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Health tips (Indian Express, editorial): Instead of cancelling hospital licences, bring in patient centric laws, institutional capacity to enforce them.
- The grievous error in declaring a live baby dead by the capital’s Max hospital
- Fortis hospital charging exorbitant amounts for the treatment of a seven-year-old child diagnosed with dengue
The government responded by cancelling the licence of Max
Whether this act of Delhi government is legally sustainable and, if not, what should governments do?
Unhindered Growth of the Corporate Hospitals allowed by the Govt.
- The neoliberal policies adopted by all political parties since the ’90s for addressing the distortions of a deeply fractured economy and the obsessive concern for increasing the GDP at any cost is squarely responsible for the massive disparities and inequities that exist in our country today
- These policies spurred and incentivised the growth of corporate hospitals unhindered by any need to adhere to laws, regulations or rules.
Definition: Laissez Faire
- Laissez faire means‘let do‘ translated from French or ‘let it be.
- An economic system in which transactions between private parties are free from government intervention such as regulation, privileges, tariffs, and subsidies.
Profit over Life
- In such a laissez faire environment the hospitals have been permitted to put profit above life.
- We are witnessing a tension between “compromised governments” and a profit-chasing private sector that is able to get by, with impunity.
- It is this context that made the Delhi Government’s action seem just.
A Closer look at the Order of the Delhi Govt.
The order cites three reasons:
- One, violating the conditions of ensuring free treatment to 25 per cent outpatients and 10 per cent inpatients in lieu of free land. An inspection conducted on November 20 showed that the hospital was not adhering to these conditions and a show cause notice was issued on November 22;
- Two, violating the conditions attached to the temporary permission granted on May 11 for increasing bed strength by 10-20 per cent, valid till November 10, for treating patients suffering from “dengue, chikungunya and fever cases only”. The inspection showed that the beds were, instead, being used for treating cases of hysterectomy, DJ stenting etc;
- Three, criminal negligence of the doctors and nurses on duty in relation to the baby who was born alive, yet declared dead.
Order Under Section 7 of the Delhi Nursing Homes Registration Act of 1953
Cancellation of the licence has been done under Section 7 of the Delhi Nursing Homes Registration Act of 1953 that states “subject to the provisions of this Act, the supervising authority may at any time cancel the registration of a person in respect of any nursing home on any ground to suspend or cancel the licence of the hospital for violation of any of the conditions laid down”.
Notice Period provided
Section 8 of the same Act also stipulates that before making an order cancelling any registration, the supervising authority shall give to the person registered not less than one calendar month’s notice and so on.
Requirements to issue such an Order
Read with the rules, it is clear that such power to cancel a licence granted “at any time” and “on any ground” is subject to the “provisions” of the Act that clearly pertain to three requirements:
- Running a facility only with a registration certificate;
- Maintaining the required infrastructure and human resources as per standards indicated and laid down;
- Displaying rates being charged and reporting requirements.
Thus Reasons Cited by the Govt. seem invalid
- As per these considerations, none of the three reasons cited for cancellation seems to be valid.
- In fact, the requirement to provide free treatment to the poor is based on an administrative guidance pursuant to a judgment of the high court in 2007.
- Even here, fines can be imposed and the land granting authority, DDA, can cancel the grant of land in case of any violations.
Real Reason for cancelling the License
People’s anger over medical errors and “overcharging” of patients.
Delhi Nursing Homes Registration Act of 1953 silent on cancelling licenses
Unlike the West Bengal Clinical Establishments Act of 2017 that empowers a government appointed commission to cancel any licence or registration granted to a hospital on grounds of medical malpractice, the Delhi Nursing Homes Registration Act of 1953 is silent.
Medical and Nursing Councils of India can issue such an order
Accordingly, the only bodies that are authorised to take action are the Medical and Nursing Councils of India that can delicense doctors and nurses or impose penalties on hospitals if found guilty of non-ethical behaviour, negligence or malpractice.
