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PETITIONER: STATE OF PUNJAB & ORS.

       Vs.

RESPONDENT: MOHINDER SINGH CHAWLA ETC.

DATE OF JUDGMENT:       17/12/1996

BENCH: K. RAMASWAMY, G.B. PATTANAIK

ACT:

HEADNOTE:

JUDGMENT:                             WITH      CIVIL APPEAL NOS.16980-81 OF 1996      (Arising out of SLP (C) Nos.12945 and 18828 of 1996)                          O R D E R      In CA No.16979/96 @ SLP (C) No.12472/96:      Leave granted      This appeal  by special  leave arises from the judgment and order of the Division Bench of the Punjab & Haryana High Court, made on August 8, 1996 in CWP No.15942/95.      The  respondent   had  heart   ailment  which  required replacement of  two valves  in the heart. Since the facility of the treatment was not available in the State Hospitals of Punjab, permission  was given  by  the  Director,  with  the approval of  the Medical Board, to get the treatment outside the State.  The respondent was sent for and had treatment in the AIIMS  at  New  Delhi.  The  respondent  submitted  this medical bill  on September 21, 1994 for reimbursement. While granting reimbursement  for the  actual expenses incurred in the sum  of Rs.1,29,000/-,  the appellants rejected his bill for room  rent paid  to the  hospital as  inadmissible.  The respondent filed  writ petition  stating that  when  he  had undergone the treatment in the hospital as an inpatient, the payment of the room rent is an integral part of the expenses for  treatment   and,  therefore,  he  is  entitled  to  the reimbursement of  the room  rent paid.  The  Division  Bench directed payment  of the  said amount.  Thus, this appeal by special leave.      It is  contended  for  the  appellants-State  that  the Government  have   taken  decision,   as  a  policy  in  the Resolution  dated   January  25,   1991   made   in   Letter No.7/7/85/5HBV/2498, that  the reimbursement  of expenses on account of  diet, stay  of attendant  and stay of patient in hotel/hospital will  not be  allowed. Permission  given  was subject to  the above  resolution and,  therefore, the  High Court was  not right in directing the Government to bear the expenses for the stay in the hotel/hospital contrary to para (vii) of  the Resolution of the Government. We find no force in the  contention. It  is an  admitted position  that  when specialised treatment  was not  available in  the  Hospitals maintained by  the State  of Punjab. Permission and approval

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having been  given by the Medical Board to the respondent to have the  treatment in  the approved  hospitals  and  having referred him to the AIIMS for specialised treatment where he was admitted,  necessarily, the  expenses  incurred  towards room rent  for stay  in the  hospital as an inpatient are an integral  part   of  the  expenses  incurred  for  the  said treatment. Take,  for instance,  a case  where an  inpatient facility is  not available in a specialised hospital and the patient  has  to  stay  in  a  hotel  while  undergoing  the treatment, during  the required  period, as certified by the doctor, necessarily, the expenses incurred would be integral part of  the expenditure  incurred towards  treatment. It is now settled law that right to health is an integral to right to life. Government has constitutional obligation to provide the  health   facilities.  If  the  Government  servant  has suffered  an   ailment  which   requires  treatment   at   a specialised approved  hospital and  on reference whereat the Government servant  had undergone such treatment therein, it is but  the duty  of  the  State  to  bear  the  expenditure incurred  by  the  Government  servant.  Expenditure,  thus, incurred requires  to be  reimbursed by  the  State  to  the employee. The  High Court  was, therefore,  right in  giving direction t  reimburse the  expenses incurred  towards  room rent by the respondent during his stay in the hospital as an inpatient.      The learned  counsel then contends that the State would be saddled  with needless  heavy burden, while other general patients would  not be able to get the similar treatment. We appreciate the  stand taken that greater allocation requires to be  made to  the general  patients but  unfortunately due attention for proper maintenance and treatment in Government Hospitals is  not being given and mismanagement is not being prevented. Having  had the constitutional obligation to bear the expenses  for the Government servant while in service or after retirement  from service,  as per  the policy  of  the Government,  the  government  is  required  to  fulfill  the constitutional obligation.  Necessarily, the  State  has  to bear the expenses incurred in that behalf.      The appeal is accordingly dismissed. No costs.      IN CA @ SLP (C) NO.12945/96 - State of Punjab & Ors. v. Waryam Singh:      Leave granted.      Heard learned counsel on  both sides.      While the  respondent was  a Government servant, he had developed   sudden    coronory   ailment.   After   required angiography and  other reports  of tripple  vessets diseaase was  diagnosed   in  CMC  Hospital,  Ludhianaa  and  he  was recommended by  the said  hospital to  go  over  or  Escorts Hearts Institute,  New Delhi  for urgent  treatment. On  its basis, the  respondent had  the treatment. The Medical Board granted by  its proceedings  dated January 12, 1969, ex-post facto  sanction   for  treatment  with  one  attendant.  The appellant  had   granted   reimbursement   of   a   sum   of Rs.1,03,267/- less  the  rent  paid  for  the  room  in  the hospital for  the period  of stay.  It is  the  Government’s stand that  the reimbursement  could be allowed as per rates charged  by   All  India   Institute  of  Medical  Sciences. Accordingly, a sum of Rs.20,000/- paid as rent was deducted. When the respondent filed the writ petition, the High Court, by judgment  dated April  12, 1996  in CWP  No.16570/95, the Division bench  allowed the writ petition. Thus, this appeal by special leave.      It  is   contended  for   the  State  that  though  the Government had  granted ex-post  facto sanction  through the Medical Board and permitted the patient to undergo treatment

