Delhi High Court
Court On Its Own Motion vs State Of Nct Of Delhi And Ors on 27 July, 2020
$~3 & 4
* IN THE HIGH COURT OF DELHI AT NEW DELHI
Date of Decision: 27th July, 2020
+ W.P.(C) 3250/2020 & CM APPL.11769/2020
COURT ON ITS OWN MOTION ..... Petitioner
Through: Mr. Om Prakash, Amicus Curiae
versus
STATE OF NCT OF DELHI AND ORS ..... Respondents
Through: Mr. Rahul Mehra, Standing Counsel
with Mr. Anuj Aggarwal, ASC,
Mr. Chaitanya Gosain, Mr. Ankit
Monga & Mr. Shikhar Sheel, Advs.
for GNCTD.
Mr. Chetan Sharma, ASG with
Mr. Sahaj Garg, Adv. for UOI.
Mr. Dayan Krishnan, Sr. Adv. with
Mr. Mahesh Agarwal, Ms. Parul
Shukla & Mr. Anirudh Bhatia, Advs.
for Intervener (Indraprastha Apollo
Hospitals).
Ms. Nancy Roy, Adv. for Intervener
in CM No.11769/2020.
+ W.P.(C) 3376/2020
KRISHNA KR. SHARMA ..... Petitioner
Through: Petitioner-in-person.
versus
GOVT. OF NCT OF DELHI ..... Respondent
Through: Ms. Hetu Arora Sethi, ASC, GNCTD.
Digitally Signed By:JUSTICE D
N PATEL
Location:
Signing Date:28.07.2020
10:44:58
CORAM:
HON'BLE THE CHIEF JUSTICE
HON'BLE MR. JUSTICE PRATEEK JALAN
D.N. PATEL, Chief Justice (Oral)
Proceedings of the matter have been conducted through video
conferencing.
1. W.P.(C) 3250/2020 has been initiated by the Court on its own motion
on the basis of the video clipping circulated through Mobile
No.9971993060. Vide order dated 26.05.2020, suo moto cognizance was
taken by this Court, especially about the inadequate arrangements to deal
with patients of Covid-19 who require hospitalisation and treatment,
including easy access to helplines, availability of beds, ambulances, etc.
2. W.P.(C) 3376/2020 has been preferred as a Public Interest Litigation
with the following prayers:
"i. Issue a writ in the nature of Mandamus or any other writ of
like nature thereby passing order or direction to the Respondent
for ensuring that those Government and Private Hospital or
Nursing home in the National Capital Territory that refuses
emergent medical care to the person amid Covid-19 pandemic,
an immediate action shall be taken against those defaulters.
ii. Issue a writ in the nature of Mandamus or any other writ of
like nature thereby passing order or direction to the Respondent
for ensuring that the Government and Private Hospitals shall
not deny the admission of asymptomatic and symptomatic
Covid-19 patient and complying with the order of the
Respondent pertaining to the treatment and admission of
asymptomatic and symptomatic or (COVID-19 and non-
COVID-19) patients.
iii. Issue a writ in the nature of Mandamus or any other writ of
like nature thereby passing order or direction to the Respondent
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for ensuring that Covid-19 test shall not be mandatory before
admitting elective and even emergency patients by Government
and Private Hospitals.
iv. Issue a writ in the nature of Mandamus or any other writ of
like nature thereby passing order or direction to the Respondent
for ensuring that Hospitals are not forcing Frontline health
worker to wear used PPE.
v. Issue a writ in the nature of Mandamus or any other writ of
like nature thereby passing order or direction to the Respondent
for ensuring that hospitals are not charging high amount for
PPE (beyond the actual cost) from patients, shall charge
reasonable.
vi. Pass any other appropriate Order or Direction as this
Hon'ble Court may deem fit."
3. We have heard learned counsel for both the sides including counsel
appearing for Indraprastha Apollo Hospital.
4. Learned counsel appearing for Government of National Capital
Territory of Delhi (hereinafter, "GNCTD") has submitted in detail about the
various steps taken by the GNCTD. Multiple affidavits have been filed
during the course of these proceedings regarding the various facilities which
have been put in place. It is inter alia stated therein as to how the
respondent/Government has extended the centralised helpline 1031 along
with 50 hunting lines through which the public at large can avail the details
of the availability of beds in the hospitals and the other facilities.
