RIGHT TO HEALTH IN INDIA: ISSUES AND CHALLENGES
Author: Riddhi Kashyap, I year of BBA LLB from Symbiosis Law School Hyderabad
Health, as defined by WHO, is the complete wellbeing of physical, mental and social aspects. Health is not restricted to any individual. It includes personal health as well as societal health. The right to health has been included under article 21 of the Indian constitution which talks about the fundamental right to life and personal liberty. It is included in the state list and all the responsibilities for public health must be carried out by the state. Right to health is a broad term that comprises authoritative responsibility, easy reach to available services and direct delivery of the required services in the proper manner.
It is one of the challenging issues of current times. Health infrastructures and their easy access is the major problem. The rural population of India is approximately 65% which amounts to more than half of the country. Most people in India come from remote villages and rural backgrounds which lack special health infrastructures and easy access to it. Lack of awareness and affordability are other reasons for poor development in the sector of health. Many people are unaware of the different services and schemes available as a part of governmental health development programs. Also, there is a large percentage of people who are often misled by frauds and cheaters. Lack of transparency and manpower crisis in the health sector is another important challenge in right to health in India. The entire procedure of providing health services to the public can sometimes be complicated and misguided by lack of appropriate authority and crisis of manpower. The healthcare department is directly and indirectly in the hands of public sectors, private sectors and non-governmental organizations.
In a country like India, where the population is approximately 135.26 crores, a large percentage of children are affected by malnutrition. This deficiency of nutrients and vitamins is because of the lack of a healthy diet. Often children affected by it turn out to be diseased and remain sick for the rest of their lives. Also, this country has a record of several communicable diseases such as hepatitis, malaria, aids etc. which are easily spread between youngsters and children. The reasons for this are mainly lack of awareness and indulgence in other unworthy activities. The female health issue is another kind of challenge which is entirely based on a specific gender. Menstrual health and anaemia are the most concerned agendas of current times. Lack of proper sanitation is one of the most important leading cause of many health issues in India. Apart from these, the degradation of the environment is concerning.
Right to health was considered to be a part of Directive Principles of State Policy (DPSP) and the state was made responsible for looking after this matter of importance. It was observed that the health of the individual as well as the community is crucial. Therefore, entrusting the state with the right to health will be suitable and the best way of tackling health issues. However, with the advent of time and evolution in society, the Supreme Court decided to shift the Right to Health from DPSP to Article 21 of the Indian Constitution. Article 21 of the Indian constitution guarantees life to the people of India.[i]It has been held in several judgements that ensuring life is not merely the right to breathe. Rather, the constitution ensures every person with quality and liberty of life. Therefore, connecting the Right to health with Article 21 is logical and necessary. In the case of State of Punjab v. Mohinder Singh Chawla and others[ii], the court held that clinical considerations incurred by anyone also falls under the ambit of the Right to health. In this case, a public servant suffered through a heart ailment which was treated in the AIIMS Hospital of Delhi. The state denied reimbursing the room rent paid by that person. However, the court observed that room rent or any other medical expense should be immediately reimbursed by the state as it falls under the right to health and nobody’s right should be violated.
In another case of Occupational Health and Safety Association v. Union of India and others[iii], the court defined how the Right to health is an integral part of Article 21. Because of Occupational health hazards, the court was very practical in affirming that a clean and hygienic environment is required for leading a healthy life which cannot be ignored by the constitution of India in any way.
After studying the provisions of the Right to Health, the researcher wants to analyze another important aspect related to it, i.e., Public Health. It is an interdisciplinary field that is concerned with biostatistics and health management of different organizations and communities. It aims to improve the health and lifestyle of society by providing various facilities and incentives to people at large. This process is affected by the advancing modern lifestyle of people in India. Therefore, providing remarkable public health is very dynamic. In the case of Municipal Council, Ratlam v. Shri Vardhichand and others[iv], the court observed that the municipality committee has to ensure public health by ensuring the cleanliness and proper maintenance of drainage and sewage. It also said that no excuses or shortcomings would be tolerated on the account of public health. However, provisions of public health are more evident in papers than in reality[v].
The scenario of Indian society is not very remarkable and the drawbacks can be seen easily. This is a direct result of the large illiteracy percentage of India. People lack awareness and knowledge and often do not understand its concept. In developing countries like India, the matter of public health is of greater concern because of the lack of trained workers and facilities.
India is engrossed with many types and levels of health issues ranging from diseases to unavailability of resources. One of the major health issues prevalent in India is the spreading of communicable diseases. Since it is a poor country, therefore the transfer of diseases is up to a great extent. However, diseases like polio have been eradicated but the cases of malaria, dengue or Kala- Azar can be seen easily. Also, the spreading of HIV/AIDS is very concerning. The government has formulated certain norms and guidelines to check communicable diseases. However, the number of cases is still remarkable. Another very crucial challenge is malnutrition. The lower strata of people are often seen to be deficient and malnourished. The sole reason for it is the lack of a healthy diet and nutrients. This has resulted in several other issues related to health. There are some factors that directly or indirectly cause health hazards.
