Right To Health/Medical Care A Fundamental Right, Enforceable Through Corresponding Obligation On State To Create Facilities: Karnataka HC

The Karnataka High Court has directed State Department of Health and Family Welfare, to constitute a three member Committee headed by its Secretary to continuously oversee and implement the mechanism to ensure medical facility and infrastructure–including medical and para-medical personnel at all levels–City, District and Rural.

A division bench of Chief Justice N V Anjaria and Justice K V Aravind issued the direction while disposing of a suo-motu public interest litigation initiated taking cognizance of a news report published in The New Indian Express newspaper, highlighting a shortfall of around 16,500 medical personnel in the State.

The court said, “When the right to health and right to medical-care is treated as fundamental right, it stands enforced only with corresponding Constitutional obligation on part of the State to create medical facilities. For effective enjoyment of this right, the creation of medical cadre, adequate medical personnel, setting up of infrastructure, availability of medicines in sufficient quantity and without interruption, as also establishment of Primary Health Centres in the rural area, are the concomitants. They become inseparable necessities for enjoyment of right to health and right to medicare.”

 The court underscored that it expects the State Government and the Department of Health and Family Welfare to remain "attentive and active" in catering to the needs of the medical facilities in the State and especially in rural areas ensuring that medical infrastructure is widely available and medical facilities as well as treatment reach the "door steps of the rural inhabitants". 

The court thereafter directed, "Respondent No.2-Department of Health and Family Welfare, State of Karnataka, shall constitute a three member Committee headed by the Secretary, Department of Health, to continuously oversee and implement the mechanism to ensure the providence of medical facility and medical infrastructure including the medical and para-medical personnel at all levels-City, District and Rural".

Following which it directed the Committee shall meet every six months to collect and assess the relevant details from deterrent Districts about the number of vacancies of medical staff in different categories, the need for upgrading or further extending the medical infrastructure and medical facilities including medicines to the various Government Hospitals and Primary Health Centres run by the Government.

It said “The Committee shall gather the information about the medical staff vacancies in the Government Hospitals and Primary Health Centres and take steps for filling up the vacant posts. This exercise shall be undertaken every six months.”

Further, the government has been directed to periodically and preferably every six months undertake surveys of the Primary Health Centres in the rural areas for the purpose of its upgradation, in terms of medical facilities to be catered by them and also decide about establishing additional Primary Health Centres on need basis in the villages.

The court also said that the Department shall evolve and set up a mechanism to see that there is proper co-ordination and supervision in implementing different Health Schemes of the Central Government and the State Government, as also the health related strategies. The budgeting provision for the purpose shall be properly and adequately made and there shall be ensured purpose-serving spending of the budgetary allocations.

As per the news report dated 16-10-2023, which refers to The Federation of Indian Chambers of Commerce and Industry (FICCI) report released in September 2023. The report had stated that along with medical personnel, there is a shortage of Primary Healthcare Centres across Karnataka with 454 centres (245 urban and 209 rural centres) in deficit.

As per the report, there is a shortfall of 723 MBBS Doctors, 7,492 nurses, 1,517 lab technicians, 1,512 pharmacist, 1,752 assistants, 3,253 Group D employees

During the hearing the state government submitted that all steps are taken to effectuate and upgrade the medical facilities in the State. It was claimed that sufficient budgetary amount is allocated and spent towards medical health schemes, for running the Primary Health Centers and to provide medical infrastructure thereat and also for meeting with the salary and other expenses of medical personnel.

Further it was suggested that various health schemes such as Pradhan Mantri Ayushman Bharat Infrastructure Mission or Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana floated by the Central Government as well as the schemes of the State Government such as Karnataka State Integrated Health Policy are effectively implemented to the benefit of those who need the medical care and treatment. Moreover, steps are made effective to undertake the recruitment to address the issue of shortage of staff.

In regards to the filling up of posts the court said, “Considering the immediate requirement to medical services in the entire State and for the reasons stated hereinabove, it is expedient to direct respondent No.2 to file affidavit setting out the timeline which the State Government will adhere to for filling up the vacant posts for medical services.”

Further it said “The respondents are directed to take immediate steps to complete the process which has already started but has not been taken to its logical end. The time schedule and the steps taken in this regard shall be placed on record of this Court in the present proceedings by filing an affidavit, notwithstanding the disposal of the proceedings.”

Appearance: Advocate Shridhar Prabhu, amicus curiae Advocate B. Vachan for Petitioner.

Advocate Vidya Pail for Advocate Nayana Tara B G, for R-1.

AGA Niloufer Akbar for R-2.

Citation No: 2025 LiveLaw (Kar) 26

Case Title: The Registrar General AND Union of India & Others

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