PUBLIC HEALTH CARE SYSTEM AND ADMINISTRATION

Public Health is "the science and art of preventing disease, prolonging life and promoting health
through the organized efforts and informed choices of society, organizations, public and private,
communities and individuals". The health care system in India is primarily administered by the
states. India's Constitution tasks each state with providing health care for its people.

India has a vast health care system, but there remain many differences in quality between rural
and urban areas as well as between public and private health care.India has a vast health care
system, but there remain many differences in quality between rural and urban areas as well as
between public and private health care.

Public health legislation concerns the legal power and duties of the state to improve the health of
the general population (e.g. to identify, prevent and ameliorate risks to health in the population)
and the limitations on the power of the state to constrain the autonomy, privacy, liberty,
proprietary or other legally protected interests of individuals for the protection or promotion of
community health.

The objectives of public health care system are:

 Protect and promote the health of their population,

 Sustain the health policies and programs,
 Prevent ill health resulting from unsafe products and unsafe living conditions,
 Fight new and re-emerging communicable disease,
 Support the development of health systems,
 Combat continuing poverty, inequities in health and discrimination.

Constitution of India places obligations on the State to ensure protection and fulfilment of right
to health to all, without any discrimination, as a fundamental right, by interpretation, under
Articles 14, 15 and 21 (fundamental right to life, equality and non-discrimination); Article 23
(prohibition of traffic in human beings and forced labour); and Article 24 (prohibition of
employment of children in factories, etc.); and also urges the State, under the Directive
Principles of State Policy, to strive to provide to everyone certain vital public health conditions
such as right to work, to education and to public assistance in certain cases.

case laws:

Municipal Council, Ratlam vs. Vardhichand & Ors, the municipal corporation was
prosecuted by some citizens for not clearing up the garbage. The corporation took up the plea
that it did not have money. While rejecting the plea, the Supreme Court through Justice Krishna
Iyer observed: “The State will realize that Article 47 makes it a paramount principle of
governance that steps are taken for the improvement of public health as amongst its primary
duties.” The Apex Court held that a responsible Municipal Council constituted for the precise
purpose of preserving public health and providing better finances cannot run away from its
principal duty by pleading financial inability. Decency and dignity are non-negotiable facets of
human rights and are a first charge on local self-governing bodies.

Labonya Moyee Chandra vs. State of West Bengal case reflected the lack of seriousness of the
State in executing its duties and the implementation of the directions and recommendations in
Paschim Banga Khet Mazdoor Samiti case. The patient was an old woman residing in a village
near the city of Burdwan who was denied admission in SSKM, a state hospital on account of
nonavailability of bed even though her condition was recorded as critical. This hospital was also
involved in the earlier case of Paschim Banga Khet Mazdoor Samiti. The patient suffered severe
chest pain and difficulty in breathing. The local doctor examined her, diagnosed a heart block
and recommended immediate hospitalization. She was taken to Burdwan where she was shown
to Burdwan Medical College hospital (BMCH) who referred her to cardiology department of
Seth Sukhlal Karnanl Medical College (SSKM) in Calcutta or any other State hospital having
cardiology department as they didn’t have the said facility. At SSKM, RMO referred her to the
cardiology department who informed her that there were no vacant beds and referred her back to
the RMO. She instead got admitted to a private hospital were she underwent an operation and a
permanent pacemaker was implanted.
Devindar Singh Shergil vs. State of Punjab dealt with a retired government employee. The
Appellant, a retired government official, who had approached the Postgraduate Institute of
medical Sciences (PGI), Chandigarh for kidney treatment, was declined admission as no
accommodation was available. Due to malignant growth of kidney, the Appellant immediately
left for UK and got himself treated. Later he filed his claim for reimbursement of the entire
amount but the Medical Board sanctioned an amount that would have been incurred if the
Appellant was treated at PGI, which equalled to Rs. 20,000. The Supreme Court dealt with the
issue “as to why the petitioner should not be reimbursed for medical expenses to the extent of the
expenditure which may have been involved for his treatment/ operation if carried out in any of
the recognized institutions/hospitals in India”.

Since the AIIMS was one such recognized hospital under the State Policy, the Supreme Court
held that the Appellant was entitled to reimbursement at the AIIMS rate and further, as an
admitted fact, if the Appellant would have been treated in India he would have been entitled to
reimbursement of expenses on medical consumable, pharmaceutical items, therefore, he would
also be entitled to reimbursement of such expenditure. The Respondent State was directed to pay
Rs.22, 000 as per AIIMS rates for surgery and Rs.73, 000/- for expenditure incurred on
medicines.

Administration of public health care system

The health system in India has 3 main links

1. Central
2. State and
3. Local or peripheral

At the Centre
The official “organs” of the health system at the national level consist of
1. Ministry of Health and Family Welfare
2. The Directorate General of Health Services
3. The Central Council of Health and Family Welfare
At the State level
The health subjects are divided into three groups: federal, concurrent and state. The state list is
the responsibility of the state, including provision of medical care, preventive health services and
pilgrimage within the state.

At the district level

Within each district, there are 6 types of administrative areas.
1. Sub –division
2. Tehsils (Talukas)
3. Community Development Blocks
4. Municipalities and Corporations
5. Villages and
6. Panchayats

CONCLUSION

The mission of the public health is defined as "the fulfillment of society's interest in assuring the
condition in which people can be healthy. Legal preparedness of the public health is the result of
the contribution legal tools make to assuring to those conditions. Therefore, the laws are to be
integral part to robust public health system. Deficiencies in public health system legal
preparedness (found generally in relation to planning, coordination and communication,
surveillance, management of property and protection of persons during a public health
emergency/crisis) in the states needs to be addressed by the proposed new public health act; the
major issues being the selection of the appropriate authority, capacity of the authority, authority
structure - coordination, and access to other support systems.

Submitted By:

Y.Keerthi

19LLM06
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