^th August 2024.

This incident caused nation-wide outrage and protest. On 15^th August 2024, a ‘Reclaim the Night’ campaign began in several areas of Kolkata. At 12:30 am, when the protest was underway at the hospital, a large mob started vandalizing the Emergency Ward and other departments of the hospital.

The Indian Medical Association showcased its agitation against the mob vandalization through a nation-wide withdrawal of medical services (excluding emergency services) for 24 hours.

Court’s Observation

The Court pointed out its amazement at the State’s inability to deploy state machinery to handle State-wide protest and prevent vandalization within the premise of the hospital.

The Hon’ble Bench expressed its recognition for lack of workplace safety in health care institutions. It noted that unrestricted access to every part of the health care institutions have made healthcare professionals, who work round the clock, vulnerable to violence. Reference to several incidents where relatives of patients have attributed their anguish to doctors and attacked them was taken into consideration.

With regards to women safety in the field of healthcare, the case of Aruna Shanbaug— a nurse who was sexually assaulted in the hospital and left in vegetative state for 41 years— was remembered. The lack of safety norms at medical establishment creating an unsafe working environment for healthcare professionals was highlighted as a concern for national interest.

It was noted that several states have enactments that prohibit violence against medical professionals. However, such legislations fail to address institutional and systemic causes underlying the problem.

Followings were flagged as indications of lack of institutional safety standards in healthcare establishments:

No adequate resting spaces for professionals working on night shift. Absence of separate duty rooms for male and female professionals.

Lack of basic amenities of sanitation, nutrition, hygiene and rest for interns, residents and senior residents working 36-hour shift.

Open access to healthcare facilities without proper security personnels in medical care units.

Hostels and places of stay for medical professionals are situated far from the hospital, and for those who travel a lot to reach the medical facility, no travel facilities are provided for safe commute.

Absence or insufficiency of working CCTV cameras to monitor ingress and egress to the hospital.

Absence of supportive facilities and communication training for doctors who shoulder the responsibility of being medical and emotional care giver to their patients and patient’s relative.

Court’s conclusion

After analysing the backdrop of the situation, the Court directed formation of a National Task Force (NTF) consisting of diverse people with experience in health care institutions.

It enlisted members from various medical establishments and enumerated Cabinet Secretary of Government of India (“GOI”), Home Secretary GOI, Secretary, Ministry of Health and Family Welfare GOI, National Medical Commission Chairperson and National Board of Examination President as ex-officio members of NTF.

The Hon’ble Apex Court assigned the NTF the task of formulating effective recommendations to remedy concerns related to safety, working condition and well-being of medical professionals and other matters highlighted by the Bench. An action plan is to be prepared by the Force, and such action plan is to be categorized under two heads: (1) Preventing Violence, including gender -based violence against medical professionals; and (2) Providing an enforceable national protocol for dignified and safe working conditions for all medical professional, including interns, residents, nurses, and doctors.

NTF is requested to submit an interim report within three weeks and final report within two months from the date of order. Moreover, Centre and State Government are asked to submit information related to safety and security facilities available in hospitals run by them, including information related to constitution of Internal Committee and discharge of duties as per section 19 under Sexual Harassment of Women at Workplace Act 2013.

Lastly, the Hon’ble Bench directed CBI to submit status report on the progress in the investigation of RK Kar Medical Hospital incident by 22^nd August 2024. The State of West Bengal was also directed to file status report on progress of investigation into vandalism of the hospital on the same date.

Disclaimer: This summary does not reflect the final order in this case. The matter is pending before the Supreme Court for further proceedings.

Supreme Court: Lack of safety norms at medical establishments is a concern for national interest