Amala Cancer Hospital And Research Centre v. State of Kerala
2018-09-27
A.K.JAYASANKARAN NAMBIAR, HRISHIKESH ROY
body2018
DigiLaw.ai
JUDGMENT : Hrishikesh Roy, J. 1. Heard Sri. K. Jayakumar, the learned Senior Counsel appearing for the appellant/writ petitioner. Also heard Sri. N. Manoj Kumar, the learned Special Government Pleader representing the respondents. 2. For the sake of convenience, the parties are referred to as they appear in the Writ petition. The petitioner is a reputed Cancer Hospital registered under the Travancore Cochin Literary, Scientific and Charitable Societies Registration Act, 1955. The hospital operates on no profit no loss basis and from the very inception, the hospital has set apart a reasonable percentage of its income, to provide free treatment. In fact, 120 beds in the hospital are set apart for the poor patients. 3. During the year 1994, the Government of Kerala introduced a 'Saving Scheme for Cancer Care' (hereinafter referred to as 'the Scheme'), which envisaged mobilisation of fund collection under the 'Indira Vikas Pathras' and utilisation of 20% of the amount so collected, for detection and treatment of cancer and research on cancer treatment. Considering the track record of the petitioner hospital, the Kerala Government involved the petitioner, in implementation of the Scheme, which envisaged that 20% of the total income generated through sale of 'Indira Vikas Pathras'is utilised for development of the Cancer Institute as well as for care of the cancer patients. 4. Admittedly, the petitioner hospital mobilised Rs.26.38 Crores and as per the Ext.P2 schedule, they became entitled to 20% of the mobilised deposit, by way of grant. A committee was constituted to evaluate the progress of the implementation of the Scheme and also to decide the quantum of fund to be provided for different scheme/projects. Instructions were also issued for release of the fund amount, under the Ext.P3 Government Order dated 20.10.1994. 5. The Deputy Collector, Thrissur in his proceedings dated 1.9.1995 (Ext.P5) noted the participation of the petitioner hospital in the mobilisation efforts under the Schemeand declared that, out of Rs.26.38 Crores generated by them, they are entitled to 20% of the collection, as incentive grant. Consequently, Rs.200 Lakhs was allotted to the Amala Cancer Hospital and Research Centre, Thrissur (writ petitioner), under the Ext.P5 order with direction that the institution shall utilise the grant amount, only for the approved program under the Scheme.
Consequently, Rs.200 Lakhs was allotted to the Amala Cancer Hospital and Research Centre, Thrissur (writ petitioner), under the Ext.P5 order with direction that the institution shall utilise the grant amount, only for the approved program under the Scheme. Consequent to such decision, the administrative sanction was accorded to the petitioner for a sum of Rs.200 Lakhs for meeting expenditure towards setting up of Cobalt Teletherapy Unitand appurtenant structures (Ext.P6). 6. The petitioner hospital utlised the sanctioned amount for the approved purpose and on being satisfied, the request for additional grant was considered and accordingly, under the Ext.P7 communication dated 19.7.1996 additional disbursement of Rs.90 Lakhs was approved for the hospital. 7. While situated thus, the Government Order dated 24.10.1995 (Ext.P8) was issued, which took note of the steps taken for implementation of the Scheme as also utilisation of the collected sum under the Scheme. In Clause (6) of the Ext.P8 order, the Government noted that the Cancer Unit in the Thrissur Medical College is being equipped and in the interregnum the patients referred from the Medical College will be offered free treatment, by Amala Cancer Hospital, Thrissur. 8. The above communication was followed by the purported complaint made on 19.8.1997 (Ext.P9) by the Principal, Medical College, Thrissur, where, it was stated that the Amala Cancer Hospital is reluctant to give free medical treatment to the poor patients referred by the Thrissur Medical College. Acting on the complaint, the District Collector ordered for an enquiry to be conducted by the District Medical Officer of Health, Thrissur and accordingly a hearing was scheduled on 26.9.1997. This was followed by the Government Order dated 19.3.1998 (Ext.P11) where it was ordered that the District Collector, Thrissur will keep aside the grant amount for the Amala Cancer Hospital in the TPA account, until further instructions is issued by the Government. 9. The above developments led to the issuance of show cause notice dated 8.1.1998 (Ext.P13) to the petitioner hospital, where it was alleged that they denied free treatment to the cancer patients sponsored by the Medical College, Thrissur. The 2nd allegation was that out of the grant sanctioned to them, the petitioner had utilised Rs.1,25,43,812/-for purchase of various equipments and implements which are not covered under the cancer care scheme.
