Summary
Taking suo motu cognizance after the rape and murder of a postgraduate doctor at RG Kar Medical College Hospital, Kolkata, and the later vandalism of the hospital, the Supreme Court found that the lack of institutional safety for medical professionals is a systemic national problem. It constituted a National Task Force to recommend a national protocol on preventing violence, including gender-based violence, and on safe working conditions, and called for data from all governments and status reports on the investigations.
Issues
- Whether systemic deficiencies in institutional safety at healthcare establishments, exposing medical professionals and particularly women to violence and sexual violence, required the Court's intervention.
- What mechanism should be put in place to evolve a national protocol for the safety, working conditions and well-being of medical professionals.
- What reports were required on the investigation of the crime and of the vandalism at the hospital.
Provisions considered
- Section 2(o)(ii) and (iii), Sexual Harassment of Women at Workplace (Prevention, Prohibition and Redressal) Act, 2013The Court noted that the definition of workplace covers hospitals and nursing homes, including private health service providers, so an Internal Complaints Committee must be constituted in all of them. (¶ 12)
- Section 19, Sexual Harassment of Women at Workplace (Prevention, Prohibition and Redressal) Act, 2013The employer's duties under this section, including providing a safe working environment and organising sensitisation programmes, were listed among the matters the National Task Force must address, and governments were asked to report whether hospitals discharge them. (¶¶ 12, 16)
- Provisions penalising violence against medical professionals and damage to property, State laws on violence against medicare service persons (Maharashtra, Kerala, Karnataka, Telangana, West Bengal, Andhra Pradesh, Tamil Nadu)The Court noted that these Acts make such violence a non-bailable offence punishable with three years' imprisonment, but observed that they do not address the institutional and systemic causes, and enhanced punishment alone falls short. (¶ 8)
Held
- Violence against doctors, nurses and paramedical staff in hospitals reflects a systemic failure to protect them. Women medical professionals are at particular risk of sexual and non-sexual violence, including from within institutional hierarchies. Safe working conditions are central to equality of opportunity and are a matter of national interest, and change cannot wait for another rape or murder. (¶¶ 6, 7)
- The Court expressed its inability to understand how the State was unprepared for the vandalism of the hospital, given that the State was expected to deploy its machinery to maintain law and order while the investigation of a crime within the hospital was under way. (¶¶ 4, 5)
- State laws penalising violence against medical professionals do not address the underlying institutional causes. The Court set out a non-exhaustive list of deficiencies: inadequate and non-segregated duty rooms, 36-hour shifts without basic amenities, lack of security, CCTV and weapon screening, unrestricted access to all areas, poor lighting and transport, and no grief-handling support. (¶¶ 8, 9)
- A National Task Force of named medical experts, with the Cabinet Secretary, Home Secretary, Health Secretary (as Member-Secretary), the Chairperson of the National Medical Commission and the President of the National Board of Examinations as ex officio members, was constituted to recommend an action plan after consulting all stakeholders. The plan covers preventing violence, including gender-based violence, and an enforceable national protocol for safe and dignified working conditions, with timelines. (¶¶ 10, 11, 12, 14)
- The matters the Task Force must consider include triaging security by area, screening at entrances, separate gender-wise duty rooms, access control, lighting, CCTV, night transport, grief counsellors and workshops, Employees Safety Committees, accreditation criteria, police posts, and constitution of Internal Complaints Committees and discharge of employer duties under the 2013 Act, with a 24x7 helpline. (¶ 12)
- 'Medical professionals' in the order includes doctors, MBBS students on compulsory rotating internship, resident and senior resident doctors, and nurses including nursing interns. (¶ 13)
Result
Directions issued: the National Task Force to file an interim report within three weeks and a final report within two months; the Union to file, within one month, tabulated data collated by Central, State and UT health secretaries on security, duty rooms, CCTV, screening, Internal Complaints Committees and related matters in government hospitals; the CBI and the State of West Bengal to file status reports by 22 August 2024; matter listed on 22 August 2024.