R.G. Kar Medical College case- Supreme Court forms National Task Force

By Vikrant Rana, Anuradha Gandhi and Rachita Thakur

Introduction

The Supreme Court heard the case Re: Alleged Rape and Murder Incident of a Trainee Doctor in R.G. Kar Medical College and Hospital, Kolkata^[1] and Related Issues at length in the suo moto hearing held by Supreme Court’s three judge bench led by Hon’ble Mr. Chief Justice of India, DY Chandrachud followed by Justice Mr. JB Pardiwala and Justice Mr. Manoj Misra on August 20, 2024. Noting the series of developments in the case and the history of violence against doctors, specifically, female doctors, in the country ranging from Aruna Shanbag’s case, the court flagged the ground reality of institutional safety measures for doctors in healthcare establishments.

Key concerns highlighted by the Court

1. Medical professionals posted on night duties are note provided with adequate resting spaces. Most often they rest in patients’ rooms or in available public spaces with no separate duty rooms for male and female medical professionals;
2. Interns, residents and senior residents perform thirty-six hour shifts in conditions lacking basic sanitation, nutrition, hygiene and rest.
3. Lack of security personnel in medical units has become a norm than an exception.
4. Medical care facilities do not have sufficient toilet with most of the times, there is online common toilet for medical professionals in one department;
5. The hostels and places of stay are situated far from the hospital. Doctors and nurses who travel to and from hospitals are not provided with transport facilities by the institutions.
6. There is absence and lack of proper functioning CCTV cameras to monitor ingress and egress to the hospital and to control access to sensitive areas;
7. The patients and their attenders have unrestricted access to all places within the hospitals, including intensive care units and the doctors resting rooms;
8. Lack of screening for arms and weapons at the entrance of the hospitals;
9. Dingy and ill-lit places within the hospitals
10. Medical professionals have to shoulder the responsibility of being both medical and ‘emotional’ caregivers to patients and their relatives. There are no supportive facilities and no training in communications skills;
11. Certain spaces within hospitals such as Intensive Care Units are prone to greater risk of violence because of severity of medical conditions of patients in these departments.

Remedial steps – Formation of a National Task Force

After consultation with several stakeholders, the Court noted that there is urgent need to formulate protocols governing the issues. The court formulated a National Task Force (hereinafter referred to as the NTF) the members of the medical profession with the aim to provide effective recommendations to remedy the issues of concern pertaining to safety working conditions, and well-being of medical professionals.

Guidelines

In view of the same, the Court directed the NTF to prepare an action-plan under the following two heads-

1. 1. Prevention violence including gender based violence against medical professionals –
      1. Ensuring due security in medical establishments – Triaging departments places based on the degree and possibility of violence, baggage and person screening system at entrances, training of security personnel
      2. Infrastructural Development – Provision for separate resting rooms with basic amenities and facilities, technological intervention to regulate access to critical and sensitive areas through use of biometric and facial recognition, installation of CCTV cameras on all entry and exit points, corridors leading up to patient rooms, transport facilities. Provision for separate resting rooms basic amenities and facilities in each department for (a) male doctors; (b) female doctors; (c) male nurses; (d) female nurses; and (e) a gender-neutral common resting space. Adopting appropriate technological intervention to regulate access to critical and sensitive areas including through use of bio-metric and facial recognition
      3. Employment of social workers trained in grief and crisis counselling
      4. Conducting workshops for all employees of medical establishments
      5. Constitution of Employee Safety Committees’ composed of doctors, interns residents and nurses at every medical establishments to conduct quarterly safety audits
   2. Prevention of sexual violence against medical professionals

The Court noted that the Prevention of Sexual Harassment of Women at Workplace (Prevention, Prohibition and Redressal) Act, 2013 is applicable on hospitals and nursing homes ^[2] and therefore, Internal Committee must be constituted in all hospitals and nursing homes.  Along with that the POSH Act obligates employers to organize senstitisation programmes and provide safe working space which must be discharged. Every medical institution should have a 24×7 helpline number for medical professionals.

Noting the urgency and immediate requirements to create safe working environment, the Court requested the Cabinet Secretary to the Union Government to associate with the work of NTF who is also made a member of the NTF to facilitate proper coordination with the State Governments.

The NTF has been directed to submit an interim report within three weeks and final report within two months from the date of the Order dated August 20, 2024 of the Supreme Court.
Directions to the Governments of all States and Union Territories
The Court directed all the State and Union Territory Governments to collate all the information from all the hospitals run by State and the Central Government including the following key aspects:

1. Number of security personnel employed at each hospital and each department;
2. Whether there is any baggage and person screening mechanism in place
3. Total number of resting/duty rooms in the hospitals
4. Facilities provided in resting/duty rooms
5. Information on whether all; areas are accessible to the general public, with or without restrictions
6. Whether there are CCTV cameras installed?
7. Whether Internal Committee in terms of POSH Act has been constituted?
8. Whether Employer of the establishment has discharged the duties prescribed under Section 19 of the POSH Act? If so, the details of the same.

The said data is to be submitted and filled with an affidavit by the Union Government within a period of one (01) month of the said Order.

Status Report to be submitted by the CBI

Further, the Court has been directed to submit a status report by August 22, 2024 on the progress in the investigation.

[1]SMW (Crl) No. 2 of 2024

[2]Section 2 (o) of the POSH Act, 2013