The 2nd allegation was that out of the grant sanctioned to them, the petitioner had utilised Rs.1,25,43,812/-for purchase of various equipments and implements which are not covered under the cancer care scheme. A four member enquiry committee then gave the report dated 10.6.1999 (Ext.P19), where it was reflected that the petitioner hospital had utilisied the grants for procurement of medical equipments, which are not directly related to the care of cancer patients. That apart, a further sum of Rs.57,51,089/-was proposed as not allowable from the allotted sum as it was opined that permissible construction in respect of the Cobalt Unit, was only Rs.9.8 Lakhs. Thus, the total amount to be disallowed was quantified at Rs.1,65,76,940/-. 10. On receipt of the notice dated 13.10.2018 (Ext.P18) based on Ext.P19 report, the petitioner approached this Court through O.P.No.32189 of 2000. The learned Judge, in the judgment dated 20.6.2006 (Ext.P20) found that Ext.P18 notice was issued without affording the petitioner any opportunity to comment upon Ext.P19 enquiry report. Accordingly reconsideration of the notice by providing opportunity to the petitioner was ordered by the court. 11. The petitioner then filed Exts.P21 and P22 objections/written arguments before the committee and this led to Government Order dated 27.11.2006 (Ext.P25) where the committee observed that the petitioner denied free treatment to the poor patients referred from the Thrissur Medical College and that they had mis-utilised an extent of Rs.1,65,76,940/-, for effecting purchase of equipments for development of infrastructure, which are not related directly to the treatment of cancer patients. In Ext.P25, recovery of this amount was contemplated from Amala Cancer Hospital and they were directed to remit the sum into the District Treasury, Thrissur. It would be relevant to note that in Ext.P25 communication, there was no mention of the forfeiture of the balance amount to which the petitioner was entitled, consequent to their mobilisation of funds under the Scheme. 12. The case set up by the petitioner before the learned Single Judge was that they became entitled to the grant consequent to their mobilisation efforts under the Scheme and there can be no justification for alleging that out of the sanctioned amount (Rs.2.90 Crore) some portion was mis-utilised or was not utilised, for treatment of cancer patients.
12. The case set up by the petitioner before the learned Single Judge was that they became entitled to the grant consequent to their mobilisation efforts under the Scheme and there can be no justification for alleging that out of the sanctioned amount (Rs.2.90 Crore) some portion was mis-utilised or was not utilised, for treatment of cancer patients. They also questioned the bonafides of the enquiry with regard to denial of the treatment to the cancer patients referred by the Medical College, Thrissur by projecting that 120 beds are set apart in the Amala Hospital for free treatment and in fact the hospital functions as a charitable institution, on no profit no loss basis. 13. On the other hand, the respondent would argue that the court should not sit in judicial review of the decision taken by the Government on the basis of the findings recorded by the enquiry committee to the effect that the petitioner had partially misutilised the grant. They also contended that equipments purchased by the petitioner hospital were not directly related to cancer care and therefore, the Government of Kerala was justified in asking for refund of the grant amount, utilised for non-permitted purposes. 14. In order to substantiate the genuineness of the utilisation of the fund, learned Senior Counsel Sri. K. Jayakumar has produced the document -“WHO list of priority medical devices for cancer management” and with this he contends that all the equipments procured by the Amala Cancer Hospital are very much useful and necessary in cancer care. 15. On consideration of the facts and circumstances and submissions made by rival counsel, we find that under the Exts.P2 and P3 scheme, institutions like the petitioner, which were engaged in care of cancer patients, were entitled to a grant equivalent to 20% of the deposit mobilised by them towards the Indira Vikas Pathras between the period 1.11.1994 – 31.1.1995. The entitlement of the petitioner was quantified at Rs.5.276 Crore and out of this sum, they were initially sanctioned and allotted an amount of Rs.2 Crore on 1.9.1995 as seen from Ext.P5. The Ext.P6 would indicate that the administrative sanction, that was a prerequisite for the allotment was also granted to the petitioner but the amount sanctioned was subject to the petitioner furnishing a utilisation certificate in respect of the same to the District Collector. 16.
