Right to medical aid is State's responsibility - HC directs Govt. to cut down bureaucratic chain & fund the treatment of children with genetic disorder

Court comes to the aid of two dying patients

Akanksha Jain, New Delhi, March 21, 2014

“We need to cut down the bureaucratic chain so that the money reaches needy patients,” the High Court told the Delhi Government on Thursday.

A Bench of Justice Manmohan made this remark while dealing with pleas of two poor patients who suffer from genetic disorders and have sought medical aid from the State.

One of them is 36-year-old Amit Ahuja, a bed-ridden haemophiliac, who lost his left leg and continues to bleed in a ward at the Lok Nayak Jaya Prakash Narayan Hospital (LNJP) with multiple bedsores and a pseudo tumour in the right leg.

Criticizing the government and its hospitals for not creating dedicated bank accounts where the public can donate money for the treatment of poor patients, the Bench asked: “Has anyone heard of any account of the All India Institute of Medical Sciences [AIIMS] or LNJP for anyone to deposit money by way of charity? Why is it not in place? Why is LNJP shy of accepting public money for poor patients?”

When told by the Health Secretary that the Government has one such account, the Bench said: “We need to cut down the bureaucratic chain so that money reaches the needy. The account should be subject to audit. The head of any government hospital should not need to request the State for treating the poor.”

Hearing the plea of Mr. Ahuja, the court said: “No person can bleed to death.”

Meanwhile, the Bench transferred Rs.7.75 lakh collected by High Court lawyers into a bank account of AIIMS for immediate treatment of Mohammad Ahmed, the son of rickshawpuller Mohammad Sirajuddin who broke down outside court while talking to The Hindu .

“Even the Prime Minister’s Office did not come to aid when I lost three children to the same disorder,” he said.

“I am faced with grave crisis today. One person is bleeding, his wounds are not healing. The other patient needs enzyme therapy. His three siblings have died of the same disorder. I have to look for a legal answer to this. Every person has a right to medical aid,” Justice Manmohan said.

During the hearing, counsel for Mr. Ahuja advocate Gurmit Singh Hans told the Bench that he is being treated for the disorder since he was nine-months-old, but now when all his family assets stand exhausted the hospital has denied him treatment, which is worsening his condition.

The LNJP Hospital Department Head told the Bench that the only drug available for haemophilia costs more than Rs.50 lakh and is to be given daily to the patient.

“When medical science has made some advances, we have to give it to the common man. Otherwise what is the idea of having such lofty ideas in the Constitution? It cannot be only for the high and mighty,” the Bench said.


“We need to cut down bureaucratic chain so the money reaches needy patients”

Source: The Hindu

Welfare Trust Fund for Disabled swells to 223 crore; remains unutilized

The documents submitted in Supreme Court show that the trust has so far has utilised only Rs 18.59 crore towards extending benefits to physically disabled.

Fund for disabled set up 10 years ago lies unused

Written by Utkarsh Anand | New Delhi | March 3, 2014 11:49 pm

A fund created on the order of the Supreme Court for welfare of the disabled has swollen to Rs 223 crore, but not even 10 per cent of it has been utilised in almost a decade now.

The only plan in place, a scholarship scheme for disabled students, is yet to be introduced in any of the union territories or Northeastern states.

In 2004, the court had ordered that the Comptroller and Auditor General set up a trust with the money recovered by it from banks as illegal collection from borrowers. The money, the court said, would be used for the benefit of disabled. The trust was to be managed by the CAG as its chairman, with the finance secretary and law secretary as ex-officio members.

The RBI recently wrote to the under secretary, Ministry of Finance, that Rs 173 crore in all had been deposited in the fund. While 46 commercial banks had deposited Rs 154 crore towards excess interest charged to borrowers, Rs 19.5 crore had been deposited as part of the additional Rs 50 lakh each the banks gave in accordance with the Supreme Court order.

This money, Additional Solicitor General Rakesh Khanna informed a Supreme Court bench led by Justice K S Radhakrishnan recently, has grown to Rs 223 crore along with interest.

However, as the documents submitted in court showed, the trust has so far utilised a meagre Rs 18.59 crore towards according benefits to the physically challenged. Only money allotted for a scholarship scheme has been entirely used, benefiting 1,500 students per year. The number of scholarships has now been raised to 2,000 students per year.

