Shirking their primary obligation?

Under the Constitution of any free country, 'right to life' is considered to be the most important of all fundamental rights that a State is supposed to guarantee its citizens. The Indian Constitution guarantees this right under the Article 21 that clearly states that "no person shall be deprived of his life or personal liberty except according to procedure established by law." Unfortunately, even 66 years after the Constitution was adopted, the government of India has done little to protect the life of its citizens by way of a guaranteed healthcare and minimum living income. Lately, the important aspect of healthcare of citizens has been left largely with money-making private business establishments — hospitals, nursing homes, clinics, path labs, pharma companies, devices suppliers, etc. The need for providing jobs to its citizens guaranteeing a minimum living wage, or, giving doles to those unemployed and a minimum living pension to all senior citizens has never topped the agenda of any government since India's Independence. The right to life remains practically meaningless in the absence of a right to livelihood and healthcare. Although the jurists of such eminence as Justice Bhagwati and Justice Iyer considered Article 21 as an embodiment of "a Constitutional value of supreme importance in a democratic society" and "the procedural Magna Carta protective of life and liberty", the country's political administration did little to protect the value of life by ignoring the government's primary obligation to provide livelihood and healthcare to its citizens.

While the government accounts for at best four crore jobs in a country of over 130 crore people, the rest are left to fend for themselves as seasonally-employed farmers, entrepreneurs of all sorts, managers, private practitioners in legal, financial, and medical and other professions, full-time and part-time workers, artisans, contract labour, domestic help, etc. Few, outside the government and its aided organisations, enjoy the guarantee of a living wage and pension. The minimum pension for industrial workers guaranteed by the government is ridiculously meagre at Rs.1,000 each per month, making a joke of the 'right to life' for such retired individuals. At a time when the government is going all out to push its 'digital India' programme, it does not seem to have similar enthusiasm and concern for life, livelihood, and healthcare of its citizens.

The 'right to life,' regarded as the foundation of all our laws and legal protections, can only be claimed when a person is deprived of his or her 'life' by the 'state' as defined in Article 12. Any violation of the right by private individuals is not within the purview of Article 21. This makes the government 100 per cent liable for the 'right to life' of people. However, it would appear that the successive governments since the framing of the Constitution showed scant respect for this fundamental right of citizens and the Preamble to the Constitution which aimed to provide a welfare state and 'socialistic patterns' of society. The principle of socialism was also embodied in various provisions of part III & part IV of the Constitution. No one talks about the 'directive principle of state policy' anymore, these days. If we go through those provisions under the directive principle, we will find that several of them have directly or indirectly related to public health. It directs the state to take measures to improve the condition of healthcare of the people. A careful reading of Articles 38, 39 (e), 41, 42 and 47 will clearly show the importance the Constitution lays on the government's duty to protect workers' health, public assistance to the sick and disabled, protection of infant and mother, offering maternity benefits, etc. Article 47 spells out the duty of the state to raise the level of nutrition and the standard of living of the people as its primary responsibility.

Today, going by on the ground reality, few will disagree that the government has substantially failed in its Constitutional duty and obligation to protect the 'right to life' of its citizens by providing a guaranteed minimum living standard and healthcare to meet even medical emergencies.

India has only 0.6 graduate medical doctors per 1,000 people. It ranks lowly, some 123rd position, among nations, even below neighbouring Pakistan, regarding the number of medical doctors a country has per 1,000 population. This is unacceptable after nearly 70 years of the country's Independence. Even economically depressed Cuba boasts 5.91 doctors per 1,000 population. Why didn't India, supplying good number of doctors in rich countries such as the US, UK, Australia, etc. to support their national healthcare systems, set up enough number of medical colleges, postgraduate medical institutes, medical research centres and ensure good salaries to medical professionals in the public service, comparable to salaries of other high earning professionals? This could largely prevent them from leaving the country or joining corporate hospitals, private clinics to work under stressful sales targets for those hospitals and clinics instead of concentrating on their job to cure a patient and save his or her life.

According to the Medical Council of India, the doctor-population ratio in the country stands at 1:1681, based on the assumption that 80 per cent of these doctors are available on any given day. Between April 2013 and March 2016, 4,701 doctors who graduated from India chose to go abroad. The government made little effort to prevent doctors from migrating or making the atmosphere more conducive for them to practice in the country. Many global experts think India is on the brink of a major healthcare crisis. Health and medical education appear to be less important subjects for the government. The current high cost of medical education is an impediment to the pursuance of research and exploring medical advances. This works as a disincentive for medicos who struggle for sustainability, while bearing the motto of service, aiming to improve healthcare accessibility while an individual's Constitutional 'right to life' is exploited by unethical practices by private healthcare centres taking full advantage of India's self-made healthcare crisis with the blessings of the government. It appears that the fundamental 'right to life' is largely left at the mercy of private enterprises to deliver or devour.