5. For ready reference, paragraph 3 of the counter affidavit filed by
GNCTD dated 15.07.2020 reads as under:
"3. That the deponent has gone through the directions issued by
this Hon'ble Court and the following submissions are being
made for kind perusal of this Hon'ble Court:
a)It is humbly submitted that 50 hunting lines have been added to
augment the capacity of helpline number 1031 and therefore
Digitally Signed By:JUSTICE D
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Signing Date:28.07.2020
10:44:58
more calls are being attended simultaneously and effectively.
In the period ranging from 01.07.2020 to 09.07.2020, a total of
37,289 calls were received out of which 34,087 calls were
attended by call center executives and 2479 calls were attended
via interactive voice response system. The number of unattended
called are dropping significantly over the period of time. The
details of call logs for the aforesaid period is attached herewith
as ANNEXURE-R1.
b) It is submitted that presently there are 273 Ambulances
dedicatedly available for COVID-19 patients and an additional
294 ambulances have been made available for non-COVID
patients. Furthermore, 9 ambulances are equipped with ALS
while 294 ambulances which includes CATS ambulances, army
ambulances, DSHM Rakshak Ambulance, Medulance and DHS
ambulance are equipped with BLS and BLS GVK facility.
Presently, the total fleet of ambulance (including 200 taxis for
non-critical patients) have significantly increased to 602 as
against the last availability of total 334 Ambulances as were
available on 05.06.2020. Further efforts are being made to
enhance the ambulance fleet. A copy table containing the details
of the ambulance fleet as on 09.07.2020 is attached herewith as
ANNEXURE- R2.
c) A major overhauling of COVID testing has been carried out by
the Answering Respondent, keeping in mind the ever-increasing
demand of testing kits in the near future. There are three types of
testing kits available which differ with each other in the process
they use to give results. These are Rapid Antigen Detection Kits,
RT PCR molecular testing and CBNAAT/TrueNat testing.
d) It is submitted that Rapid Antigen testing has been recently
introduced in Delhi. A total of 11.0 lac Rapid Antigen Detection
Kits have been procured by NCT of Delhi. The Answering
Respondent has a sufficient buffer of 8.27 lac testing kits as on
14.07.2020 to meet the future demands. Furthermore, orders for
testing kits will be placed in advance as and when required in
case the buffer is reduced by a significant quantity. The Antigen
testing model for COVID is capable of giving results in roughly
30 minutes and is the frontline testing method being used. NCT of
Delhi has taken various steps to augment testing and make
Digitally Signed By:JUSTICE D
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testing available and accessible to the general public with
considerable ease. It is pertinent to mention that the quantity
acquired of these testing kits are sufficient to meet the demand of
testing for more than two months. Since its inception on
18/06/2020, accessibility of Rapid Antigen Detection Tests has
been increased across Delhi. Apart from Containment
zones/Hotspots, this testing has been made available at 37
hospitals with all Delhi Govt, hospitals offering the Point of care
test for which results are available within 30 minutes. Rapid
Antigen Testing is being further expanded to Delhi Govt.
dispensaries and Polyclinics.
e) It is pertinent to mention that Rapid Antigen testing has been
made available free of cost at all government hospitals and 182
Delhi government dispensaries. Furthermore, the Answering
Respondent vide order dated 05.07.2020 and 09.07.2020 has
directed all health facilities to compulsorily conduct Rapid
Antigen Testing for individuals in high risk group like
asymptomatic elderly patients with co-morbidities (>65 years),
asymptomatic patients seeking admission for chemotherapy, HIV
patients, asymptomatic transplant patients etc. The copies of
order dated 05.07 .2020 and 09.07.2020 is attached herewith as
ANNEXURE-R3 (colly).
f) The testing kits available to undertake RT PCR based
molecular testing which is the gold standard for testing, are
sourced from multiple Public-sector labs including the Indian
Council of Medical Research, State procurement, Philanthropic
donations and procurement by individual labs/institutions. RT
PCR testing takes minimum 2-5 hours. Kits to undertake RT PCR
based testing are now available with all the labs. The RT PCR
testing is primarily being used on those symptomatic individuals
who are reporting as "negative" under the rapid antigen testing
(taken from SR).
g) Furthermore, Kits to undertake CBNAAT/TrueNat based
testing which also provide quick results, is sourced from Public
sector that includes supply from Govt. of India (Revised National
Tuberculosis Control Program /Central TB Division) and
procurement by individual labs/institutions. There has been
scarcity of CBNAAT testing kits available because of its limited
Digitally Signed By:JUSTICE D
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availability, however, the Answering Respondent is making
continuous efforts to ensure its availability.
h) The capping of price of testing has been done by NCT of Delhi
based on the recommendations of the committee under Dr. V.K.
