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2018 DIGILAW 364 (ALL)

KANTI (DEVI) v. STATE OF U. P.

2018-02-08

RAJAN ROY, RAJESH SINGH CHAUHAN

body2018
JUDGMENT : 1. Counter affidavit filed on behalf of the opposite party no. 8 is taken on record. Heard. 2. This is an unfortunate case where the son of the petitioner died without getting proper treatment of his disease (Cancer). 3. The facts of the case in brief are that the son of the petitioner Satish Kumar, who was 24 years old and was working as Mechanic on part time basis as informed by the petitioner who is present in person, was suffering from Lymphoma, which is a malignancy. It appears a request was made to the Chief Minister's Office on 24.04.2017 in the 'Janta Darshan'. Some noting was made thereon to the Chief Medical Superintendent, Sitapur. Thereafter, it appears that Late Satish Kumar appeared before the Chief Medical Superintendent, District Hospital Sitapur on 25.04.2017 in response to a telephonic communication by the C.M.S. on 24.04.2017 obviously in pursuance to the submission of the application in the Chief Minister's Office and on the said date he was examined by Dr. J.N. Singh and was advised to undergo further treatment at the SGPGI, Lucknow and was referred to the said hospital accordingly. The letter of the C.M.S., Sitapur dated 25.04.2017 which is addressed to the Incharge Officer, I.G.R.A., Sitapur mentions the aforesaid facts and it also mentions that the petitioner was advised to get an estimate of the expenses to be incurred in his treatment prepared from the SGPGI, Lucknow and to submit the same at District Hospital, Sitapur whereupon the requisite formalities including filling up the requisite form would be got done and financial assistance would be extended. In this manner the complaint submitted during Janta Darshan was partly disposed of. It appears thereafter, the petitioner along with her ailing son went to SGPGI, Lucknow and visited its Out Patient Department (OPD). The patient OPD record is annexed as Annexure No. 4 to the writ petition. As treatment of the said ailment involved substantial amount of money, therefore, in utter desperation after having visited various hospitals in this regard and having ultimately got himself discharged on account of lack of adequate funds for getting himself treated, the deceased son of the petitioner wrote to the Office of the Chief Minister begging for financial assistance. As treatment of the said ailment involved substantial amount of money, therefore, in utter desperation after having visited various hospitals in this regard and having ultimately got himself discharged on account of lack of adequate funds for getting himself treated, the deceased son of the petitioner wrote to the Office of the Chief Minister begging for financial assistance. Though, the date of this letter is not known, the Court finds that on this last letter written by the deceased son, there is a noting at the top 'C.M.O. admit' which is dated 15.05.2017. 4. The contention of the learned counsel for the petitioner is that the patient was not admitted at SGPGI, Lucknow nor any examination etc. were got conducted, nor the estimate of the expenditure to be incurred in the treatment could be prepared. 5. However, on being asked as to whether any application was filed in the OPD before the concerned Doctor or officials of SGPGI, Lucknow for getting an estimate prepared learned counsel for the petitioner submitted that the petitioner is an illiterate lady so is her husband and possibly no such document (discharge slip) as is being claimed was given to them by the C.M.S., Sitapur for submitting at the SGPGI, Lucknow. 6. Shri Rajesh Tiwari, learned counsel appearing for the State has placed before the Court a 'discharge slip' on which the word 'discharge' has been crossed out, which contains a noting by the Chief Medical Superintendent, District Hospital Sitapur asking Late Satish Kumar or his father Kamta to get an estimate as referred herein above prepared from the SGPGI, Lucknow and to submit it in the Hospital. The said document bears a note by Shri Kamta the husband of the petitioner and father of Late Satish Kumar to the effect that he was taking Late Satish Kumar for treatment to SGPGI, Lucknow and would return back and get the complaint disposed of. 7. However, it is not very clear as to whether this document was handed over to Kamta or to the petitioner or Late Satish Kumar. 8. 7. However, it is not very clear as to whether this document was handed over to Kamta or to the petitioner or Late Satish Kumar. 8. Be that as it may, the fact of the matter is that the estimate could not be got prepared, for whatever reason , but, primarily it appears on account of a communication gap on account of the parties being illiterate and the son not being in a position to decide for himself in the medical condition in which he found himself. This of course is on the assumption that the Discharge Slip was handed over to them. 9. It appears that after this the letter which is annexed as Annexure No. 5 to the writ petition, may have been written. The factum of its receipt is not in dispute because it bears an endorsement of some officer at the top as already referred. 10. The unfortunate aspect of the entire sequence of events is that a young boy of 24 years, who did not have the necessary resources died for want of treatment on account of this. The parents are illiterate. The mother does odd jobs in households. The father plies a Rickshaw Thela. 11. The mother stands before us in tears. 12. While we can not put the clock back nor bring her son back we can certainly make efforts to ensure that such incidents do not happen again. 