The Supreme Court has left it to state governments to decide on the regulation of private hospitals' medicine charges. The Court was hearing a Public Interest Litigation (PIL) that challenged private hospitals' alleged compulsion on patients and attendants to buy medicines, implants, and medical devices exclusively from their in-house or recommended pharmacies. These pharmacies reportedly charge prices higher than the notified market rates, leading to concerns of exploitation.
A bench comprising Justices Surya Kant and N Kotiswar Singh disposed of the matter, directing all state governments to consider the issue and take appropriate policy decisions.
"We dispose of this petition with direction to all state governments to consider this issue and take appropriate policy decision as they deem fit," the Court stated.
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The Supreme Court observed that matters related to public health, hospitals, and dispensaries fall under List II (State List) of the Constitution. Therefore, it is within the purview of state governments to take measures addressing local conditions. The Court refrained from issuing a mandatory directive to private hospitals but emphasized the need to sensitize state governments on the alleged issue of unreasonable charges.
"It may not be advisable for this Court to issue any mandatory directions which may hamper the functioning of private hospitals. At the same time, it is necessary to sensitize state governments regarding the alleged problem of unreasonable charges or exploitation of patients in private hospitals," the Court noted.
Additionally, the Court questioned whether it would be prudent for the Union or state governments to introduce a policy regulating every activity within private hospitals. While acknowledging the concerns raised in the petition, the Court emphasized that policymakers are best positioned to take a holistic approach to ensure fairness for both patients and private healthcare providers.
"Policymakers are best equipped to take a holistic view of the matter and frame guidelines as may be required to ensure that there is no exploitation of patients and their attendants. At the same time, there should be no discouragement or unreasonable restriction on private entities entering the health sector," the judgment stated.
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Petitioners' Claims and Court’s Response
The petitioners sought a directive preventing private hospitals from forcing patients to purchase medicines, devices, or implants exclusively from in-house pharmacies, where prices are allegedly inflated compared to market rates. They also urged the Union and state governments to formulate policies addressing the issue.
The petitioners argued that hospital pharmacies sell medicines and consumables at artificially high prices and that the government had failed to take corrective measures to prevent patient exploitation. Their claims were based on a personal experience where a patient admitted under their care was subjected to this alleged practice.
In response, the Supreme Court reviewed the submissions and observed that:
- The Union Government stated there is no legal compulsion for patients to purchase medicines from hospital-run pharmacies.
- Several States and Union Territories (UTs) questioned the petitioners’ locus standi.
- Various state-run initiatives, such as Amrit Shops and Jan Aushadhi stores, have been established in government hospitals to provide medicines at affordable rates.
- Many states have implemented their own schemes to ensure access to cost-effective drugs, consumables, and medical services.
Right to Medical Facilities and Policy Decisions
The Supreme Court reiterated that access to medical facilities is a fundamental right traceable to Article 21 of the Constitution. However, it emphasized that policy decisions regarding healthcare regulations should be made by the government rather than the judiciary.
"Provision of medical facilities to all is a right under Article 21 of the Constitution. However, it is the policymakers who are best-equipped to deal with this issue," the Court stated.
This decision underscores the role of state governments in addressing concerns related to private healthcare pricing while balancing the need to support private investments in the healthcare sector.
Case Title: Siddharth Dalmia and Anr. v. Union of India and Ors., W.P.(C) No.337/2018