Paul , Member, NITI Aayog. The GNCTD vide its order dated
18/06/2020 capped the price of RT PCR based molecular testing
at Rs. 2,400/- inclusive of taxes in order to keep the prices of the
testing kits affordable for the public at large. A copy of the order
dated 18.06.2020 is attached herewith as ANNEXURE- R4.
Furthermore, ICMR has capped the price of Rapid Antigen
Detection Kit at Rs. 450/-. The Answering Respondent currently
has 51 ICMR accredited labs (21 in public sector and 30 in
private sector) to carry out COVID- 19 testing through RT PCR
/CBNAAT/TrueNat.
i) It is submitted that an e-mail was sent to all private sectors
labs to ensure that home-sample collection is not being refused
on any grounds. A copy of the email dated 29.06.2020 is attached
herewith as ANNEXURE- R5. It is humbly submitted that the
number of tests being conducted has increased from 18,000 (as
previously submitted before this Hon'ble Court) to approximately
22,000 per day. The Answering Respondent is making all efforts
to ensure that sufficient amount of testing is conducted to combat
the COVID-19 situation. A table showing the number of tests
undertaken during the period ranging from 09.07.2020 to
15.07.2020 is attached herewith as ANNEXURE - R6.
j) The Government of NCT of Delhi vide order dated 28.06.2020
endorsed the advisory of the ICMR to increase the number of
tests in the state, both in public and private sector, and the same
is being implemented. A copy of order dated 28.06.2020 is
attached herewith as ANNEXURE-R7.
k) It is submitted that the Answering Respondent vide order dated
09.07.2020 has directed all hospitals to update data on the
mobile application called Delhi Corona and the website, in the
given Integrated Disease Surveillance Program (IDSP) format.
A copy of the Order dated 09.07.2020 passed by the Principal
Secretary (H&FW) directing all hospitals to comply with the
directions of this Hon'ble Court in relation to updating
information on the mobile app and the website in IDSP format is
Digitally Signed By:JUSTICE D
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Signing Date:28.07.2020
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attached herewith as ANNEXURE- R8. It is submitted that the
aforesaid order is issued as a warning to all hospitals.
l) It is humbly submitted that the Answering Respondent is under
the process of collating data pertaining to IDSP and Real time
data as per this Hon'ble Court's direction vide order dated
26.06.2020 and the same shall be filed as an additional affidavit
at the earliest.
m) It is humbly submitted that Nodal officers have been
appointed to mitigate any difficulty faced by the public at large
and to also ensure that there is no communication gap between
the government and the hospitals. The nodal officers will
exercise general superintendence and control over their
respective hospitals. All the relevant details qua the nodal
officers so appointed, are as under:-
LIST OF NODAL OFFICERS APPOINTED
Name of the officer Name of the hospital
Mr. Arava Gopi Krishna Lok Nayak Hospital
Mr. Binay Bhusan, IAS GTB Hospital
Mr. Vikram Singh Malik, IAS Burari COVID health centre
Ms. Akriti Sagar, IAS Satyavadi Raja Harish
Chandra Hospital
Mr. Ravi Dhawan, IAS Ambedkar Nagar Hospital
Mr. Vikram Singh Malik, IAS Rajiv Gandhi Super Speciality
Hospital
Mr. Awinash Kumar, IAS Deep Chand Bandu Hospital
A Copy of the orders passed to appoint the aforesaid officials as
Nodal Officers is attached herewith as ANNEXURE-R9(colly).
Furthermore, 114 Senior Nursing Officers (SNO's) were
appointed as previously submitted before this Hon'ble Court for
all private hospitals to manage admission of patients and ensure
proper communication with the government. Moreover, a
Special Secretary, Mr. Udit Prakash IAS, has been appointed for
overall supervision of the aforesaid SNOs in case there is a need
to escalate the matter.