Documents also revealed that no union territory or Northeastern state barring Assam had benefited from the scholarship scheme, which has more male recipients than female.

At a hearing earlier, ASG Khanna had told the court about the recovery of the amount so far and sought some additional orders on issues like merger of banks, or closure of banking operations by some entities, mode of recovery from state finance corporations etc.

The bench, which was hearing a petition filed by Ravi Shankar Bhushan, a disabled person working in an NGO, said it would pass appropriate orders with assistance from the petitioner’s counsel Colin Gonsalves.

Source: Indian Express

US Supreme Court questions Death Penalty based on rigid IQ score threshold for determining intellectual disability

US Supreme Court scrutinizes Florida’s death penalty law

WASHINGTON — Florida’s death penalty came under fire from a key Supreme Court justice Monday, as a divided court confronted the role of low IQ scores in exempting convicted murderers from execution.

Justice Anthony Kennedy, the court’s frequent swing vote, joined more liberal justices in questioning Florida’s rigid IQ score threshold for determining intellectual disability. Kennedy’s positioning hinted at the possibility that the court, probably on a close vote, might strike down the strict IQ rule used by Florida, Idaho, Kentucky and several other death-penalty states.

More broadly, Kennedy raised doubts about Florida’s administration of the death penalty and the long delays that have ensued. His implicit criticism went beyond Monday’s case, and hinted at other capital punishment debates to come.

“The last 10 people Florida has executed have spent an average of 24.9 years on death row,” Kennedy reminded Florida Solicitor General Allen Winsor. “Do you think that is consistent with the purposes of the death penalty, and is it consistent with sound administration of the justice system?”

Pressed several times, Winsor noted that Florida lawmakers had addressed “a number of issues” Kennedy raised with passage of legislation last year. Many prison inmates have since challenged the state’s Timely Justice Act, which is now before the Florida Supreme Court.

Freddie Lee Hall, the 68-year-old convicted murderer whose case was before the U.S. Supreme Court on Monday, has been on the state’s death row since 1978. He and an accomplice were convicted of murdering a 21-year-old pregnant woman and a Hernando County deputy sheriff.

“He is the one who seized the young woman, who pushed her into a car, who drove the car with his accomplice following in another car and who killed her, and . . . killed a policeman, too, later,” Justice Antonin Scalia recounted, suggesting that Hall’s actions showed some level of mental competence.

Hall didn’t raise the mental retardation issue for the first 10 years of his imprisonment. After he did, Kennedy noted pointedly, five years passed before the state conducted the hearing designed to assess his intellectual capacity.

The Supreme Court has previously decided, in a 2002 case called Atkins v. Virginia, that the execution of those variously called mentally retarded or intellectually disabled violates the Eighth Amendment’s prohibition against cruel and unusual punishment. The court left the definition up to individual states.

Florida imposes a three-part test, which starts with a rigid requirement that the inmate score 70 or below on the IQ test. If the inmate scores below the cutoff number, the state also will assess for “deficits in adaptive behavior” and an onset before the age of 18.

“Florida has an interest in ensuring that the people who evade execution because of mental retardation are, in fact, mentally retarded,” Winsor said.

Hall and his allies counter that Florida errs by not taking into account the standard 5-point margin of error, which means someone who scores a 75 might actually have a testable IQ of 70.

“If a state conditions the opportunity to demonstrate mental retardation on obtained IQ test scores, it cannot ignore the measurement error that is inherent in those scores, that is a statistical feature of the test instrument itself,” Hall’s attorney, former Solicitor General Seth Waxman, told the court.

Kennedy joined Justices Sonia Sotomayor, Stephen Breyer, Ruth Bader Ginsburg and, in particular, Elena Kagan in raising questions about Florida’s rigid IQ testing cutoff.

“Your rule prevents us getting a better understanding of whether that IQ score is accurate or not,” Kennedy told Winsor.

Kagan added that “we know from the way these standard margins of error work” that an inmate who scores a 71 might actually “have an IQ of 69.” Hall has registered IQ scores from the low 70s to as high as 80.

Scalia was most vociferous in his apparent support for Florida’s rigid rule, arguing that courts should defer to a state’s legislative judgment rather than look to evolving standards set by groups such as the American Psychological Association.

