The Hindu Editorial Analysis- 13th May 2023 | Current Affairs & Hindu Analysis: Daily, Weekly & Monthly - UPSC PDF Download

Diagnostic imaging of the Rajasthan Right to Health Act

Why in News?

The Rajasthan Right to Health (RTH) Bill, which became an Act in April, had caused a bitter row following which the State government agreed on some exclusions. Many doctors termed the Act draconian, while public health activists have largely stood by it. But there are certain aspects of the Act that have attracted little discussion, which also make it unfit to be an ideal precedent for other States.

Key Features of the Bill

• The Bill provides the right to health and access to healthcare for people in the state. This includes free health care services at any clinical establishment to residents of the state.
• The Bill sets certain obligations on the state government to ensure the right to health and maintain public health.
• Health Authorities will be set up at the state and district level. These bodies will formulate, implement, monitor, and develop mechanisms for quality healthcare and management of public health emergencies.

Need for the Bill in Rajasthan

• Share in Population: Bihar, Jharkhand, Uttar Pradesh, Uttarakhand, Madhya Pradesh, Chhattisgarh, Odisha and Rajasthan--account for about 47% of India's population; they are more rural and socioeconomically backward compared to the rest of the country.
  • They are also high focus states under the National Rural Health Mission (NRHM), in view of their relatively higher fertility and mortality indicators.
• Post COVID: The COVID pandemic has exposed the incompetence of the health care system and refutation of basic health amenities. 
  • Simple functions of health care such as testing, contact tracing or even changing the behaviour of citizens required the intervention and undivided attention of the district administration. 
  • During the pandemic, even non-COVID patients were denied treatment and still they were unable to give adequate treatment to all the COVID affected patients.  
• Demand for Right to Health: It’s also been nearly a decade since various civil organisations have been demanding and persuading different governments to propose laws that make health a public right.
• Political Will: It was only in the election manifestos of a couple of political parties that this issue was highlighted and political commitment was visible. However, that went to the gallows as they never came near to being in power or having any say as such in government decision making.

Does the Constitution guarantee a right to health?

• The Indian Constitution does not explicitly talk about a right to health. A “Right to health”, in theory, is derived from the Right to life and liberty as guaranteed under Article 21 of the Constitution.  
• Previously, courts have highlighted the State’s obligation to protect and promote the health of citizens, pointing to Constitutional provisions such as Article 38 (promoting the welfare of people) and Article 47 (which directs the government to meet the nutrition and health requirements of the population). 
• In Paschim Banga Khet Mazdoor Samity v. State of West Bengal (1996), the Supreme Court averred that it is the government’s responsibility to provide medical aid in the interest of bolstering public health.
• As per a 2013 study, more than half of the world’s countries have a guaranteed and specified right to public health and medical care written into their constitutions.

Key Issues

• Commercially Unviable for Private Establishment: A resident of the state has the right to avail free healthcare services from any clinical establishment including private establishments. There is no provision for reimbursing private health establishments for providing free healthcare services.  This may make these establishments commercially unviable and violate Article 19(1)(g) (Right to practice any profession) of the Constitution.
• Privacy of the Patients: The District Health Authority is required to upload an action taken report on the web portal for complaints.  The Bill does not specify who will have access to the report on the web portal.  This may infringe on the patient’s right to privacy in medical cases.
• Financial Burden on States: Implementing the right to health may increase the financial obligation of the state.  The Bill does not provide for such additional costs.
• Institutional and health worker shortage: Ensuring free and quality healthcare at all establishments would require adequate human resources and infrastructure at all clinical establishments.  Data suggests that there may be a shortage of such resources in the state.  This may affect the effective implementation of the right to health.