The Madras High Court has strongly emphasized that it is the constitutional responsibility of the State to provide proper medical facilities in government hospitals, particularly for the poor and underprivileged. In a landmark judgment, the Court directed the Tamil Nadu government to establish Bone Marrow Transplant (BMT) facilities in the Government Rajaji Hospital, Madurai, and eventually extend them across the state.
The division bench of Justice M.S. Ramesh and Justice A.D. Maria Clete, while hearing two public interest litigations, criticized the lack of medical infrastructure and BMT services outside Chennai. Presently, such critical procedures are only available at the Rajiv Gandhi Government General Hospital and the Institute of Child Health and Hospital for Children in Chennai, with additional services offered by JIPMER, Puducherry.
The Court remarked:
"The provision of a medical facility in government hospitals to reach the poor, downtrodden and underprivileged citizens is a constitutional obligation of the State. When such facilities are neglected, this Court is well within its powers under Article 226 of the Constitution to issue positive directions.”
The petitioners highlighted that many patients from southern districts like Madurai and Kanyakumari must travel long distances for BMT procedures, causing financial and emotional distress. Since these procedures cost lakhs in private hospitals, access remains a major barrier for economically weaker sections.
According to the status report filed by the Directorate of Medical Education, the total estimated cost for establishing the BMT unit in Madurai, including civil infrastructure, equipment, and staff, is around ₹13.53 crores. The Court was, however, displeased with the government's position that no timeline could be committed due to it being a "policy decision".
Reaffirming the principle laid down by the Supreme Court in Paschim Banga Khet Mazdoor Samity v. State of West Bengal, the High Court stated:
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“Financial constraints cannot be an excuse for the State to avoid its constitutional duty to provide adequate medical services.”
The Court directed the State Government to allocate funds within three months and establish the BMT facility in Madurai within six months thereafter. It also allowed petitioners to represent the need for uniform guidelines to improve medical and infrastructure standards across all government hospitals in Tamil Nadu.
Counsel for the Petitioner: Mr. S. Venkatesh for Mr. S. Ramesh, Mr. R. Alagumani
Counsel for the Respondent: Mr. J. Ravindran, Additional Advocate General, assisted by Mr. P. Thilak Kumar, Government Pleader
Case Title: Dr. S. Gurushankar v. The Chief Secretary to Government of TN
Case No: W.P.(MD) Nos.11886 of 2019 & 19218 of 2024