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outside the  State with  the policy,  for  reimbursement  of medical expenses incurred and the medical treatment taken in the  Hospital   to  the   Government  servant/pensioners  or dependents, as  per rules,  the  Government  has  imposed  a condition to pay room rent at the rates charged by the AIIMS for stay in the hospital. the reimbursement will be given at those rates.  The Government,  therefore, is  not obliged to pay the actual expenses incurred by the patient while taking the treatment as inpatient in the hospital, for rent.      We are  unable to  agree with  the stand  taken by  the Government. It  is seen  that the  Government had decided in the proceedings  dated October  8,  1991  to  reimburse  the medical  expenditure   incurred  by  the  Punjab  Government employees/pensioners  and   dependents  on  treatment  taken abroad in private hospital. It is stated in paragraphs 2 and 3 that  the Government has prepared a list of those diseases for which  the specialised  treatment is  not  available  in Punjab Government  Hospitals but  it is available in certain identified private  hospitals, both  within the  outside the States.  It  was,  therefore,  decided  to  recognise  these hospitals for  treatment of  the diseases  mentioned against their names  in the  enclosed list for the Punjab Government employees/pensioners and  their dependents,  The  terms  and conditions contained  in the  letter under  reference  would remain applicable.  The Government  can, however, revise the list in  future. The  name of  the  disease  for  which  the treatment is not available in Punjab Government hospitals is shown as  Open Heart  Surgery and  the name  of the  private hospital is  shown as  Escorts Heart Institute, New Delhi as one of  the approved  hospital/institution. Thus,  for  open heart surgery or heart disease the Escort Heart Institute is authorised and  recognised institution  by the Government of Punjab. Consequently,  when the patient was admitted and had taken the  treatment in  the hospital  and had  incurred the expenditure   towards    room   charges,    inevitably   the consequential rent  paid for  the room  during his  stay  in integral part of his expenditure incurred for the treatment. Consequently the  Government is  required to  reimburse  the expenditure incurred for the period during which the patient stayed  in  the  approved  hospital  for  treatment.  It  is incongruous that  while the  patient is  admitted to undergo treatment and  he is refused the reimbursement of the actual expenditure incurred  towards room  rent and  is  given  the expenditure of the room rent chargeable in another institute whereat he had not actually undergone treatment. Under these circumstances, the  contention of  the State  Government  is obviously untenable  and incongruous.  We hold that the High Court was right in giving the direction for reimbursement of a sum  of Rs.20,000/- incurred by the respondent towards the room rent for his stay while undergoing treatment in Escorts Heart Institute, New Delhi.      The appeal is disposed of accordingly, No costs.      In CA & SLP (C) No.18828/96:      Leave granted      Heard counsel for the parties,      The appeal  is disposed  of in terms of order passed in CA No. 16980/96 @ SLP (C) No.12945/96.