November, the month of Constitutional Law Day, invites not just celebration but reflection – on the brilliance of the Constitution and the paradoxes it reveals in action. This remarkable document, balances rights and duties to build a just society. From the debate over same-sex marriage to the delicate dance between free speech and communal harmony, the Supreme Court has arguably mediated ideals with reality, embodying the notion of a living document, as Justice Krishna Iyer had noted. Yet, its handling of the tragic case of the young resident at RG Kar Medical College is a reminder that even noble legal interventions can stumble – at times inspiring but ultimately ineffective.
Since the incident, a cascade of troubling developments has fuelled public suspicion about the state’s conduct. Delays in police action, the rushed cremation of the victim’s remains, and the rapid passage of the Aparajita Bill have sparked outrage, exposing more than just administrative failures – they point to a potential breach of the state’s constitutional duty under Article 21 of the Constitution, which guarantees the right to life and personal liberty. While much has been written on these concerns, which go beyond the scope of this piece, the Calcutta High Court’s response merits attention. Acting swiftly on a Writ Petition by the victim’s parents, the High Court transferred the investigation to the Central Bureau of Investigation (CBI) on August 13, mandated regular progress reports, and began hearing the matter daily. The petition also sought systemic reforms, such as the installation of CCTV surveillance in hospitals and adequate rest facilities for staff.
Just two days later, chaos erupted as a mob of nearly 7,000 stormed the hospital, vandalizing facilities and destroying evidence – all while the investigation remained under the High Court’s oversight. This led the Supreme Court to take swift suo motu cognisance, underscoring the urgent need to address both the specific incident and the broader safety concerns for medical professionals. The Supreme Court’s authority to intervene in pending matters, rooted in Article 142 of the Constitution, is well established, allowing it to act when extraordinary circumstances threaten fundamental rights or the dispensation of justice. However, such interventions must align with judicial restraint to avoid perceptions of encroaching upon the High Courts’ jurisdiction. While the Supreme Court’s aim to bolster protections for medical professionals is commendable, it is essential to recognize that Article 226 vests High Courts with the authority to issue writs and safeguard rights within their states, affirming their role as co-equal custodians of constitutional justice.
In its first sitting, the Supreme Court directed the CBI to submit progress reports directly to it – effectively edging out the High Court’s oversight of the investigation. While the state police were tasked with reporting on the vandalism, the Supreme Court’s vision stretched beyond the immediate case. It cast its gaze on wider patterns of violence against healthcare professionals across the country, exposing systemic vulnerabilities that defied existing safeguards. Despite protective state laws (e.g., in Tamil Nadu, Karnataka and Maharashtra), the Court noted these measures leave deeper institutional issues unaddressed. Thus, it constituted a National Task Force (NTF), tasked with addressing the root causes of violence and crafting safety protocols for healthcare professionals. Yet, as promising as this step appeared, this is where the complications start to unfold.
‘Public health and sanitation; hospitals and dispensaries’ fall under the state list (Seventh Schedule, Entry 6, List II, of the Indian Constitution), granting states autonomy over healthcare regulation within their territories. This reflects the constitutional principle of federalism, integral to the basic structure doctrine affirmed in S.R. Bommai v. UOI (1994). While the Central Government’s notification of the NTF to establish safety standards is a step in the right direction, the question remains: can states be mandated to adopt these recommendations without risking an overreach into their constitutionally protected powers? Article 246 delineates legislative powers between the Union and the states, ensuring a delicate balance that upholds cooperative federalism. This framework, designed to respect India’s socio-political diversity, implies that while the Centre can offer guidance, it must tread carefully so as not to unravel the threads of state autonomy.
Equally troubling is how the NTF was constituted – a process that, in hindsight, seems rushed and lacking consultation. While the inclusion of eminent professionals was ensured, the absence of input from grassroots stakeholders casts a shadow over its inclusivity. A glance at the panel reveals a distinguished line-up of nine members – five from central government institutions and four from reputable private ones, and other ex officio members who are high-ranking officials of the central government (with no state representation). Yet, this esteemed cohort brings with it an inherent disconnect. Despite their impressive credentials, their lived experiences are far removed from those of young professionals at the frontline who often bear the brunt of unsafe working conditions. This gap raises the question – can a task force without voices from the trenches truly address the realities it seeks to reform?
Moreover, it is notable that almost all members of the NTF come from tier-1 city institutions. It prompts the question – are healthcare challenges outside these urban centres any less pressing, or would members from metropolitan institutions naturally understand the challenges faced by professionals in smaller towns? Either presumption would miss the mark, for, as the saying goes, ‘Those who wear the shoe know where it pinches.’ Considering that the catalyst for the Court’s intervention emerged in West Bengal, one could argue that regional representation would have offered a more grounded, first-hand perspective for meaningful solutions.
Although the Supreme Court, in a later hearing – and only after suggestions from the bar – acknowledged that the voices of interns, residents, doctors, nurses, and paramedical staff should be included in the task force’s deliberations, this realization came belatedly. Following this, the central government set up a web portal to facilitate the submissions of suggestions. The NTF has since filed a 73-page interim report on November 7, long after the original timeframe set by the Supreme Court. This report outlines short, medium, and long-term measures to be adopted by healthcare institutions and by states and union territories. Under the Court’s direction, a copy of this report has been sent to all states and union territories for feedback. With NTF’s recommendations made before state input, one may argue what weight state feedback will now hold, especially if their perspectives diverge? While the report holds promise in its volume, it may only be the prologue to a more formidable tale.
All hope is not lost. The continued protests and calls for justice stand as a testament to the resilience of democratic and constitutional values. When the nation’s conscience is awakened, it is this collective drive that keeps the Constitution’s promises alive. Hats off to the doctors who did not let their voices be drowned out by bureaucracy. The recent stabbing of a doctor in Chennai by a patient’s attendant is a sobering reminder that the battle for healthcare professionals’ safety is far from over. But as this paradoxical match between progress and inertia plays out, one could echo Charles Dickens – “It was the best of times, it was the worst of times.”
[The writer is an Advocate at the Delhi High Court and extends sincere gratitude to Dr. Adhish Basu, a distinguished plastic surgeon, for his invaluable insight.]