It is most significant to note that the Delhi High Court in a most learned, laudable, landmark and latest judgment titled Mr Amandeep Singh Dhall vs Directorate Of Enforcement in Bail Appln 2093/2023 & connected matter and cited in Neutral Citation No.: 2023:DHC:9341 that was reserved on 19.12.2023 and then finally pronounced on 22.12.2023 has minced just no words absolutely to hold most commendably that every prisoner, regardless of his financial standing, is entitled to basic medical care. Thus it was made clear by the Court that there cannot be discrimination in providing basic medical care to every prisoner between rich and the poor. It must be noted that the Delhi High Court directed the Secretary (Home), Government of NCT of Delhi and Secretary, Health and Family Welfare, Government of NCT of Delhi to ensure that the health care requirements of the prison inmates are met and adequate medical infrastructure in the jail premises is maintained for ensuring that the right of prisoners to appropriate medical care.
At the very outset, this brief, brilliant, bold and balanced judgment authored by the Single Judge Bench comprising of Hon’ble Ms Justice Swarana Kanta Sharma of Delhi High Court sets the ball in motion by first and foremost putting forth succinctly in para 1 that, “The instant applications under Sections 439 read with Section 482 of the Code of Criminal Procedure, 1973 (‘Cr.P.C.’) read with Section 45 of the Prevention of Money Laundering Act, 2002 (‘PMLA Act’) has been filed on behalf of the applicant seeking grant of interim bail in ECIR/HIU-II/14/2022 dated 22.08.2022, registered with ED, Delhi under Section 3 and 4 of PMLA and in RC003/2022/A/0053 dated 17.08.2022, registered at Police Station CBI, Anti-Corruption Branch Lodhi Road, Delhi, for a period of twelve weeks on medical grounds.”
As we see, the Bench specifies in para 2 that, “The Grievance of the applicant, in a nutshell, is that the applicant is not being provided proper and appropriate treatment in terms of post-epidural care in the prison premises, and thus, the applicant seeks that he be released on interim bail, in order to get appropriate treatment from Indian Spinal Injuries Centre, Vasant Kunj, Delhi.”
To put things in perspective, the Bench envisages in para 11 that, “This Court, after considering the medical history of the applicant and the medical status report filed on record, notes that the medical facility at the prison complex, at this stage, is not able to provide appropriate medical care which is required by the applicant in terms of post-epidural care. The dispensary at Central Jail-07 does not have the required medical equipment required for physiotherapy sessions of the applicant. This Court also notes that the applicant, due to his medical condition which relates to his spine, cannot be taken to any outside hospital on OPD basis, as the constant jerks and vibrations may further aggravate his medical condition. This Court observes, based on the medical history of the applicant and medical report dated 16.12.2023, that the medical condition of the applicant is such that if the medical treatment as suggested to the applicant is not provided to him, the same may also lead to paralysis of his upper limb.”
Do note, the Bench reaffirms the prisoner’s right to health and appropriate medical treatment in para 12 noting that, “Every prison inmate, regardless of the fact that such person is an accused or convict, possesses an inherent right to life and humane treatment. This includes the right to receive medical care that addresses his health needs and prevents unnecessary suffering. To neglect the medical well-being of prisoners is to deny them a fundamental right to life.”
Be it noted, the Bench notes in para 13 that, “Incarceration does not deprive individuals of their fundamental right to life which includes right to appropriate health care. Prisoners, like all members of society, may face various health issues, both pre-existing and emergent during incarceration. Denying them access to necessary medical care not only deteriorates their health conditions but can lead to preventable suffering and, in extreme cases, loss of life. This neglect not only undermines the principles of justice but also challenges the moral foundation of a society that values the dignity and worth of every human being even if, he is a prisoner.”
Most significantly, the Bench minces absolutely no words to hold unquestionably in para 16 that, “It is a common public perception that affluent individuals who find themselves incarcerated receive preferential treatment, including access to luxurious hospital facilities. However, it is crucial to dispel this misconception and highlight the fact that the provision of medical care within the criminal justice system is not determined by one’s economic status. Every inmate, regardless of his financial standing, is entitled to receive basic medical care, a fundamental human right that transcends socio-economic disparities.”
Equally significant is what is then pointed out in para 17 that, “In a just and equitable legal system, the principle of equality before the law is paramount. This means that every individual, regardless of their wealth or social status, is subject to the same legal standards and protections. The right to medical health care is intrinsic to this principle, ensuring that no inmate is denied basic healthcare services solely based on their financial resources. It is essential to recognize that, in the eyes of the law, every prison inmate is equal and possesses the basic human right to receive adequate medical care, reinforcing the foundational principles of a legal system which is not only just but also humane.”
It is worth noting that the Bench notes in para 18 that, “The present case brings to light a critical issue concerning the standard of medical treatment within correctional facilities, shedding light on the alarming inadequacies in the healthcare infrastructure for prison inmates.”