But theses bodies already discredited
The fact that India is estimated to account for over 5 lakh patients dying due to medical malpractice and not even a single doctor has so far been delicensed or hospitals punished (including Max, that seems to be a repeat offender) speaks volumes on the functioning of these discredited regulatory bodies.
In other Countries Govts. Intervene
In every country, except India, governments intervene and institute strong laws to ensure patient safety.
India’s record is abysmal and such “negligence” of our lawmakers appears deliberate.
Will Regulation Unleash Inspector Raj?
On the excuse that any regulation will only unleash “inspector raj”, political parties have caved into creating an environment where health is seen as an investment destination and a grand business opportunity best left to the private sector. Nothing can be more self serving.
IMA posing a roadblock
The IMA — the trade union of doctors, responsible for prevailing upon the political leadership to go slow on regulations to the extent of not even agreeing to institute grievance redressal mechanisms for patients — is finally, and largely due to the media, on the back foot.
Govts. Must act
- While the Central government needs to relook at the Clinical Establishments Act of 2010, (that though adopted by 14 states stands unimplemented) state governments must seize the moment and bring in regulations along the lines of, or bettering upon, what West Bengal and Karnataka have recently done.
- Karnataka legislated the constitution of empowered grievance redressal mechanisms at district levels; mandated hospitals to display prices for procedures; and ensure observance of a patient’s charter. Such patient-centric laws are urgently required.
There is an equal urgency to building the institutional capacity to enforce them. Setting of protocols, computerisation of every patient interaction and supervision on real time basis and an uncompromising approach to non-adherence of conditions need to go along with legal frameworks. Such an environment protects both doctors — of whom a majority want to do good — and patients, from the greed of hospital investors and managers.
Suspending hospital licences is not a sustainable solution to a complex problem.
Crime & punishment(Indian Express, editorial)
There can be no impunity for those who kill in the name of honour
The conviction of six persons for the murder of a young Dalit by a trial court in Tirupur, Tamil Nadu, is significant. The trial was completed in less than two years and eight of the 11 accused found guilty.
Scheduled Castes and the Scheduled Tribes (Prevention of Atrocities) Act
This is the first conviction in a case tried under the Scheduled Castes and the Scheduled Tribes (Prevention of Atrocities) Act, since its amendment in 2015, which made exclusive special courts mandatory for crimes that come under the purview of the Act.
Of course, the convicts may appeal in a higher court, but the trial court convictions carry a larger message: Justice and closure is possible in cases of honour killings.
Shankar, a 22-year-old Dalit engineering student, was hacked to death by relatives of his wife Kausalya, in March last year. Remarkably, the case was fought by Kausalya, while her father was the prime accused.
This newspaper does not support capital punishment. But, arguably, the death sentences awarded to six of the eight convicted, including Chinnasamy, suggest that the judiciary recognises honour killing as a heinous crime.
Strange case of Tamil Nadu
- Tamil Nadu represents the strange case of a society regressing to a social condition that it sought to leave behind decades ago.
- The recurrence of caste violence directed against Dalits, particularly honour killings in recent times, also points to the limits of the anti-caste moblisations the state has seen over the past century.
The Self-respect Movement of Periyar and its legatee, the Dravidian Movement, were distinguished by their criticism of the caste system and opposition to the privileging of Brahmins in the social and political order. Political offsprings of the Dravidian Movement, the DMK and AIADMK, rode successful anti-caste mobilisations to win office for over half a century.
Dalits left behind
The non-Brahmin political assertion, however, only managed to transfer political, social and economic power to the OBCs; it failed to build a political imaginary that would accommodate the rights and aspirations of the Dalits, who constitute over 20 per cent of Tamil Nadu’s population
The Kerala State Literacy Mission Authority (KSLMA) is all set to kick-start the second phase of Akshara Sagaram
KSLMA programme in Ernakulam, Kozhikode, and Kollam
Buoyed by its success in the first phase
The Kerala State Literacy Mission Authority (KSLMA) is all set to kick-start the second phase of Akshara Sagaram, an ambitious literacy programme for coastal areas, by rolling it out in three more districts, including Ernakulam.
