Doctors Can’t Adopt Pick & Choose Attitude While Treating Patients; Poor Persons Unable To Afford Treatment Can’t Be Treated Differently: Madras HC

The Madras High Court remarked that the doctors cannot adopt a pick and choose attitude while treating patients and therefore, poor persons must not be treated differently.

The Court was deciding two writ petitions challenging the proceedings of the Director of Public Health and Preventive Medicine appointing the petitioner Doctors as Assistant Surgeon (Specialists) based on the bond agreement under Rule 19(1) of the Tamil Government Servants (Conditions of Services) Act, 2016

A Single Bench of Justice S.M. Subramaniam said, “The prime object of medical profession is to render service to humanity. Doctors cannot adopt a pick and choose attitude while treating patients. Especially poor patients receiving treatment from government run hospitals are entitled to receive the same level of specialised treatment as any other paid treatment. Denial of treatment to poor patients in government hospitals inspite of agreeing to the same under the bond goes against the ethos of medical ethics. It is not the case were the doctors are forced to treat patients for free throughout their career. The bond is such that it operates only for a particular period of time.”

The Bench noted that the petitioner Doctors were well aware of the terms in the bond and with full agreement to the same had agreed to abide by the terms in the bond.

“Any poor person who is unable to afford paid treatment can in no way be treated differently. A life is a life and it has its value. No person should be denied quality treatment on economic grounds”, emphasised the Court.

Advocate M. Vijaya Ragavan appeared for the petitioners while Government Advocate K. Tippu Sulthan appeared for the respondents.

In this case, the petitioners/doctors signed a Bond by accepting the conditions to serve two years of period in the Government Hospital. In compliance with the terms of the agreement, an appointment order was issued by the respondents to the petitioners. The bond was executed by the Government taking into consideration the amounts spent for these Post Graduate Medical Course students to undergo the course. In order to compensate the Government expenditures and with an object to provide free specialised medical treatments to the poor and the needy people across the Tamil Nadu State, the condition was proposed at the time of admission to PG Medical course.

The aforesaid condition was accepted by the students i.e., the petitioners and they signed and promised to serve two years of period in Government Hospital after completion of their PG/Speciality Medical course. On completion of the course, the petitioners claimed that they had served during COVID-19 Pandemic period and the said period was to be reckoned for the purpose of calculating two years of service. They further said that the contemplation of two years’ period of service itself was untenable. They argued that such conditions imposed in the bond are not binding on them and therefore, the same is to be set aside.

The High Court in the above context of the case observed, “It is nothing but a service to humanity and to the poor sections of the society who due to financial constraints are unable to get paid treatment. Such limited services sought for from the petitioner doctors cannot be denied. It is not the case were the doctors are prevented from practising their profession but they have agreed to render their specialised services for a limited period to the less fortunate strata of the society.”

The Court enunciated that saving of lives is unparalleled to none and the Government Hospitals today are in need of specialised Doctors. It added by saying that the specialised treatments today have become an expensive affair.

“Economically weaker sections of the society cannot be denied their fundamental right to health under Art 21 of the Constitution merely on the grounds of financial constraints. It is no fault of his/her that they are unable to afford specialised treatments today. So the Bond scheme is an all conducive scheme whereby various layers of difficulties are addressed”, it said.

Furthermore, the Court observed that the PG doctors after fully agreeing to the terms in the bond had agreed to render their services and it is only in true spirit of the medical profession that their valuable services are rendered for these people who have come to the government hospitals in search of specialised treatments which is in fact the greatest form of service to the humanity and is a testament of a true Doctor.

“… it goes without saying that the medical profession is a noble one. This court is not suggesting that all medical services must be rendered free of cost to the citizens though the goal of any welfare state is to move towards affordable and easily accessible health care to all its citizens. Therefore the government is in need of qualified speciality doctors who can treat patients coming to government hospitals with quality and affordable healthcare”, it also emphasised.

The Court held that the argument that the petitioner doctors rendered their services during the COVID-19 period and that it must counted in as the two years period under the Bond policy is unsustainable.

“It was a period were the country witnessed immense crisis. It was a period of test to the humanity. And many people suffered innumerable losses. But to use this period of selfless service as a way out of the bond policy is utterly unjustifiable and unacceptable. It was a time when people from different walks of lives contributed their services in their own way and the frontline workers like aforementioned risked their lives in the process”, it noted.

The Court remarked that our Great Nation values human resources as an important facet to the economy and more so than ever, human resources play a vital role in the Nation building process.

“People from rural villages contribute a larger portion in this process. And it is the duty of any welfare state to protect the health and cater to the needs of these people. Bond policies play an important role in ensuring affordable specialised healthcare to these individuals from the rural backgrounds. Hence through theses bond policies the government will be able to seep in to the most vulnerable contributors of the economy and be able to provide quality health care services”, it said.

Moreover, the Court observed that there is a common tendency to retract and approach the Court challenging the bond by the PG medical students after completing their education. It added that the services of a doctor is far different from any other service and saving one life is a contribution not only to the patient but his family, his dependants and even the economy of a country and hence, it is a service to the Nation.

“In view of the fact that the petitioners have admittedly signed the bond and accepted the terms and conditions stipulated therein, they are not entitled to claim any concession for further reduction of period stipulated under the bond conditions. Therefore, the petitioners have to serve in Government Medical College and Hospitals as per the appointment order in compliance with the conditions and after completion of the period stipulated, appropriate decision may be taken by the respondents”, it concluded.

Accordingly, the High Court dismissed the writ petitions at the admission stage itself.

Cause Title- B. Anantha Lakshmi v. The State of Tamil Nadu & Ors. (Neutral Citation: 2024:MHC:2088)

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