Summary
A public-interest writ petition under Article 32 sought to restrain private hospitals from compelling patients to buy medicines, implants and consumables from hospital pharmacies at inflated prices and to direct the Union and States to frame a regulatory policy. The Court held that the matter involves policy choices best left to the executive, that public health and hospitals fall within the State List, and disposed of the petition by directing all State Governments to consider the issue and take appropriate policy decisions, without expressing any opinion on the merits.
Issues
- Whether the pricing of drugs, equipment and accessories sold by pharmacies run by or tied to private hospitals can be regulated through administrative or legislative measures.
- If so, what the extent of such measures can be.
- What mechanism should enforce such measures and to whom that task can be entrusted.
Provisions considered
- Article 21, Constitution of IndiaThe Court reaffirmed that provision of medical facilities to all is an essential component of the right to life, which is why the States have promoted private entities in the health sector to make up for the shortfall in public medical infrastructure. (¶¶ 6, 13)
- Articles 38, 39 and 47 (Part IV, Directive Principles), Constitution of IndiaThe petitioners relied on the Directive Principles to argue that the States are obliged to introduce regulatory measures; the Court noted the States' commitment to provide medical facilities in furtherance of Part IV but treated the manner of doing so as a policy matter. (¶¶ 6, 13)
- Seventh Schedule, List II (public health and sanitation, hospitals and dispensaries), Constitution of IndiaBecause public health, hospitals and dispensaries are State List subjects, any regulatory measure of the kind sought must be taken by the State Governments keeping their local conditions in mind. (¶ 16)
- Article 32, Constitution of IndiaThe writ petition was filed under Article 32 in public interest; the Court disposed of it with a direction to the States rather than issuing mandatory directions. (¶¶ 1, 17, 18)
Held
- Access to medical facilities is part of the right to life under Article 21, and since the States have not been able to build adequate public medical infrastructure, they have promoted private hospitals, on which both the public and the States now depend for basic and specialised care. (¶ 13)
- Whether and how far the pricing practices of private hospital pharmacies should be regulated, and how such regulation should be enforced, are questions of paramount public importance but primarily involve policy decisions for which policy-makers are best equipped; any measures must protect patients from exploitation without unreasonably discouraging private investment in the health sector. (¶¶ 14, 15)
- Public health and sanitation, hospitals and dispensaries fall within List II of the Seventh Schedule, so measures of this kind must be taken by the State Governments having regard to local conditions. (¶ 16)
- It is not advisable for the Court to issue mandatory directions that may hamper the growth of private hospitals; instead the State Governments are to be sensitised to the problem of unreasonable charges and exploitation of patients in private hospitals and directed to consider the issue and take such policy decisions as they deem fit. No opinion was expressed on the merits. (¶¶ 17, 18, 19)
Result
Writ petition disposed of with a direction to all State Governments to consider the issue of unreasonable charges by private hospital pharmacies and take appropriate policy decisions; no opinion expressed on merits; pending interlocutory applications disposed of.