The Madras High Court said that physicians cannot pick and select patients and that impoverished people should not be treated differently.
The Court heard two writ petitions challenging the Director of Public Health and Preventive Medicine’s appointment of the petitioner Doctors as Assistant Surgeons (Specialists) based on the bond agreement under Rule 19(1) of the Tamil Government Servants (Conditions of Services) Act, 2016.
A Single Bench of Justice S.M. Subramaniam said, “The prime object of medical profession is to render service to humanity. Doctors cannot adopt a pick and choose attitude while treating patients. Especially poor patients receiving treatment from government run hospitals are entitled to receive the same level of specialised treatment as any other paid treatment. Denial of treatment to poor patients in government hospitals inspite of agreeing to the same under the bond goes against the ethos of medical ethics. It is not the case were the doctors are forced to treat patients for free throughout their career. The bond is such that it operates only for a particular period of time.”
The Bench observed that the petitioner Doctors were aware of the bail requirements and decided to comply with them.
“Any poor person who is unable to afford paid treatment can in no way be treated differently. A life is a life and it has its value. No person should be denied quality treatment on economic grounds”, said the Court.
Advocate M. Vijaya Ragavan represented petitioners while Government Advocate K. Tippu Sulthan represented respondents.
The petitioners/doctors signed a Bond to spend two years at the Government Hospital. The respondents appointed the petitioners per the agreement. The government bonded these Post Graduate Medical education students based on their education costs. The condition was presented at the time of PG Medical course admission to recompense government expenses and give free specialist medical care to the underprivileged and needy in Tamil Nadu.
After completing their PG/Speciality Medical course, the petitioners signed and committed to work at a government hospital for two years. After completing the training, the petitioners claimed they had served during the COVID-19 pandemic, which counted towards two years of duty. They said that two years of duty was unthinkable. They contended that bond requirements are not binding on them and should be set aside.
The High Court said, “It is nothing but a service to humanity and to the poor sections of the society who due to financial constraints are unable to get paid treatment. Such limited services sought for from the petitioner doctors cannot be denied. It is not the case were the doctors are prevented from practising their profession but they have agreed to render their specialised services for a limited period to the less fortunate strata of the society.”
The Court said that preserving lives is unmatched and that government hospitals require specialist doctors. It said that expert therapies are now costly.
“Economically weaker sections of the society cannot be denied their fundamental right to health under Art 21 of the Constitution merely on the grounds of financial constraints. It is no fault of his/her that they are unable to afford specialised treatments today. So the Bond scheme is an all conducive scheme whereby various layers of difficulties are addressed”, it said.
The Court also noted that the PG doctors had agreed to render their services after fully agreeing to the bond’s terms, and it is only in the true spirit of the medical profession that they provide these people who have come to government hospitals for specialised treatments, which is the greatest form of service to humanity and a true doctor.
“… it goes without saying that the medical profession is a noble one. This court is not suggesting that all medical services must be rendered free of cost to the citizens though the goal of any welfare state is to move towards affordable and easily accessible health care to all its citizens. Therefore the government is in need of qualified speciality doctors who can treat patients coming to government hospitals with quality and affordable healthcare”, it said.
The court ruled that the petitioner physicians’ services during COVID-19 should not count towards the Bond policy’s two-year timeframe.
It remarked that, “It was a period were the country witnessed immense crisis. It was a period of test to the humanity. And many people suffered innumerable losses. But to use this period of selfless service as a way out of the bond policy is utterly unjustifiable and unacceptable. It was a time when people from different walks of lives contributed their services in their own way and the frontline workers like aforementioned risked their lives in the process”.
The Court noted that our Great Nation valued human resources as a key part of the economy and more than ever, in nation-building.
“People from rural villages contribute a larger portion in this process. And it is the duty of any welfare state to protect the health and cater to the needs of these people. Bond policies play an important role in ensuring affordable specialised healthcare to these individuals from the rural backgrounds. Hence through theses bond policies the government will be able to seep in to the most vulnerable contributors of the economy and be able to provide quality health care services”, it added.
The Court further noted that PG medical students often rescind and challenge the bond after graduating. It stated that a doctor’s services are unique and that preserving one life benefits the patient, his family, and the nation’s economy.
“In view of the fact that the petitioners have admittedly signed the bond and accepted the terms and conditions stipulated therein, they are not entitled to claim any concession for further reduction of period stipulated under the bond conditions. Therefore, the petitioners have to serve in Government Medical College and Hospitals as per the appointment order in compliance with the conditions and after completion of the period stipulated, appropriate decision may be taken by the respondents”, it determined.
The High Court denied the writ petitions at admission.
Cause Title : B. Anantha Lakshmi v. Tamil Nadu & Ors.