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Private Practice by Government Doctors

                                                                                                                           WIP(C)(PIL)No.01 of 2013

                                                                B E F O R E
                                HON’BLE THE CHIEF JUSTICE MR.DEEPAK GUPTA
                                                HON’BLE MR JUSTICE S. TALAPATRA


                For the petitioner                            : None

                For the respondents                        : Mr. B.C.Das, Adv.Gen

                                                                       Mr.S. Chakraborty, Addl.G.A.


                We have perused the affidavits filed by the Chief Secretary as Well as the Secretary, Health.

As far as Generic Medicines are concerned we are fairly satisfied with the progress which has taken place and we expect that the Government should set up more and more shops.  We also request the Secretary, Health to examine the system of distribution of medicines being followed in the Sanjay Gandhi Post Graduate Institution of Medical Sciences, Lucknow whereby the department itself sells medicines at a nominal profit of 10 to 15 percent and as per our information so much revenue been generated that all poor patients are being provided medicines free of cost in that hospital.

As far as private practice is concerned from that affidavits of the Chief Secretary as well as the Secretary, Health it is more than obvious that the State was in a state  of deep slumber till orders were passed by this Court.  From the affidavits it is apparent that right from the time when the Rules were framed except in one case no action was ever taken in any case.  That too was a case of a Director, Health Services who was not permitted to do private practice,  No attempt was made by the State to ensure that Doctors permitted to do private practice charge fees as fixed by the State Govt.  It is apparent that no effort was made by the State to ensure that the Doctors permitted to do private practice adhere to the conditions laid down.  Even from the affidavit filed it is apparent that such Doctors are charging very heavy fees much more that the sum of Rs.50/- fixed by the Government.

We have in our order dated 2nd March, 2015 highlighted certain issues are thereafter on 30th March, 2015 we had passed another detailed order after referring to Rule 25 of the Tripura Health Service Rules (for short,   THS  Rules) which permits doctors to give an option of doing private practice.  We had, however, pointed out that the first, portion of the Rule clearly  envisages that private practice should be the exception and not the norm.  The aforesaid section also clearly lays down certain guidelines which must be followed.  It is more than obvious that nobody bothered to ensure that the mandate of the law as contained in Rule 25 of the THS Rules was being followed or not.

There is no use of crying over spilt milk and what has happened in the past has already happened.  What we have to ensure is that at least from now the Government keeps a check on the doctors who are permitted to do the private practices.  We are also clearly of the view that the Doctors who are permitted to carry on private practice do not do this in a manner which adversely affects their Governmental duties.  There are only 24 hours in a day.  A doctor is also a human being requiring sleep, time for the family, time to eat, time to bathe, time to rest, time to read newspapers or watch television, time to socialize time to enhance his knowledge by reading journals etc.  Since the State is still contemplating making certain guidelines, we direct that till the State frames any guidelines the following guidelines shall be followed:

(1)    Any doctor who applied for private practice and those doctors who are already doing private practice shall within one month from today submit an affidavit to the Head of the Department or to the Secretary, Health (as the Government may decide) stating therein the address at which they will conduct private practice and also the consultation fees which they will be charging from the private patients,  We are aware that the fees of Rs.50/- was fixed as far back as 1999 and we, therefore, permit till the Government takes a policy decision, the doctors to charge first time consultation fe3es up to a maximum of Rs.200/- per patient and subsequent fees shall not be more than Rs.100/- per patient.

(2)    We further direct that to ensure that a doctor who is permitted to engage in private practice shall not engage in such private practice for more than 3 (three) hours a day and in case of holidays for a maximum of 6 (six) hours in a day.  In the affidavit the doctors shall clearly set out the hours during which he will be available for private consultation.

(3)    We direct that as provided in the THS Rules, no doctor shall direct a patient who has come to the Govt. hospital to visit his private clinic or charge any fees from such patient.

(4)    The doctors permitted to do private practice shall maintain a detailed diary of their practice as envisaged in Rule 25 of the THS Rules in which they shall not only maintain the details of the patient attended to, they shall also enter the nature of the ailment, the nature of the treatment given  and the fees charged from such patient.  Every doctor shall give a receipt to every patient attended upon by him.

(5)    The timings, the fees, the hours etc. shall also be prominently displayed on a board in the chamber of the doctor.

(6)     We further direct that any doctor who is permitted to engage in private practice shall do his private practice only in his own chamber whether owned or rented by him but shall not sit in any poly clinic or private nursing home.  That is totally prohibited.  In the affidavit to be filed by the doctor, he shall also state that he is not associated with any nursing home, poly clinic or diagnostic clinic.

Whoever violates any of the aforesaid directions or the provisions of Rule 25 of the THS Rules the State must be dealt with severely.  The State must start disciplinary proceedings against such doctor for misconduct and the permission to engage in private practice shall be immediately cancelled by the State.

We direct the State to ensure that this order is immediately circulated amongst all the doctors who are permitted to engage in private practice and the affidavits in this regard are obtained latest by 31st July, 2015.  Thereafter, the matter be listed in Court on 17thAugust 2015 on which date the Chief Secretary and the Secretary, Health  shall both file their latest status report.

We against request the State of Tripura through the Chief Secretary to the State to seriously consider disbarring teaching doctors from private practice because these specialist doctors who have to teach in the hospitals not only have to attend to the patients in the hospital but they also have to spend a lot of time preparing their lectures.  The State should make available sufficient fund to compensate these doctors by paying them handsome Non Practicing Allowance.  The State must file an affidavit through the Chief Secretary giving reasons in support of its decision by the next date.