Facts about the programme
- The project, being implemented by KSLMA with financial assistance from the Fisheries Department, will also be implemented in Kollam and Kozhikode districts. Initially, it was implemented in Thiruvananthapuram, Malappuram and Kasaragod districts.
- In the second phase, the project will be rolled out in 234 wards with poor levels of literacy, spread across 36 local bodies in three districts.
Where it will run?
The project will be run within 15 local body limits in Ernakulam namely, Pallippuram, Kuzhuppilly, Kumbalanghi, Kumbalam, Chellanam, Kadamakkudy, Elankkunnapuzha, Kochi Corporation, Edavanakkad, Nayarambalam, Njarakkal, Kottuvalli, Varapuzha, Mulavukad, and Udayamperoor.
Selection of Instructors
Selection of instructors, gathering of data about potential beneficiaries, and formation of ward-level organising committees have been completed as a prelude to the implementation of the project.
- The primary objective of the project is to streamline the fourth, seventh and tenth standard equivalent programmes of KSLMA in coastal areas.
- Illiterate people, newly literate, school dropouts, physically and mentally-challenged people, and all fisherfolks who have not cleared fourth standard have been identified as potential beneficiaries.
Planning Board figures
KSLMA formulated the project targeting coastal population based on the finding of the State Planning Board that among the 18 lakh illiterate people in the State and 12 lakh newly literate people, literacy levels are the lowest in coastal areas.
Phase – 1
In the first phase, 65 wards spread over 13 coastal panchayats were covered under the project, and 1,605 candidates wrote the fourth standard equivalent examination.
The project will be implemented with the support of local bodies, Fisheries Department, and Matsyafed (Matsyafed, the Kerala State Co-operative Federation for Fisheries Development Ltd., is the Apex Federation of 654 Primary Fisherman Co-operative Societies).
Continuous education programmes in coastal areas
The literacy mission authority hopes that apart from improving literacy levels, the project will give impetus to continuous education programmes in coastal areas.
Improving the living standards of coastal people and coastal area protection measures, women empowerment, elimination of drug abuse, creating awareness about environment, sanitation, cleanliness, health, and various welfare programmes and services provided by the State government have been identified as the other immediate benefits of the project.
The government on Wednesday extended the December 31 deadline for linking bank accounts to Aadhaar numbers by three months to March 31, 2018.
Deadline extended from Dec. 31 to March 31, 2018
The deadline for linking insurance policies and mutual fund holdings to Aadhaar would also be extended to March 31 next year, from the present December 31 deadline.
PMLA rules amended
The revenue department in the Ministry amended the relevant rules pertaining to maintenance of records by financial entities under the Prevention of Money Laundering Act of 2002, to drop the December 31 deadline specified for bank account holders to link Aadhaar and PAN (permanent account number).
- Acount holders will need to submit the Aadhaar number, and Permanent Account Number or Form No. 60, by such date as may be notified by the Central Government.
- The notification also stated that if Aadhaar was not linked to bank accounts as per the date notified by the government, the account would be blocked till the submission of Aadhaar and PAN numbers.
Last week, the government submitted before the Supreme Court that it intended to issue a notification, extending the deadline for mandatory linking of Aadhaar with services from December 31 to March 31, 2018.
For Linking Mobile Numbers there is no extension
The deadline for linking Aadhaar to mobile numbers, however, remains February 6, 2018.
Disqualification moves (Hindu, editorial)
Was the Vice-President’s action against two JD(U) MPs a case of speedy justice or a hasty decision?
Anti-defection law 1985
- The objective of the landmark anti-defection law of 1985 was to enhance the credibility of the country’s polity by addressing rampant party-hopping by elected representatives for personal and political considerations.
- While this enactment brought about some order in the system, some politicians found ways of circumventing it over the years.
A member of Parliament or the State legislature incurs disqualification if he either voluntarily gives up the membership of the party or votes or abstains from voting in his legislature, contrary to the direction (whip) of the party
The orders of the Chairman have established a benchmark, both in terms of speedy disposal (about three months) as well as the quality of the decisions. Since the anti-defection law came into place, there have been a large number of cases where proceedings have dragged on for years.