13. While we do not find any error on the part of the Chief Minister's Office in the facts of this case, but, we certainly find that the appropriate mechanism to cater to the needs of poor and illiterate people such as the petitioner is not in place. We have to keep in mind that poor and illiterate citizens do not have the necessary awareness and skills to deal with the complex formalities required of them as in this case where the petitioner or her husband were required to take the discharge slip allegedly given to them by the C.M.S., Sitapur and submit it in the OPD at SGPGI, Lucknow, and after getting an estimate prepared to submit it again before the C.M.S., Sitapur for further action. For lack of requisite understanding about the functioning of Hospitals and the absence of necessary communication skills in these times of excessive professionalism bordering on indifference these poor and illiterate people, who are substantial in number, at least in this state, often suffer for no fault of theirs, as in this case. One wonders as to why in this age of communication and technological development a mechanism can not be put in place under which the C.M.S. or whosoever is involved, directly transmits and communicates to the concerned Hospital where the patient is being referred, the need for an urgent estimate of expenditure to be incurred for treatment of the patient 'online' or through any other speedy means of communication, with a response by the said Hospital as to the date for examination of the patient for this purpose depending upon the urgency of the situation, whereupon, the patient can be informed of the said date by the referring hospital itself, if he is literate telephonically or through SMS (if mobile facility is available) in Hindi or any other language known to the patient or his attendant and if they are illiterate or not so literate so as to manage on their own, then, by personally providing him requisite guidance orally with clarity, may be, with the help of MSWs or similarly qualified personnel engaged by the hospital for this purpose who can also ensure proper communication and follow up with the concerned referral hospital so as to obliterate any miscommunication between the parties so that these patients or their attendants, are spared the bureaucratic wrangles involved in such an exercise for which they are not adept considering the constrains of language, mannerism, lack of communication skills, education etc., so that they can be examined by the concerned referral hospital without much hassle and an estimate of expenditure be prepared accordingly so that lives are not lost, as in this case. This would militate against situations of loss of life merely on account of such people not being able to cope up with these hassles. 14. In addition, a hard copy of such communication in Hindi should also be given to the patient or the attendant, as the case may be, and specific endorsement should be obtained on the office copy that he or she has received it. 14. In addition, a hard copy of such communication in Hindi should also be given to the patient or the attendant, as the case may be, and specific endorsement should be obtained on the office copy that he or she has received it. This should also be accompanied by proper oral guidance apart from the written one as regards the steps that are to be taken for facilitating the preparation of such estimates. 15. We have gone through the Rules of 2013 in this regard and find that such a mechanism is conspicuously absent therein. All District Government Hospitals, Medical Colleges or other Government Medical Institutes and SGPGI should be covered by such a procedure and the Doctors and Officials therein should be sensitized about the special attention and guidance to be provided to the poor especially illiterate citizens of the State. The aforesaid is only a suggestion. If a better mechanism can be devised after proper deliberations, it would be welcome. 16. We find that there was a gap from the stage of preparation of discharge slip by the C.M.S., Sitapur and the petitioner's appearance in the OPD at SGPGI, Lucknow. Even in the Rules, 2013 there is a vacuum in this regard which needs to be filled. The gap needs to be plugged in the larger interest of poor and illiterate persons. 17. While the object of the Rules, 2013 is laudable it is required to be revisited in the light of what we have stated herein above. 18. This will go a long way in allaying the feeling of marginalization amongst the poorest and the feeling that 'good life' is only for the rich. Adequate Medical facilities are part of the basic needs of the people in any civilized society, more so for the poor and illiterate. Government funds should first and foremost be utilized towards this end. 19. This apart, we find that after the death of the petitioner's son, the district authorities vide Annexure No. 7 to the writ petition recommended the grant of financial assistance to her from the Chief Ministers Discretionary Fund, but, we are informed that even this has not been paid till date, although, almost four months have lapsed since then. 20. 19. This apart, we find that after the death of the petitioner's son, the district authorities vide Annexure No. 7 to the writ petition recommended the grant of financial assistance to her from the Chief Ministers Discretionary Fund, but, we are informed that even this has not been paid till date, although, almost four months have lapsed since then. 20. In these circumstances, we direct the State Government, especially the Chief Minister's Secretariat, to look into the matter in the light of our observations made herein above and take all necessary measures in compliance of this judgment to consider and evolve a suitable mechanism for the smooth and hassle free extension of financial assistance under the Rules, 2013, if need be by amending them, to the poor and illiterate citizens of the State keeping in mind their lack of awareness, absence of requisite communication skills etc., within a time bound frame work, say, within the next six months. 21. The State Authorities are also directed to consider the petitioner's application as contained in Annexure No. 7 to the writ petition for grant of financial assistance from the Chief Ministers Discretionary Fund at the earliest, say, within a period of two months from the date a certified copy of this order is submitted. 22. Before parting, we must reiterate that we are quite anguished and pained at the unfortunate turn of events in this case. We hope and trust that the State Government takes up the matter with the seriousness and sincerity expected of it, at the earliest. 23. The learned Additional Chief Standing Counsel Shri Rajesh Tiwari shall inform all the concerned officials for compliance of this judgment. 24. The writ petition is disposed of in the aforesaid terms.