Further, the Bench adds in para 19 that, “The report submitted by the prison dispensary in the present case points to a distressing reality– the lack of a proper medical care facilities, i.e. physiotherapy equipments. The absence of these essential equipments not only signify lack of adequate medical infrastructure in the prisons, but also the direct repercussion of the same on the health of the inmates requiring physiotherapy etc.”
Most commendably, the Bench expounds in para 20 that, “In this Court’s opinion, in cases of a convicted prisoner, contracting a disease or his health deteriorating and him being not extended health care is not part of his sentence. Similarly, in case of under trial prisoners, this fact becomes even more significant as some of the under trials may be suffering from serious diseases or may contract or suffer from serious diseases which may have the potential of being fatal or potentially disabling. This has led this Court to consider that the basic right of a citizen while being incarcerated to health care is not obliterated or surrendered to the State. Prisoners are human beings too and they retain some undeniable human rights which have to be acknowledged by every Court of law and the State. Respect for, and the resolute of the Court’s to unfalteringly uphold the human rights of the prisoners as a constitutional Court has traditionally been in India evidenced in the various judgments of the Apex Court and this Court.”
Most forthrightly, the Bench postulates in para 21 that, “It is important to recognize that the responsibility for ensuring the well-being of individuals in judicial custody lies squarely with the State Government. Prisons, as custodial institutions, must provide not only security but also essential medical facilities to meet the healthcare needs of inmates. It is also the duty of the State to ensure and monitor not only the conditions of the prisoners in general, but also their health issues and the health facilities provided in the prisons.”
Needless to say, the Bench then states in para 22 that, “Health care is a critical issue for the prisoners as they cannot look after themselves for the reason of their detention, therefore, it is the responsibility of the State to provide for adequate health services to the prisoners equivalent to that available to the free population.”
Lamentably, the Bench laments in para 23 that, “Unfortunately, in the present case, as per report of the Medical Officer Incharge, Central Jail-07, Dispensary, Tihar, New Delhi, the machines required for the physiotherapy sessions of the applicant were not in working order. The prison population which includes vulnerable groups in terms of health conditions needs to be taken into account and adequate health facilities should be provided inside the jail as due to various reasons, the under trials have to remain within confines of the jail. Inadequate access to medication and health care or delays in providing timely medical interventions may, at times, have permanent devastating effect on prisoners health.”
To be sure, the Bench then underscores in para 24 aptly observing that, “The Courts cannot allow inadequate prison health care system to violate a prisoner’s right to timely and adequate medical health care. Preserving the health of the prisoners would require a mechanism to monitor and promote the health care system available in the prisons. In face of increased health vulnerabilities, many prisoners have heightened risk of permanent damage to their bodies. In this regard, it became important for this Court to review the protection and legal obligations of the State to provide high, however, attainable standard of health care, which is part of right to life.”
As things stands, the Bench concedes in para 25 that, “At the same time, this Court also acknowledges that it is not possible for the jail authorities through the State, to have every kind of advanced medical equipment in the jail medical set up to meet the requirements of some prisoners, who may require special treatment for the diseases they suffer from. For this reason, this Court has directed that a high, however attainable standard of health care which is part of right to life be ensured within the confines of the prison to the prisoners who depend on the State for health care.”
Most sagaciously, the Bench underscores in para 26 that, “This Court also reiterates that there can be no distinction between rich and poor in terms of finances for the purpose of providing them medical facilities and the prisoners in case of special needs will have to be first referred to the referral hospitals as per jail referral policy and in case, such treatment as required or recommended for them is not adequate or available in those hospitals, they can be allowed by the order of a Court to be treated at a hospital where the treatment required by them is available, thus, ensuring that their health is not compromised with.”
Quite rightly, the Bench directs in para 27 that, “At this stage, this Court notes that the medical facilities available at the jail dispensary is not able to provide the medical treatment which is required by the applicant, as advised by the doctors concerned in terms of post-epidural care after his spinal surgery. Thus, considering that at this stage, no immediate arrangement can be made by the jail dispensary for ensuring appropriate medical care. of the applicant, this Court deems it fit, for the purpose of ensuring that a balance is struck between the right of the prisoners to appropriate medical care and the right of the State to ensure rule of law, to allow the request of applicant to get the required physiotherapy treatment at the Safdarjung Hospital, Delhi. In case, the required medical care is not available at Safdarjung Hospital, Delhi, the applicant may move a fresh application before this Court for being treated at Indian Spinal Injuries Centre, Vasant Kunj, Delhi.”