Digitally Signed By:JUSTICE D
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Signing Date:28.07.2020
10:44:58
n) It is submitted that Convalescent Plasma (COPLA) Therapy is
a treatment that is being used as treatment for people with severe
COVID cases. It has been observed that people who have
recovered from COVID- 19 have antibodies to fight the disease
to some extent. The liquid portion of the blood is known as the
convalescent plasma. The Answering Respondent has set up a
"Delhi Plasma Bank" at the Institute of Liver and Biliary
Sciences (ILBS), Vasant Kunj, New Delhi to ensure the
availability of COPLA for the patients. Furthermore, all medical
critically ill Superintendents have been instructed to appoint
Nodal Officers from their respective hospitals to communicate
and coordinate with Delhi Plasma Bank. It is pertinent to
mention that COPLA is being made available free of cost. A copy
of the order dated 08.07.2020 setting up the Delhi Plasma Bank
is attached herewith as ANNEXURE - R10.
o) It is submitted that the Answering Respondent has instructed
all the medical superintendents of all public/private hospitals to
obtain feedback of patients and their willingness to donate
plasma at the time of their discharge to ensure that the Plasma
bank is sufficiently stocked to meet the future demands. Based on
the information provided in the feedback form, the patients who
have recovered, can also be contacted in case there is dire need
of plasma. A copy of the directing the Medical dated 07.07.2020
order Superintendents to collect feedback of patients who have
recovered from COVID- 19 is attached herewith as ANNEXURE
- R11. Furthermore, another Plasma Bank has been recently
opened at Lok Nayak Hospital, New Delhi."
6. In view of the aforesaid facts stated by GNCTD, it appears that now
several of the facilities and resources available to the public have been
augmented by the respondents, to meet the requirements in the face of the
Covid-19 pandemic. For example, 50 hunting lines have been added to
extend the capacity of already existing centralised helpline No.1031. As
many as 37,289 calls have been received and attended in a period from
01.07.2020 to 09.07.020, details whereof have been given in Annexure R-1.
Digitally Signed By:JUSTICE D
N PATEL
Location:
Signing Date:28.07.2020
10:44:58
7. Similarly, the number of ambulances available was initially 334 as on
05.06.2020, which has now been increased upto 602 as on 09.07.2020.
Moreover, 273 ambulances have been dedicated for Covid-19 patients and
additional 294 for non-covid patients.
8. The quantum of Covid-19 testing has also seen a sharp increase after
the introduction of rapid antigen testing. Even thereafter, the daily number
of tests conducted has increased from the initial count of 18,000 tests to
approximately 22,000 per day. So far as buffer stocks of the Rapid Antigen
Testing Kits is concerned, it appears that the respondents have a sufficient
buffer of 8.27 lakh testing kits as on 14.07.2020. Learned counsel for the
GNCTD states that the quantity of these testing kits acquired by the GNCTD
is sufficient to meet demand of testing for atleast two months.
10. It further appears that Rapid Antigen Testing is available in
Government hospitals and government dispensaries free of charge.
Similarly looking at the further steps initiated by the GNCTD, for high risk
groups/persons, reverse transcription polymerase chain reaction (RT-PCR)
test is capped at Rs.2,400/-.
11. Various office orders, notifications and directions have been issued,
including an email dated 29.06.2020 to all private sector labs to ensure that
home collection of blood samples is not refused on any ground.
12. It further appears from the facts of the case that Nodal officers have
been appointed to mitigate any difficulty faced by the public at large. These
facts we have highlighted in our previous orders, including the order dated
25.06.2020. Nonetheless, we have reproduced above the table which has
been supplied in paragraph 3(m) of the aforesaid affidavit, and reflected at
Annexure R-9 to the memo of the counter affidavit.
Digitally Signed By:JUSTICE D
N PATEL
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Signing Date:28.07.2020
10:44:58
13. Similarly, as we have already pointed out in our earlier orders that
Central Government has also appointed specific nodal officers by name for
real time updation of beds availability data in the Central Government
hospitals i.e. Safdarjung Hospital, Ram Manohar Lohia Hospital, Lady
Hardinge Hospital and All India Institute of Medical Sciences (AIIMS).
After nomination of said specific nodal officers, there ought not to be any
difficulty in updation of beds availability data as well as any communication
gap between the Government and the hospitals, and no specific grievance in
this regard has been raised by any of the counsel.
13. One more significant initiative has been taken by the GNCTD, i.e.
setting up of "Delhi Plasma Bank", to assist in the treatment of Covid-19
patients. Two "Delhi Plasma Banks" have been opened by GNCTD which is
an important step taken by GNCTD. One such plasma bank is available at
Institute of Liver and Biliary Sciences (ILBS), Vasant Kunj and another at
Lok Nayak Jai Parkash Hospital, Delhi Gate. More than 300 plasmas are
available as submitted by counsel for GNCTD.