Committee of Privileges
A reading of the rules prescribed by the Rajya Sabha show that the Chairman is required either to proceed to determine the question himself or refer it to the committee of privileges for a preliminary inquiry. But reference to the committee is contingent upon the Chairman satisfying himself that it is necessary or expedient to do so; it is not mandatory. As a matter of fact, in several cases in the past, the Speaker of the Lok Sabha and the Chairman of the Rajya Sabha, whenever “the circumstances of the case” so warranted, have “determined the question” themselves, without referring it to the committee
Facts of the cases
- In any case, in the interests of natural justice, the respondents were given adequate opportunity to present their arguments on the petitions filed against them. Apart from the written statements, the members were given the opportunity of personal hearing, which they availed. The cases were decided in a short period of three months, but not in a hurry.
- Period of around three months, of course, by giving an opportunity, as per law, to the concerned Members against whom there are allegations, which lead to their disqualification under the Tenth Schedule to the Constitution of India, so as to effectively thwart the evil of political defections, which if left uncurbed are likely to undermine the very foundations of our democracy and the principles which sustain it.”
- It is pertinent here to mention that the Chairman recalled that the then Law Minister, A.K. Sen, while piloting the bill in 1985 in the Lok Sabha had clearly stated that if defection was to be outlawed effectively “then we must choose a forum which will decide the matter fearlessly and expeditiously”.
What needs to be done?
Further, Rule 7(3) of the Members of Rajya Sabha (Disqualification on Grounds of Defection) Rules clearly stipulates that a member against whom the petition has been made, has to forward his comments to the chairman within seven days of the receipt of copy of the petition. The seven-day time clearly indicates the need for expeditious disposal of the petition.
Mr. Naidu’s orders assume significance in the context of instances where members have switched sides and became ministers in the governments, which are formed by parties against whom they contested and won.
Yet, no action was taken in such instances defeating the very objective of the anti-defection law. It is hoped that presiding officers of State legislatures will take the advice of the Chairman of the Rajya Sabha in the right spirit.
On adultery law (Hindu, editorial): The real issue about our adultery law is whether it should be treated as a crime
The real issue about our adultery law is whether it should be treated as a crime
Reconsideration of the law on adultery is long overdue
There is no doubt at all that a reconsideration of the law on adultery is long overdue. By agreeing to have another look at the constitutional validity of Section 497 of the Indian Penal Code, under which men can be prosecuted for adultery, the Supreme Court has re-opened a question that has been decided thrice in the past.
Provision discriminating against men
- This time the court will have to do more than pronounce on whether the provision discriminates against men on the basis of gender and gives an unconstitutional exemption to women
- While agreeing to issue notice to the government, the Bench has observed that the provision is archaic.
Gender Equality absent
It has further noted that in a case of adultery, one person is liable for the offence but the other is absolved, and that the concept of gender neutrality, on which criminal law normally proceeds, is absent.
Married Man treated like a criminal
In the past, the Supreme Court has emphasised that a married woman is a “victim” and the man is “the author of the crime”. It has treated the exemption given to women as a special provision that has the protection of Article 15(3).
Only outsider can be prosecuted
- It has rejected the argument that it is discriminatory by pointing out that neither a man nor a woman can prosecute their disloyal spouses
- It is only the ‘outsider’ to the matrimonial relationship who can be prosecuted, and that too by the aggrieved husband alone
- This is made clear in Section 198(2) of the Code of Criminal Procedure, a provision also under challenge.
Implicit subordination of the will of a woman?
The matter now before the court goes beyond the limited question of the culpability of women involved in a relationship outside their marriage. It raises the related question whether there is an implicit subordination of the will of a woman
However, merely positing the issue as one of discrimination in the way the law treats two parties in a consensual relationship because of their gender is misleading.
Adultery, a Crime?
The real problem is the very fact that adultery remains a crime in the form of an archaic colonial era provision
Many countries across the world do not treat it as an offence any longer.