“This APA is the same organization that once said homosexuality was a mental disability and now says it’s perfectly normal,” Scalia said. “They change their minds.”

Cornell Law School Professor John H. Blume, a death penalty expert, said in an email interview that only “around 10” death row inmates with borderline IQ scores stand to benefit immediately if the Supreme Court sides with Hall in the case heard Monday.

Justice Clarence Thomas, as is his habit, was the only one of the nine justices not to speak or ask questions during the hourlong argument. A decision is expected by the end of June.

Source: Central Daily

Disability angle in Nursery admission norms - HC issues notice to centre

Nursery norms: Centre to clarify on disability quota
TNN | Feb 26, 2014, 02.19 AM IST

NEW DELHI: The High Court on Tuesday asked the Centre to clarify if Delhi's schools still have the discretion to provide admissions in nursery classes to disabled kids, despite the Lieutenant Governor's guidelines clubbing them with children of economically weaker groups (EWS).

A bench of justices S Ravindra Bhat and R V Easwar gave a day's time to the Centre to explain after the latter told the court it is up to the Delhi government to make guidelines for providing any benefit to disabled kids since the city government has enough "elbow room" despite the LG's order.

But HC was not satisfied and questioned the Centre's stand saying "no elbow room is visible" under the guidelines or the Persons with Disabilities Act. It added that if no proper guidelines are framed for providing relief to disabled students, the "discretionary approach" of schools will get an "escape route".

"If you (Centre and Delhi governments) don't come out with guidelines, it could lead to an escape route to the discretionary approach of schools," the bench said and kept the matter for Wednesday after the counsel, appearing for the Centre, said its officials would be present in the court to explain the government's stand.

The bench was hearing a PIL, by Pramod Arora, father of a child with special needs, challenging the LG's nursery admission guidelines to the extent it clubs disabled children with kids from EWS group. His petition also seeks 3% reservation for disabled kids in the nursery class.

During the day's proceedings, the Centre said it is for Delhi government to evolve guidelines on the issue but the court pointed out only when the Centre asks the state government to do so will it acts.

It also asked the Centre to "see what is possible under the Act", whether 3% reservation is possible and if yes, how to implement the same.

Meanwhile a group of parents on Tuesday also challenged the points for interstate transfer in the new nursery admission guidelines. A bench of acting Chief Justice and Justice Siddharth Mridul sought a reply from the state government and posted the case for Thursday.

Source: Times of India

Defence Personnel get a raw deal, disabled are worst hit

Please refer to my earlier post dated 11 Feb 2014 titled: Department of Ex-Servicemen Welfare working against the interest of Disabled Soldiers. 

Defence Personnel  or Ex-Servicemen are at a great disadvantage in respect of pay, pension and medical benefits compared with civilian government employees. It is none other than their own department called Department of Ex-servicemen Welfare who is working against their interest and resorting to appeals against all orders of Armed Forces Tribunal that went in favour of the soldiers. 

FRONTLINE Article

Over the past five years, ex-servicemen have been agitating against the injustice meted out to them by the Central government. They have lost faith in the Department of Ex-Servicemen Welfare (DESW), created specifically to take care of their welfare. Ex-servicemen have won 90 per cent of the cases filed in the Armed Forces Tribunals and the Supreme Court against the government, but the government has appealed in all the cases through the DESW.

The veterans have approached the Prime Minister and the Defence Minister to seek redress in numerous cases where they felt injustice had been done to them but to no avail. The Supreme Court’s judgments in their favour have either not been implemented or not been implemented in letter and spirit in cases pertaining to disability pensions, payment of arrears with retrospective effect from January 1, 2006, rank pay, and hospital charges on authorised Ex-servicemen Contributory Health Scheme (ECHS) rates for medical treatment abroad.

The government files en masse appeals against retired defence personnel whenever any case relating to pension benefits is decided in their favour by any court of law or the Armed Forces Tribunal. Facing the brunt of the government’s apathy is the category of disabled and war-disabled soldiers. Most of the special leave petitions and appeals filed by the Ministry of Defence in the Supreme Court are against the grant of disability or war injury benefits to disabled and war-disabled soldiers. As a result, the veterans are forced into expensive litigation.

