Health Minister Parsadi Lal Meena in the assembly said that Rajasthan is becoming a ‘Model State’ in the health sector. The state spends 7% of the budget on the health sector. He said that the state government is committed to give the Right to Health to all the people of the state.
The Health Minister was replying to the discussion on the ’Rajasthan Right to Health Bill, 2022’ put by the Select Committee in the assembly. The bill was passed by a voice vote in the assembly.
He said that the ‘Right to Health’ is in the interest of people. He said that based on the suggestions of all the members, the state government sent this bill to the Select Committee. Suggestions from the members and doctors have been included in the bill.
He said that the Right to Health bill was brought so that patients are not denied treatment in hospitals. Under this, if the concerned patient is unable to bear the cost of emergency treatment then the state government will reimburse it. State Health Authority has been constituted under the Right to Health to lodge logistic grievances. Besides this, a provision has been made for the District Level Authority.
Meena said that the first religion of doctors is to provide treatment, which they should abide by. He said that the state government has given land to big hospitals at concessional rates. There is a provision to link these hospitals under the Right to Health Bill. The Health Minister said that the state government is committed to provide excellent medical and health services to the people.
Right to Health
People of the state get the Right to Health
- Each resident of the Rajasthan state will get this right in which the person will get emergency medical services without any prior payment along with there will be transparency in health services. With this, it will ensure the state government’s commitment to provide quality health services to the people of the state.
- Rajasthan has become the first state to provide the right to health to its citizens not only in the entire country but is the first state in the entire Asia and African continent.
- Each resident of the state will have the right to get free services of OPD, IPD services, consultation, testing, emergency transportation, procedures and services, emergency care in all the government medical institutions as per the available healthcare level.
- The residents of the state will have the right to get free medical facilities at medical institutions and designated healthcare centres as per the prescribed rules.
- Road accident victims will have the right as per the prescribed rules of free transportation, treatment and getting insurance.
- Each resident will have the right to get relevant information about the nature of the disease, its reason, its proposed testing and care, possible results of its treatment, possible complications arising from it and the expected cost of the treatment.
- Residents of the state will have the right to receive emergency treatment and care in the government and designated private hospitals in case of an accident-related emergency without prior payment of requisite fees or charges.
- Accidental emergency, emergency due to snakebite/animal bite and emergency as decided by the State Health Authority have been included in emergencies.
- Accidental emergency refers to the risk of death or injury to a person as a result of an event occurring in an unintentional or unexpected manner. This includes road, rail, water or air accidents.
- Emergency Care means the provision of first aid, advice and assistance to a person injured in an accident or criminal incident or any other emergency.
- Emergency obstetric care is also included in this, according to which treatment of pregnant women and suffering pregnancy complications is included.
- First aid includes treatment given by a person belonging to the medical profession to keep the condition stable of a person injured in an accident/crash/criminal incident or any other emergency before giving the prescribed treatment.
- Stabilization means such medical treatment given to an injured person before sending him to the place of treatment for the prescribed treatment, so as to stabilize his condition and prevent any damage caused to him before the prescribed treatment for him.
- It also covers the transfer and transportation required for the treatment of an injured person.
- If there is a medico-legal issue, no health care provider or institution can delay the treatment of a resident of the state based on police clearance or receipt of the police report.
- After treatment in an emergency, if the person undergoing treatment does not pay the prescribed fee or charges to the medical institution, then it will be reimbursed by the government.
- There will be a right to access patient records, test reports and detailed itemized bills have been given.
- There will be a right to know the name, professional status and job chart of the person providing health care.
- There will be a right for the presence of another woman during the physical testing of a woman patient by some male practitioner.
- Will have the right to give prior informed consent for any treatment or prescribed tests.
- Will have the right to choose alternative treatment in any other medical institution.
- The resident of the state shall have the right to receive treatment without any discrimination of religion, sex, race, caste, age, place of birth and in case of any disease or condition.
- The resident of the state shall have the right to know the rates and charges of each type of service and facility available in the medical institution.
- Will have the right to choose the place to get the medicine or get the test done.
- Will have the right to take treatment records and information from the medical institution where the treatment is going on to take a second opinion from any other doctors or institutions.
