Supreme Court orders free medical treatment scheme for poor patients

The Supreme Court remitted the case back to the Directorate General of Health Services (DGHS) for reconsideration, emphasizing adherence to natural justice principles. The court proposed an alternative scheme requiring hospitals to provide free inpatient treatment to a certain percentage of patients annually, extending eligibility to all below poverty line (BPL) cardholders. The scheme, operational for 20 years, aimed to ensure free medical assistance to the poor. Hospitals opting for the scheme would have equipment returned and customs duty refunded, while non-compliant hospitals faced action as per previous court orders. Final decisions were to be made within six months.

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Issues Involved:
1. Validity of the notification dated 01.03.1988 issued u/s 25 of the Customs Act, 1962.
2. Alleged violation of terms and conditions of the notification by the appellants/petitioners.
3. Proposal for an alternative scheme to replace the original notification's conditions.

Summary:

Issue 1: Validity of the Notification Dated 01.03.1988
The controversy arises from a notification issued on 01.03.1988 by the Central Government u/s 25 of the Customs Act, 1962. This notification allowed four categories of hospitals to import medical equipment without paying customs duty, provided they offered free medical assistance to persons with a monthly family income of less than Rs. 500. The categories were detailed by the learned Single Judge in the impugned order dated 11.02.1999.

Issue 2: Alleged Violation of Terms and Conditions
The notification also stipulated that benefits could be annulled and equipment impounded if terms were violated. The appellants/petitioners allegedly violated these terms, leading to the impounding of equipment and recovery of customs duty. This resulted in extensive litigation, including the impugned order dated 11.02.1999. The Supreme Court, in Civil Appeal No. 7284/2005, remitted the case back to the DGHS for fresh consideration, emphasizing adherence to natural justice principles.

Issue 3: Proposal for an Alternative Scheme
The court proposed an alternative scheme to provide succor to the poor, ensuring free medical assistance from the best facilities, as originally intended by the notification. Key points of the scheme include:
- Free Inpatient Treatment: Hospitals to provide free inpatient treatment for at least 20% of their inpatients annually, covering medical, surgical, and diagnostic procedures, including boarding and lodging.
- Eligibility Criteria: Extending free treatment to all BPL card-holders, replacing the original income criterion of Rs. 500 per month.
- Operational Period: The scheme to be operational for 20 years from 01.01.2012, with annual obligations based on the preceding year's inpatient count.
- Publicity and Records: Hospitals to announce the free treatment facility prominently and maintain detailed records for inspection by the DGHS or a nominated agency.

The proposed scheme was to be considered by the Central Government, with a decision expected by 31.10.2011. Hospitals opting for the scheme would not face further action under the original notification and would have their machinery returned and customs duty refunded.

Conclusion:
The appeals and writ petitions were disposed of in terms of the proposed alternative scheme. Hospitals not opting for the scheme or if the scheme was not approved by the Central Government, would be proceeded against as per the Supreme Court's order in Sir Gangaram Trust Society's case. Final orders in such cases were expected within six months.

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