They are mainly pollution (air, water and land), poor sanitation, agricultural and industrial contamination and biochemical pollutants. These factors have degraded the quality of the environmental environment of people. The improper disposal of sewage into water bodies, poor treatment of garbage has resulted in various diseases and disorders. Also, environmental health hazards are considered more important because it affects the public at large. All the people are equally responsible for cleaning and maintaining their surroundings. However, the government has framed separate departments, such as municipal committees and corporations to look after this matter. Since India is a developing country and the health index does not hold a good position concerning other countries, therefore the current situation can be considered as a state of progress. Issues of health are not always directly related to the diseases but reaching out to the healthcare facilities are also important. Lack of hospitals, clinics, dispensaries and health workers are some other reasons which have created a huge void for people seeking healthcare facilities. Also, the majority of Indian people dwell in rural and remote areas which are distant from such facilities. This undermines the purpose of healthcare and the essence of the right to health. The female class has some basic prevalent issues like sanitation, menstrual hygiene and issues related to the pregnant woman. Many initiatives have been taken by the government. Also, incentives are provided to lessen the critical condition.[vi]
Right to health, as stated earlier, is an integral part of life but the issues related to it are diverse and intense. Ensuring the right to health can be very challenging because it is a matter of national concern. To overcome the gap created, the government, as well as the citizens, should work together hand in hand and aim towards a common goal. Health has been recognized as one of the important parameters in ascertaining the global status of any country. Therefore, the responsibility lies primarily on the administration to formulate ways and means of ensuring the right to health to the people of India. Some initiatives like Health cards and health schemes like Ayushmann Bharat have been taken. This is remarkable and a huge step was taken by the government. Since health is a never-ending issue and the ways of ensuring it must be advanced with the advent of time. More awareness can be spread by organizing campaigns and fund-raising programs. Another way accepted by the administration can be building more hospitals and other health infrastructures, especially in rural areas. Mobile clinics and diagnosis centres can be another suitable initiative for reaching out to the people living in remote areas.
Also, free supply of staple balanced diets to the poor and needy. Apart from the direct access to treatment and diagnosis, another major step to overcome the challenges can be the raising of national-level laboratories and drugs formulating companies. Growth of the internal market can help in boosting the self-sufficiency of the country and its people. Since the governmental programs and schemes are carried out by different departments and officials, therefore there is always a chance of ambiguity and lack of transparency. To overcome the problem of ambiguity created, help should be provided directly to the people in need. The middle workers should be avoided to a greater extent.[vii]
After going through case laws, art6icles, journals and reports, the researcher has concluded that the right to health is regarded as one of the most fundamental rights enshrined in the constitution of India. The people of India are promised the right to life and every other factor that is necessary for sustaining a quality life. Therefore, the matter of health has been subsequently added into it. Whenever there is a right, there is a corresponding duty. Since the constitution offers the right to health, therefore they are responsible for fulfilling their duty by providing the people with all the facilities that ensure their right. However, certain issues have been observed by the researcher to answer the formulated questions. The researcher has analyzed each question under separate headings and given equal importance to all of them. After going through them, it has been noted that health can be limited to an individual or a community. However, public health has been considered very crucial since it affects a larger group of people at the same time. Also, disturbance in public health can have serious repercussions on the national level. There have been many issues and challenges in the past and present. Communicable diseases like polio have been cured with the help of vaccinations and public awareness. The campaign took several years to get success. Other issues like the unavailability of resources and facilities are being worked upon.
The researcher comprehends that medical and healthcare facilities should be charged with the nominal amount and the scientific and technological method should be made into practice. There are a lot of people who need awareness and accurate information. They are often misled by people of a fraudulent nature. Government should organize camps especially for people living in remote and tribal areas. Since the right to health has been accepted as a fundamental right, therefore people or organizations denying it should be strictly punished and apt actions should be taken. At last, the researcher would like to focus on the point that the general public is also responsible for taking care of themselves and their environment. The right to health is a right in general and no class or strata of people should be denied of it.
[i]Niloy Bagchi, Right to healthcare in India: A study of constitutional guidelines, 7, INDIAN J L AND JUST, 158, 160-161, (2016)
[ii]State of Punjab v. Mohinder Singh Chawla and others,(1997) 2 SCC 83
[iii]Occupational Health and Safety Association v. Union of India and other, (2014) 3 SCC 547
[iv]Municipal Council, Ratlam v. Shri Vardhichand and others, (1980) 4 SCC 162
[v]Jai Prakash Narain, Public health challenges in India: Seizing the opportunities, 41(2), INDIAN JOURNAL OF COMMUNITY MEDICINE (Indian J community Med), 85, 86 (2016)
[vi]Arvind Kasthuri, Challenges to healthcare in India- The five A’S, 43(3), INDIAN JOURNAL OF COMMUNITY MEDICINE (INDIAN J COMMUNITY MED), 141, 143 (2018)
[vii]S. P Srivastava, Public Health and Right to Health in India: Evaluation of Gap between Policy and Implementation, 2 NIRMA UNIVERSITY LAW JOURNAL (NULJ) 1, 5-7 (2012)