- If the patient leaves the hospital against the advice of the doctor, he will have the right to receive the treatment summary.
- Apart from this, the responsibilities and duties of the residents of the state towards doctors and medical institutions have been prescribed. Along with this, the rights and responsibilities of health care providers and institutions were also determined.
- Two types of authorities have been constituted at the state level, in which the State Health Authority for Logistic Grievances will work to solve the problems of the common people. Along with this, the second authority – State Health Authority for Treatment Protocol has been formed for treatment and technical advice under this law. This second authority consists of specialist doctors except for one member.
- District Health Authority has been constituted in which the District Collector and the doctor are included.
- Grievance Redressal Mechanism has been developed for the redressal of grievances. If a person does not get treatment or for any other complaint related to treatment, he will have to complain to the in-charge of the same medical institution within 15 days.
- If the complaint is not resolved by the institution in-charge within 3 days, then that complaint will be forwarded to the District Health Authority, which will have to be disposed of within 30 days. If the complaint is not resolved here, the matter will be forwarded to the State Health Authority for Logistic Grievances.
JSA RAJASTHAN WELCOMES RIGHT TO HEALTH ACT, BUT EXPRESSES CONCERN OVER SOME SERIOUS GAPS IN THE ACT
Jan Swasthya Abhiyan (JSA) Rajasthan welcoming the Rajasthan Right to Health Act passed in the Legislative Assembly thanked Chief Minister Ashok Gehlot on taking this great step. With this, Rajasthan now has become the first and the only state in the country to legislate such an Act, a one of its kind, thus setting an example for the rest of the country to follow.
Chhaya Pachauli, of JSA said, “However, we are also disappointed that despite some effective sections in this Act, it cannot be counted in the category of a strong law because it has some shortcomings which make it weak in many ways.”
She said that it is to be known that on 22 September 2022, the Right to Health Bill, 2022 was introduced by the State Government in the Legislative Assembly, which was then decided to be sent to the Select Committee the very next day after a brief discussion owing to protests by private doctors’ associations. Following this there were several amendments made in the bill. Some of these amendments are a matter of great concern as they substantially erode the accountability and grievance redressal mechanism under the Act, such as:
In the state and district level health authorities to be constituted as per the Act, only government officials and doctors of IMA are represented. No other representatives like public health experts, PRI members, and civil society or even for that matter paramedics will be the members of these authorities. These authorities thus take shape of extremely non-inclusive and undemocratic government structures while they should have been widely inclusive. In this scenario how these authorities, which have an important role to play in patient grievance redressal will be able to function in an unbiased and impartial manner is a huge question.
Also, while the Bill tabled in September 2022 had provisioned for the web portal and helpline for the patients to register their complaints related to any health care centre/ hospital, but now both these forums have been eliminated. The only way a patient can now file a complaint is by giving it in writing to the in charge of the concerned health facility. Thus the patients would now have only a single medium to file complaints which is in writing which would certainly discourage a lot of patients from coming up with their complaints out of fear and other obvious reasons, she added.
Dr Narendra Gupta, of JSA said that the Act also says that this law will apply only to the residents of Rajasthan. This is extremely discriminatory as it would exclude a large section of the state’s population, including migrant labourers, refugees, nomads, homeless etc who come from the most deprived communities from benefitting from this law. “We strongly believe that this law should be universally applicable to all the patients who seek treatment from any health care facility in Rajasthan, no matter whether they are permanent or temporary residents of the state. Limiting this important law to a certain population group would mean that the health rights of a large population will continue to be violated and the state wouldn’t take any responsibility of that. This would be very unfortunate,” he said.
JSA demanded that the state should pay special attention to the above mentioned points and takes concrete steps to remove these discrepancies from the law. The government will start the process of preparing the rules of the Act at the earliest possible and during the process all efforts will be made to remove these shortcomings. It is believed that the Act if implemented in its true sense and spirit would certainly lead to strengthening of public health care sector which would ensure that people, especially those from the poor and marginalised sections, would have enhanced access to quality health care services without encountering any out of pocket expense, that it would lead to greater transparency and accountability within the health systems, and that patients’ health rights will be effectively safeguarded and protected.