The Supreme Court of India has overturned a 2018 directive issued by the Allahabad High Court that required government officials in Uttar Pradesh to exclusively seek medical treatment from state-run healthcare institutions.
Court had issued a series of directives aimed at addressing systemic deficiencies within Uttar Pradesh’s public healthcare sector.
However, a judicial bench comprising Chief Justice of India (CJI) Sanjiv Khanna and Justice Sanjay Kumar ruled that the specific mandate restricting government employees’ healthcare options overstepped judicial authority, encroaching upon the executive’s prerogative in policymaking and limiting individual autonomy in medical decision-making.
During deliberations, the bench questioned the rationale for restricting government employees’ access to private healthcare providers.
“How can the High Court dictate policy decisions determining where a person must or must not seek treatment? While the intention to improve hospital conditions is commendable, such directives can’t override individual choice,” stated CJI Khanna.
The court focused on Direction No. 11 of the High Court’s ruling, which not only required government employees and public sector personnel to rely exclusively on government hospitals for medical care but also barred reimbursement for medical expenses incurred at private facilities unless public healthcare institutions were incapable of providing the necessary treatment.
CJI Khanna highlighted concerns that such a policy could inadvertently privilege government employees over the general public within already strained public healthcare facilities, thereby exacerbating inequities in access to medical care.
The bench reaffirmed that policy formulation is the domain of the executive and cautioned against judicial overreach that could disrupt the constitutional separation of powers.
While annulling the directive, the Supreme Court permitted petitioners to approach the High Court with fresh petitions, provided they were supported by empirical data and factual evidence.
The case originated from a Public Interest Litigation (PIL) filed by a working-class woman who experienced severe postnatal complications, allegedly due to medical negligence at a government hospital, compelling her to seek expensive private treatment. Her case underscored broader systemic issues plaguing public healthcare in Uttar Pradesh.
In its effort to address these deficiencies, the Allahabad High Court had issued 21 directives, including measures to fill vacancies in government hospitals and mandates ensuring the availability of high-quality pharmaceuticals and medical equipment. It also emphasized strengthening maternal healthcare services through the recruitment of female physicians and paramedical staff.
Additionally, the High Court had ordered an audit, overseen by the Comptroller and Auditor General (CAG), to investigate allegations of financial mismanagement and administrative inefficiencies in public hospitals.
While the Supreme Court invalidated the directive mandating exclusive reliance on government healthcare institutions, it acknowledged the legitimacy of concerns regarding the deteriorating state of public health infrastructure in Uttar Pradesh, leaving room for continued legal and policy discourse on the issue.
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