Over 3,000 cases decided in favour of defence personnel by the Armed Forces Tribunal have not been implemented; the Defence Ministry has contested all these judgments in the Supreme Court. Imagine the plight of a widow of a sepoy living in a far-flung rural area. How is she going to find the resources to fight her case in the Supreme Court? The tribunals were created for delivering speedy justice to defence personnel at minimum cost. But the Ministry’s decision to appeal against the tribunal’s judgments has not only delayed justice but also made it near impossible for the defence personnel to fight their cases. The Armed Forces Tribunals do not have contempt powers to get their judgments implemented whereas Central Administrative Tribunals (CATs) are vested with such powers.

This is the biggest cause of heart burning in the military community today. Military personnel with non-service-related disabilities discharged with less than 10 years of service remaining are not entitled to any form of pension, whereas the employment of civilian employees who “acquires a disability during his service” is protected under Section 47 of the Persons with Disabilities Act, 1995.

As per the Sixth Central Pay Commission recommendations, all government servants are allowed three assured career progressions. Civilians who retire at the age of 60 are allowed promotions at 10, 20 and 30 years of service, and soldiers at eight, 16 and 24 years. However, since jawans are forced to retire early, largely between 15 and 19 years of service, to keep up the young profile of the forces, they miss out on at least one assured career progression, unlike their civil counterparts, who serve their full term until superannuation. It has been proposed to the government that the third career progression should be given to jawans automatically; they should be promoted to the rank of naib subedar at the time of retirement. Surprisingly, this demand has not been accepted.

Widow’s pension

Widow’s pension is one area of concern to the defence community that has received little attention from the government. A sepoy’s widow pension has remained a meagre Rs.3,500 a month while other sections of government employees have received periodic increases in such pension. The minimum family pension in respect of defence widows must be enhanced from Rs.3,500 to Rs.10,000 a month.

It is common knowledge that soldiers retire ahead of their time. What is not known, however, is that their life expectancy is shorter than that of civilians. The Institute of Applied Research in Manpower Analysis (IARM), which studied the lifespan of civilian employees at the behest of the Fifth Pay Commission, arrived at 77 years as the average life expectancy of a civilian government servant. The Railways conducted a similar exercise for their personnel and assessed that they achieved an average lifespan of 78 years. No such study was conducted for defence personnel since it was generally believed that soldiers lived longer than civilians. However, Major General (retired) Surjit Singh, AVSM (Athi Vishisht Seva Medal), VSM (Vishisht Seva Medal), who headed the Army Cell of the Fifth Pay Commission, carried out a detailed study in 2005 along with other experts. The study revealed that the average lifespan of defence officers was 72.5 years; that of junior commissioned officers (JCOs) 67 years; and that of other ranks was between 59.6 and 64 years.

These findings were forwarded to the Chief of the Army Staff General J.J. Singh on July 7, 2005, by Lieutenant General (retd) M.M. Lakhera, PVSM (Param Vishisht Seva Medal), AVSM, VSM, who was Lieutenant Governor of Puducherry. The findings were reported by all national newspapers and a question was asked in Parliament on the subject. Pranab Mukherjee, who was the Defence Minister then, maintained that the issue would be examined in detail. Nothing was heard about it after that.

Stress and strain of early retirement is one of the major reasons for the lower life expectancy among the defence personnel. Their legitimate demand for an assured second career until the age of 60 through an Act of Parliament has not yet been accepted.

While the pensions of all ranks were enhanced with effect from September 24, 2012, to redress the anomaly of the Sixth Pay Commission, the request to enhance the pension of JCOs proportionately was not granted. Majors with 13 years and more of service who retired before 2004 have been denied the benefit of the rank of lieutenant colonel (that is, the benefit of pay band-4 in the revised scale of the Sixth Pay Commission).

The government’s policy to grant lieutenant colonel rank on completion of 13 years of service was made applicable with effect from 2004. It would have been only just to grant all those who retired before 2004 in the rank of major with 13 years of commissioned service (this number being finite) the benefit of pension on the scale of lieutenant colonel. The strong plea in this regard has not been accepted.

Also, the non-functional upgrade (NFU) granted to civilian employees has been denied to defence personnel, thereby putting them at a disadvantage.