14. Learned Amicus Curiae has also filed an additional report dated
15.07.2020. In the said report, he has submitted at length about the failure of
certain hospitals regarding real-time updation of data and difficulties being
faced by persons in getting admission in hospitals etc. Nonetheless, looking
to the aforesaid aspects of the matter, we are of the view that the updation of
the real time data is being taken care of by the GNCTD. Moreover, mobile
application has also been developed by the GNCTD for real time data
updation, from both Government hospitals as well as private hospitals. In
this regard, various office orders/ directions/notifications have also been
issued. Nodal officers have also been appointed to take care of such real
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time updation of data and the telephonic lines have also been made available
to get the information or to make a complaint. In the event there are any
hospitals which are still in breach of the directions given from time to time,
the GNCTD will coordinate with the said hospitals to remedy the situation
and may take such further action as required in the public interest.
15. The learned Amicus Curiae has also drawn the attention of the Court
to a newspaper report published in the Times of India edition of 25.06.2020
regarding the problems faced by an Advocate, Mr. Surjendu Das in
accessing treatment at Indraprastha Apollo Hospital. In particular, it is
submitted that Mr. Das was denied admission in the hospital despite the
published data showing availability of beds. As far as this aspect is
concerned, it is submitted by learned counsel appearing for Indraprastha
Apollo Hospital that general ward beds were available and offered to Mr.
Das. However, private rooms and ICU beds were not available on that
particular date. At the relevant time, approximately 30 beds were available
in the general ward. Moreover, Mr. Das's Covid-19 test result was given on
the same day and hence, the Indraprastha Apollo Hospital authority denies
the allegations levelled against it. We therefore do not consider it necessary
to pass any further directions in this regard in the present proceedings,
leaving it open to the concerned person to agitate his grievances in
accordance with law, if he is so inclined. Nonetheless, it is assured by
counsel for Indraprastha Apollo Hospital that they shall upload real time
data accurately and if any patient comes they will immediately be tested and
if beds are available, the same will be provided to the patients.
16. So far as W.P.(C) 3376/2020 is concerned, looking to the aforesaid
steps taken by GNCTD, we see no reason to entertain this case further.
Digitally Signed By:JUSTICE D
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Signing Date:28.07.2020
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Nonetheless, liberty is reserved with the petitioners in this case that, if at all
they are aggrieved in a particular case, they may initiate legal proceedings in
accordance with law before appropriate forum for an individual case so that
the concerned hospital or concerned authority can be given the opportunity
to answer the allegations levelled against it.
17. In view of the aforesaid aspects of the matter, we do not consider it
necessary to monitor these litigations further at this stage. The concerns
noted by this Court in the order dated 26.05.2020, while taking suo moto
cognisance, have been addressed by the respondents in the manner noted
above. Nonetheless, we hereby direct the respondents to ensure that the
directions/ notifications/ office orders which are issued by them are being
followed by the hospitals scrupulously. The real time updation of data must
also be done accurately so that the public at large can look into the
availability of the ventilators, beds etc. Ambulances which have been made
available with necessary facilities, the same will be continued. The helplines
must be kept in working condition. It must not happen that these helpline
numbers are not responsive to the persons in search of details. Learned
counsel appearing for the GNCTD assures the Court that the necessary steps
will continue to be taken by the GNCTD for facing the challenge of the
Covid-19 pandemic, as required from time to time.
18. We appreciate the painstaking assistance given by Mr. Om Prakash,
the learned Amicus Curiae appointed by this Court. We are thankful to the
learned Amicus Curiae who has assisted us and has narrated us in detail the
factual aspects of the matter and the steps taken by the respondents which
we have also noted in our earlier orders.
19. With these observations, these writ petitions are disposed of.
Digitally Signed By:JUSTICE D
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Signing Date:28.07.2020
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CM APPL.11769/2020 (for Intervention) in W.P.(C) 3250/2020
In view of the order on the writ petition, no orders are required on this
application.
The same stands disposed of accordingly.
CHIEF JUSTICE
PRATEEK JALAN, J
JULY 27, 2020/kks
Digitally Signed By:JUSTICE D
N PATEL
Location:
Signing Date:28.07.2020
10:44:58