United Nations Working Group wanted to repeal such laws
In 2012, a United Nations Working Group on laws that discriminate against women wanted countries that treat adultery as a crime, to repeal such laws. It is one thing for adultery to be a ground for divorce, a civil proceeding, and quite another for it to be a basis for incarceration
It will be a travesty if in the name of empowering women the ambit of the criminal law is extended to cover both genders. The correct course will be to dispense with this archaic provision altogether; it serves no real purpose in the criminal statute.
Pakistan on Wednesday filed a counter-memorial before the International Court of Justice (ICJ) against India’s plea to prevent execution of alleged Indian spy Kulbhushan Jadhav, who has been sentenced to death by a military court in April.
India had won a stay from the ICJ on Jadhav’s execution on May 18 following Pakistan’s refusal to allow consular access to the Indian High Commission in Islamabad despite repeated requests.
Months before ICJ takes up the case again
No date has been fixed for the case to resume in the ICJ. Pakistani officials associated with the case said it would take at least weeks, if not months, before the ICJ takes up the Kulbhushan case
Access granted to kin
Last week, Islamabad said it would allow Mr. Jadhav’s wife and mother to meet him on December 25. The Pakistani authorities also allowed the presence of an Indian High Commission official at the meeting as requested by New Delhi during the meeting.
A calculated move
- Pakistani officials believe that by allowing a meeting with the family and an Indian High Commission official, India will lose its main claim for approaching the ICJ
- In its counter-memorial Pakistan rejected India’s stance that it had violated international norms by rejecting consular access to the Indian High Commission
The counter-memorial stated that Jadhav, 46, is a RAW operative involved in espionage and subversive activities and supporting terrorists to conduct attacks in the restive Balochistan province. India has denied the allegations.
Bilateral consular access agreement of 2008
Pakistan has referred to the bilateral consular access agreement of 2008, which says that in case of arrest, detention, or sentence made on political or security grounds, each side may examine the case on the merits
- Pakistani officials said that there were still two forums of appeal left for Jadhav even if the Army Chief refuses his mercy appeal.
- The officials added that Jadhav had three appeals left before his sentence is executed and his execution is not apparent any time soon
The Supreme Court directed the Centre to notify a comprehensive action plan mapping the sources of air pollution in Delhi and the National Capital Region within two weeks
SC gave the Ministry of Environment two weeks to finalise the timeline for each action point in the plan with the Environment Pollution (Prevention and Control) Authority (EPCA).
First Ever Comprehensive Action Plan
This is the first ever mandatory plan that earmarks short-, medium- and long-term measures for all key sources of pollution with deadlines, and makes agencies responsible for implementation.
Can Prove Helpful in future if implemented correctly
If implemented with urgency and stringency and in a time-bound manner, this can help this region make sustained improvement in air quality
Delhi-NCR may require to reduce particulate pollution by at least 74% to meet clean air standards
All efforts will be made to complete the Polavaram project in 2018 itself, Union Minister for Water Resources Nitin Gadkari
- A target had been originally set to complete the project by 2019, but efforts were being made to provide water by gravity by 2018.
- All obstacles for Land Acquisition and R&R would be addressed to ensure that work was not hindered in anyway
- The issues with the DPR of the project would also be taken care of
One Month Timeline to improve performance
The Centre would give the contractors one month’s time to improve their performance
In case they fail to do so, the new contractors for which the State government has already called tenders would be asked to take over.
In the final stages of the ongoing summit-level negotiations of the World Trade Organisation (WTO), India upped the ante to protect its food security right, even as the U.S. refused to agree to the demands of developing nations on the issue.
Demands amendments in rules to prevent member countries from challenging current programmes
Initially, India was bargaining hard for improving an already available mechanism that safeguards government purchase of staple foodgrain from low-income and resource-poor farmers at subsidised prices for stockpiling, and then distributing them to the country’s economically weak.
