Rajasthan Right to Health Act- Highlights, Significance & Concerns
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Thousands of doctors are protesting against the Right to Health Act passed by the Rajasthan state Assembly recently. The Indian Medical Association announced its support to the protesting doctors. This legislation is expected to have significant implications for healthcare services across the state.
Right to Health:
- The ‘right to health’ is derived from the ‘right to life and personal liberty’ guaranteed by the Constitution’s Article 21.
- The courts have highlighted the state’s responsibility in protecting and promoting the citizens’ health, in accordance with other provisions of the Constitution too:
- Article 38- promoting people’s welfare
- Article 47- government to address nutritional and health needs of the people
- In the 1996 Paschim Banga Khet Mazdoor Samity v. State of West Bengal, the Supreme Court pointed out that the government is responsible for providing medical aid to bolster public health.
What are the highlights of the Act?
- The Right to Healthcare Act provides rights to patients and healthcare providers in the state. The state government is legally obligated to protect these rights.
- The Act’s Clause 3 lists 20 rights that the residents are entitled to. These include:
- Right to informed consent
- Right to seek information (in form of medical documents and records) on diagnosis and treatment
- Right to data confidentiality and privacy
- Right to discrimination-free treatment
- The state residents would be able to access check-ups, diagnostics, pharmaceutical drugs, emergency transport and care, free of cost, at all public health institutes. The Act seeks to make surgeries more affordable.
- With respect to healthcare providers, the Act covers the issue of their safety and improving healthcare infrastructure.
- No private healthcare facility is to deny emergency care to patients because of the latter’s inability to pay at the time.
- The state government, in accordance with Clause 4, is to:
- Provide funds
- Establish authorities- State Health Authority and District Health Authorities- which are to be involved in:
- Resolving complaints
- Planning healthcare services
- Monitoring healthcare services
- Conducting routine audits
- Develop a Human Resource Policy for Health to ensure availability of healthcare personnel at all levels of the state healthcare system
- Establish institutions
- Establish grievance redressal systems
Why is it significant?
- The Act, which will have a recurring annual expenditure of 14.5 crore INR, would make Rajasthan the 1st state to protect the patients’ rights to access equitable healthcare services.
- This could significantly strengthen the state’s public healthcare system.
- It would help reduce the out-of-pocket healthcare expenditure. This will be especially beneficial for those suffering rare illness that require expensive treatments.
- Its decentralized approach to offering healthcare would allow context-specific planning which would be more in tune with the local needs.
- If the legislation succeeds in making quality healthcare services equitable, it would help improve doctor-patient relationship too.
Why is it being opposed?
- The Act is facing wide opposition, with thousands of doctors hitting the streets in protest- something that has hit healthcare services in Rajasthan. The protestors claim that the Act doesn’t really help the patients and is also penalizing healthcare providers.
- The most contentious provision is that all hospitals (including private ones) must provide emergency treatment without prepayment. The doctors are protesting that the government is shifting the responsibility of protecting the right to health onto their shoulders.
- There is also a concern over the Act’s silence on when and how the government will reimburse the hospitals for such services.
- Some are worried that the redressal mechanism, envisaged by the Act, would create unnecessary troubles for the doctors. The protestors are questioning the inclusion of local politicians and government nominees to the district authority, leaving the door open for abuse of power.
What is the way ahead?
- The 1996 SC judgement has already established that all medical practitioners- public or private- are mandated to provide emergency medical care. Hence, the Act can be seen as a step in fulfilling the court mandate.
- Also, it has been argued that this provision of free emergency care is a very small portion of the legislation. Its predominant focus is on making the state more accountable with regards to healthcare.
- Various activists and civil society groups have noted that while Act could do with some sharpening to close implementation loopholes, it is an important first step in making healthcare a tangible right of the citizens. Note that over half the countries in the world have guaranteed, in their Constitutions, a right to health and medical care to their populations.
- The state government has already taken some steps to address the protestors’ complaints- like
- Including IMA (Indian Medical Association- India’s largest physician association) members in the state- and district-level authorities instead of government nominees.
- Including a detailed definition of what constitutes emergency. More details are to come out in the rules.
- To achieve wider consensus on the Act’s provisions, the government should hold talks with the protestors and could consider other existing models for emergency care- such as the one in Delhi. Delhi has a scheme for reimbursing hospitals for the free emergency care they provide for cases related to road traffic accidents, fire accidents and acid attack.
Conclusion:
Right to healthcare is a widely recognized human right. Over 50% of the countries have it written down in their Constitutions. India too recognizes it under Article 21 and as a consequence of several court judgements. The recent legislation from Rajasthan is a step in the right direction, in this regard. Discussions with the protestors to clarify and address their concerns are vital to achieving the Act’s objectives.
Practice Question for Mains:
What is the Rajasthan Right to Health Act? Why is it facing opposition and what is the way ahead? (250 words)
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