The Rajasthan Right to Health Act, 2023

Rajasthan is the biggest state in India by area. The state ranks 'weak' in NITI Aayog indicators on health and economy. To remedy this, the 'Residents' of State of Rajasthan will be provided free and timely healthcare by the State under the Rajasthan Right to Health Act, 2023. With this, Rajasthan becomes the first State in India to recognise this right. This is a laudable initiative which will include free emergency service, medicines, diagnostic tests etc.

Securing health for the citizens of India is a shared responsibility of the Centre and the State as it is covered under Concurrent List of Schedule 7 of the Constitution of India. Supreme Court has at times given examples of what right to health can include. In Parmananda Katara (1989) Supreme Court said that everyone is entitled to free emergency health services. All hospitals should provide basic emergency service to everyone without looking at their ability to pay. In Paschim Banga Khet Mazdoor Samity Case in 1996 it was said that government should provide adequate medical aid to all. In Consumer Education and Research Centre Case (1995), court recognised this right for workers so they can carry out their work. However, the right to health has never been defined.

Rajasthan became the first state to enact a law securing right to health for its residents. This includes free healthcare services at any clinic or hospital. The aim is to ensure equal access to health care service by all irrespective of their background. This will also help to maintain public health. The Rajasthan Act is very broad and gives even insurance and ambulance service for all its residents. It also includes access to drinking water and nutiritous food.

There are many responsibilities which have been laid down for the State Government.

• Financial Allocation: The government is required to make policy and allocate money so that this right can actually be realised by all citizens spread across the state. This includes infrastructure and human resources for all in the State.
• Plan to tackle epidemic and state health emergencies should also be there.
• Decentralised: Act also established Health Authorities at state and district levels. They will regulate quality of health care and manage emergencies in their area.
• Grievance Redressal: To register complaints a web portal and helpline number will be created. Timelines have been given within which any complaint should be addressed, otherwise it will be escalated to the District and then the State Health authority.

The Act is a first of its kind initiative but it leaves a lot of details to be decided in the Rules to be made under the Act.

• Vague:There is no clartiy on how much payment will be made to private clinics for the free services they will provide. By avoiding giving the details of how this right will be interpreted, State has escaped scrutiny. These details will be notified in the Rules to be issued under the Act.
• Balancing Right to Freedom of Profession: If there is a mandate for private clinics to accomondate the public free of cost, this can lead to overburderning of the clinic. Further, given the condition of government medical services in India, most people will go to private clinics. Mandating private clinics to take patients can be looked at as a as violation of their freedom to practice their profession, under Article 19(1)(g).
• Excludes the Most Marginalised: The Act also excludes migrants by restricting the application of the Act only to residents. These are often the most margianlised people who need the medical attention and can not afford it.
• Worsening Fiscal Deficit: A huge amount from the budget will have to be allocated to paying for these medical costs. This will be a challenge for State of Rajasthan to ensure sustainable financing without going bankrupt.

• Fundamental Right: Right to Health has been recognised as a Fundamental Right under Article 21 by the Supreme Court of India. This means that under the Right to Life, right to health is also necessary to ensure dignity in life.
• Directive Principles of State Policy: These are guidelines for government to make laws:-
  • Article 38 recognizes the need for a just social order to promote people's well-being. This social order cannot exist without healthy citizens, making public health an essential component.
  • Article 39(e) specifically focuses on protecting workers' health, recognizing their importance to the nation's productivity and welfare.
  • Article 41 mandates the state to provide public assistance to those in need, particularly the sick and disabled.
  • Article 42 underscores the state's primary responsibility to protect the health of infants and mothers.
  • Article 47 emphasizes the state's duty to raise the living standards and nutritional levels of its people.
• State Responsibility: Exact content and meaning of right to health was left on the State to decide under Schedule 7 LIst II.
• Judicial Decisions: in landmark cases like Parmananda Katara and Paschim Banga Khet Mazdoor Samity Case Courts have recognised right to health to be secured.
• National Commission on Human Rights: drafted the first Charter of Rights of Patient which include protections which the patients should have while they are being treated e.g. the right to know about the treatment, seek a second opinion, right to fair charges for treatment, right to health records, right to safe treatment, right to protection of patients in clinical trials etc. However this Charter is not binding.

Rajasthan's initiative presents a valuable learning opportunity for other states and the central government. Sharing best practices, fostering collaboration, and providing support can contribute to the nationwide realization of the right to health. This will require a collaborative effort involving the government, healthcare providers, civil society organizations, and citizens.

Raising public awareness about the Act and educating citizens on their rights and responsibilities regarding healthcare is crucial for effective implementation. Regularly monitoring progress, analyzing data, and conducting impact assessments are vital to refine the Act and ensure its long-term success.