Moves to ‘foolproof’
However, in the crunch phase of the talks, India sought to foolproof such a mechanism through an amendment of WTO rules on dispute settlement, to entirely prevent countries from legally challenging its food security programmes, according to sources privy to the negotiations.
- The mechanism, called the ‘Peace Clause’, shields developing countries like India from being dragged by other countries to the WTO Dispute Settlement Mechanism for breaching the ceiling on product-specific domestic support (10% of the concerned crop’s value of production)
- The ‘Peace Clause’ is available to developing nations, including India, till a ‘permanent solution’ is found by the WTO members to the issue of public stockholding for food security purposes.
Permanent Solution by 2017
- Members had agreed during the Ministerial Conference (or MC — the WTO´s highest decision-making body) in 2013 to find a ‘permanent solution’ by the 2017 meet
- The decision to expedite work on the ‘permanent solution’ was noted in the 2015 Nairobi MC decision
Peace Clause tough to use
- However, the Peace Clause’s onerous conditions (on notification etc.) make it tough for developing countries to use
- Therefore, at Buenos Aires, India, along with other developing nations, wanted the ‘Peace Clause’ provisions to be improved upon and converted into a permanent solution — a demand the U.S. showed little interest in accepting.
- Owing to the U.S. not respecting the Nairobi MC decision, India had decided not to take any chances by just agreeing to a Ministerial Text/Declaration on a ‘permanent solution
Security and Defence
Prime Minister Narendra Modi commissioned India’s first modern conventional submarine, INS Kalvari, into Navy’s fleet in Mumbai on Thursday, a first in almost two decades.
‘Kalvari is an excellent example of ‘Make in India’ and every defence vehicle, from helicopters to submarines, will be made in India,” says Prime Minister Modi after putting it into commission in Mumbai.
Putting it into commission in Mumbai, Prime Minister Narendra Modi lauded the efforts of the Navy for its role from disaster management to combating piracy. “Be it terrorism via sea, piracy, drug smuggling or illegal fishing, India is playing an important role in combating them,” he said
“I call it SAGAR — security and growth for all in the region,” he noted.
First of 6
- Kalvari is the first of the six Scorpene-class submarines that will be handed over by shipbuilder Mazagon Dock Limited (MDL) to the Navy
- The submarines, designed by French naval defence and energy company DCNS, are being built by MDL in Mumbai as part of Project-75 of the Navy.
- Kalvari is a potent Man o’ War capable of undertaking offensive operations spanning across the entire spectrum of Maritime Warfare.
- The Navy last inducted conventional diesel-electric submarine INS Sindhushastra, procured from Russia in July 2000.
- Kalvari, named after a deep sea tiger shark, weighs about 1,600 tonnes and carries the sea skimming SM 39 Exocet missiles and the heavyweight wire guided Surface and Underwater Target (SUT) torpedoes. For self-defence, it has mobile anti-torpedo decoys.
- Navy Chief Admiral Sunil Lanba, Vice Admiral Girish Luthra, Flag Officer Commanding of the Western Naval Command and top defence officials attended the ceremony.
Science and Technology
Microsoft on Wednesday rolled out new features on its Bing search engine powered by artificial intelligence
Bing will deliver two perspectives
- One that summarizes the two opposing sides of contentious questions
- Another that measures how many reputable sources are behind a given answer.
Trying to distinguish itself from Google
Microsoft is also trying to distinguish its second-place search engine from long-dominant Google and position itself as an innovator in finding real-world applications for the latest advances in artificial intelligence.
Is Coffee good for you?
The new search features side-by-side opposing perspectives for a question like above.
One source emphasizes coffee’s ability to increase metabolism and another shows it can raise blood pressure
Similar questions can also be asked on more sensitive topics, such as whether the death penalty is a good idea.
For now simple questions only
On more complicated questions is there a god? Bing doesn’t have enough confidence to provide a pro-con perspective. But on questions that involve numbers, it boils information down into digestible doses. Iraq, for instance, is described as “about equal to the size of California.”
The search engine features were announced along with updates to Microsoft’s voice assistant Cortana and a new search partnership with the popular online forum Reddit.