Most interestingly, the Bench then states in para 28 that, “This Court issues the following directions qua the prayer of the petitioner:
a) The applicant be admitted to Safdarjung Hospital, Delhi, which is also a referral hospital as per Jail Referral Policy, Delhi for a period of two weeks, within two days of receipt of this order. However, the applicant shall continue to be in the custody of Superintendent of Jail concerned, and the Jail Superintendent concerned shall ensure that appropriate and adequate security is provided/deputed in the hospital since the accused will continue to remain in judicial custody though under treatment in the hospital.
b) The Jail Superintendent concerned shall make arrangement to shift the applicant in an ambulance to the said Hospital.
c) The Medical Superintendent of Safdarjung Hospital, Delhi will constitute a medical board which will furnish a weekly report to this Court regarding the medical status of the applicant and the need to continue treatment or hospitalization and also provide a copy of the same to the Enforcement Directorate and Central Bureau of Investigation.
d) It is also ordered that the entire expenses of medical treatment, hospitalization, security, and other incidental expenses incurred on the treatment shall be borne by the applicant.
e) During hospitalisation, the wife and children of the applicant are permitted to meet him between 11 AM to 12 PM and between 4 PM to 5 PM subject to the meeting hours and applicable rules of the hospital. The mother of the applicant Smt. Simrit Dhall will be permitted to meet the applicant daily during the prescribed meeting hours of the hospital. The sisters of applicant i.e. Smt. Simer Dhall and Smt. Komal Singh Dhall will be permitted to meet the applicant on alternative days during the meeting hours of the hospital.
f) The concerned Superintendent Jail shall ensure that the meeting schedule so mentioned above will be strictly adhered to.
g) The applicant shall not be allowed to use phone.
h) The family members of applicant may provide him home-cooked food, if so allowed by the doctor concerned.
i) The family members of the applicant shall not be allowed to carry phone with them, while meeting the applicant.
j) The learned counsel for the applicant will be allowed legal interview with the applicant, as per jail manual and rules.”
As a directive to the Government of NCT of Delhi, the Bench then notes in para 29 that, “This case serves as a reminder that the quality of medical care within correctional facilities must be held to high standards, with a focus on the well-being and rehabilitation of inmates. The State Government has a moral and legal obligation to ensure that the healthcare needs of inmates are met with the same diligence and commitment as any other citizen.”
Finally and far most significantly, the Bench then concludes by holding in para 30 that, “This Court observes that Government of NCT of Delhi is responsible for the management and maintenance of the prison premises. Since, it is crucial to have appropriate medical care system in the prisons which meets the requirements of the inmate patients, thus, the following directions are being issued to the Government of NCT of Delhi by this Court:
a) This Court directs the Secretary (Home), Government of NCT of Delhi, and Secretary, Health and Family Welfare, Government of NCT of Delhi to ensure that the health care requirements of the prison inmates are met and adequate medical infrastructure in the jail premises is maintained for ensuring right of prisoners to appropriate medical care.
b) This Court further directs the concerned doctors Incharge of respective Jail Dispensaries to furnish the list of requirements of adequate medical equipment which is essential for the medical care of the prison inmates, to the concerned Chief Medical Officers.
c) The Chief Medical Officers of all the prisons will submit a weekly report to the Director General, Prisons, who will communicate this report to the Jail Visiting Judicial Officer/Judge concerned regarding inadequacies or urgent requirements in their respective jail hospital/dispensary including the working or nonworking condition of the machines and medical equipment and availability of medicines, etc.
d) The weekly report prepared by the Chief Medical Officers of all the prisons will also be sent to Secretary (Home), Government of NCT of Delhi, and Secretary, Health and Family Welfare, Government of NCT of Delhi. The issues so pointed out in the report mentioned above, will be addressed and the necessary supplies, equipments, medicines will be ensured to be provided within two days. The machines/medical equipment if not in order, will be repaired or a substitute will be provided immediately by the State.
e) The Secretary, Health and Family Welfare, Government of NCT of Delhi will constitute a Committee which apart from him will include the following:
i. Director General (Prisons)
ii. The CMO of the Delhi Prisons
iii. Two senior Jail Visiting Judges of the District Courts to be nominated by the Principal District & Sessions Judge (Central District),
iv. The Secretary, DSLSA
v. Sh. Sanjay Dewan, Advocate
vi. Ms. Gayatri Puri, Advocate
f) The above committed will give suggestions, regarding improving the health care facilities in the prisons and ways to promote equal health care to all prisoners, within a period of one month to this Court.
g) The committee will also specifically inform the Court as to whether facilities are available in the jail hospital to deal with emergency situations such as cardiac arrest, hemorrhages etc. as the first few minutes in such eventuality are crucial to save life of a person.”
In a nutshell, we thus see that the Delhi High Court has made it indubitably clear that every prisoner is entitled to basic medical care. It rightly called upon the Government of NCT of Delhi to improve the medical infrastructure in jail so that the prisoners can get timely medical aid and don’t suffer from lack of it. The Court made clear that the State Government has a moral and legal obligation to ensure that the health care needs of inmates are met with the same diligence and commitment as that of any other citizen. It was also made crystal clear by the Court that there cannot be discrimination of any kind between the prisoners on the basis of rich or poor! Very rightly so!
Sanjeev Sirohi