The Ext.P6 would indicate that the administrative sanction, that was a prerequisite for the allotment was also granted to the petitioner but the amount sanctioned was subject to the petitioner furnishing a utilisation certificate in respect of the same to the District Collector. 16. The District Collector in the Ext.P7 communication dated 19.7.1996, acknowledged the utilisation of the initial amount of Rs.2 crore by the petitioner and thereafter additional sanction for Rs.90 lakhs was made subject to similar submission of the utilisation certificate by the petitioner. It is relevant to note that, at the time of sanctioning the additional amount, there was no case for the District Collector or the State Authorities that there was any mis-utilisation in respect of the Rs.2 crore that had been initially sanctioned to the petitioner. The allegation regarding mis-utilisation was raised for the first time, based on a complaint received from the Thrissur Medical College, alleging non-imparting of free treatment to patients referred from there. It was thereafter, based on the said complaint, that the Ext.P13 communication dated 8.1.1998 was issued to the petitioner, proposing to recover an amount of Rs.1,25,43,812/-, which allegedly was mis-utilised to purchase equipments that did not come under the Cancer Care Scheme. 17. It needs to be noted at this stage that the issue of denial of free treatment, which was raised in the said communication, was not one that flowed from the express terms of the Scheme, as can be seen from Exts.P2 and P3. The obligation to offer free treatment to those referred from Thrissur Medical College was imposed on the petitioner in terms of clause 6of the Ext.P8 communication dated 24.10.1995, during the stage of implementation of the Scheme and therefore had no bearing on the entitlement of the petitioner to the initial grant of Rs.2 crore. In fact, the quantification of the benefits to which the petitioner was entitled was done independently and without reference to the subsequent obligation of the petitioner, to provide free treatment to the patients referred from the Medical College Hospital, Thrissur. Besides, it is not in dispute that the petitioner hospital even otherwise was providing free treatment to a significant number of cancer patients. 18.
Besides, it is not in dispute that the petitioner hospital even otherwise was providing free treatment to a significant number of cancer patients. 18. As regards the report (Ext.P19) of the four member enquiry committee which suggests that equipments purchased by the petitioner hospital were not directly related to the care of cancer patients, we must admit that we are surprised by the said finding. In the list of equipments disallowed by the committee, there are equipments such as Gastro video scope, mobile c arm & Mammo diagnost, Manman Ortho surgery drill and saw, and several such other items, which are intrinsically linked to cancer treatment. The exclusion of these items for the purpose of disentitling the petitioner to the benefits of the Scheme, is indicative of the myopic approach that appears to have been taken by the respondents while determining whether the equipments purchased by the petitioner, were actually in connection with cancer care and treatment. In this context, when we look at the priority medical devices prescribed by the WHO, for cancer management, it is apparent that the equipments procured by the petitioner/Hospital would relate to various aspects of cancer treatment such as use in clinical assessment and endoscopy, surgery, clinical laboratory and pathology, systemic therapy, palliative care and other essential requirement for cancer treatment. Therefore, it would be reasonable to assume that the report given by the four member committee was prepared without due application of mind. According to us, the expenditure towards these items could not have been excluded and therefore, the cost incurred by the hospital for procuring those equipments had to be allowed under the Scheme. 19. As a matter of fact, the equipments in question were used for cancer care and treatment but the disallowance is based on mere surmises that perhaps these equipments were not specifically needed for cancer care and treatment. The petitioner hospital is essentially a cancer treatment hospital which has been the premium hospital for cancer care in the State for several decades and has since been conferred the status of a full-fledged medical college hospital with specialty for cancer treatment. Therefore we find it rather absurd that the committee would conclude that the equipment purchased by the hospital was not related to cancer care and treatment.
Therefore we find it rather absurd that the committee would conclude that the equipment purchased by the hospital was not related to cancer care and treatment. The finding of the committee that the equipments in question purchased by the petitioner were not directly related to the cancer care is a fallacious finding and cannot be made the basis for recovery of the amount already sanctioned to the petitioner under the scheme. For the same reason, we have no hesitation to hold that the reasons contained in the enquiry report cannot be the basis for forfeiture of the balance entitlement due to the petitioner, in terms of the Scheme. 20. The learned Senior Counsel for the petitioner would point out at this stage that while he had approached this court seeking a mandamus to direct the respondents to sanction the balance amount to which the hospital is entitled, taking note of the subsequent development, whereby he is informed that the amounts that were intended for the writ petitioner, have since been diverted to other hospitals which participated in the scheme, the petitioner does not intend to pursue the claim for the balance amount since the said amounts have admittedly been utilised for cancer care. The chief concern of the learned Senior Counsel is with regard to the tarnishing of the good name of the petitioner which has earned its reputation through its commitment in the field of cancer care. 21. Taking note of the said submission, while we disagree with the findings of the learned Single Judge holding the petitioner dis-entitled to the amounts to which he was entitled under the Scheme (Rs.5.276 crores), the limited relief that can be granted to the petitioner at this stage, according to us, is to declare that the respondents shall not recover the amount of Rs.1,65,76,940/-from the petitioner from out of the amount already sanctioned to them. We, therefore, set aside the judgment of the learned Single Judge so as to erase any doubt that could have been cast on the reputation of the petitioner institution, pursuant to the findings in the impugned judgment, we also quash the Ext.P19 enquiry report, and Ext.P25 order that were impugned in the writ proceeding. The writ appeal stands allowed as above.