One Rank One Pension

One of the major demands of veterans is same pension for same rank and same length of service, that is, same rank + same length of service = same pension, irrespective of the date of retirement. They want a legislative guarantee to this. Although all major political parties have agreed to this in principle and frequently incorporate it in their election manifestos, this 40-year-old demand has not been implemented. The bureaucratic excuses in the form of administrative, legal and financial hurdles in implementing the demand were heard in detail in 2011 by the Rajya Sabha Petition Committee set up to look into all aspects of the demand and rejected them in the strongest terms. Prime Minister Indira Gandhi had agreed to this provision in principle, but her untimely death scuttled the proposal. Successive Standing Committees on Defence and the Rajya Sabha Petition Committee have recommended this but to no avail.

Before 2006, the difference in the pensions of Major General and Lieutenant General was only Rs.1,400. Subsequently, it became Rs.700. With the extension of higher administrative grade (HAG) and HAG+ to the rank of Lieutenant General and above, the difference in pension is more than Rs.8,000 even after the increase with effect from September 24, 2012. The government has overlooked the Sixth Pay Commission recommendations, which suggested that all government employees with a basic pay of Rs. 20,000 and above be clubbed under the same pay band. Major Generals retire with a basic pay of Rs.22,400 and above while Lieutenant Generals retire with a basic pay of Rs.23,500 and above. Non-inclusion of major generals in HAG has caused an anomaly.

On losing the case, the Defence Ministry filed a review petition in the Supreme Court, denying enhanced arrears to army pensioners as ordered by the Delhi High Court with retrospective effect from January 1, 2006, instead of September 24, 2012.

Civilian employees are provided health care under the Central Government Health Scheme (CGHS) while ex-servicemen are covered under the ECHS. The provision of budget for the CGHS is calculated (for 2013-14) at the rate Rs.10,700 for every beneficiary while for the ECHS, it has been budgeted at Rs.3,150 a beneficiary. As a result, super-speciality hospitals do not offer themselves for ECHS empanelment. Over 80 per cent of the health care units have withdrawn from empanelment in view of delayed payment of bills and inadequate rates for various medical procedures. This has resulted in unsatisfactory or poor medical care for ex-servicemen. Sophisticated procedures have not been included in the ECHS. The veterans’ request for inclusion of the latest medical procedures on the ECHS benefits list has not been accepted yet. Ex-servicemen had requested that the budget be enhanced and not be less than the CGHS rates.

Here is an example to illustrate the poor nature of health care benefits provided by the government to ex-servicemen. Non-availability of funds with the ECHS and, as a consequence, non-payment of hospital dues made an empanelled hospital in Gurgaon in the National Capital Region to stop accepting patients for cashless medical treatment. Ex-Subedar Prakash Chandra Tomar from Meerut was brought to the hospital in a serious condition on December 8, 2013, which as per the ECHS scheme is permitted. The family was asked by the hospital authorities to deposit the money for the treatment or transfer the patient to some other hospital. Since the condition of the patient was serious, the family raised a loan and deposited Rs.11 lakh for 20 days of hospitalisation and treatment.

When the family was in no position to arrange further funds, Tomar’s son, Raj Kumar Tomar, approached the Indian Ex-Servicemen’s Movement (IESM) and the case was taken up with the Managing Director of the ECHS, who promised to get cashless treatment. But he did not succeed. The family deposited another Rs.2 lakh in the hospital. On January 1, Subedar Prakash died. The hospital did not accede to the request of the ECHS to release the body and insisted that the family clear the hospital bills.

In November 2008, the government had announced that in future there would be a separate pay commission for the defence forces. The defence fraternity feels betrayed as the government has not constituted a separate pay commission, and, as in the case of the previous commissions, there is no representation for defence forces in the newly constituted Seventh Pay Commission. Some 39 anomalies in defence pensions are yet to be resolved and with no defence representation in the new pay commission, more anomalies are likely to appear thereby increasing the magnitude of injustice already done to defence pensioners.

Denial of voting rights

It is surprising that serving defence personnel are denied the right to get themselves registered as voters at the place of posting. In spite of a clear judgment by the Supreme Court in 1971, this basic right has not been extended to soldiers. The option of postal ballot and proxy voting available to serving soldiers has not proved effective. There is no restriction imposed in the Representation of the People Act, 1950, to deny this right to defence personnel. There is an urgent need to restore this right immediately to allow serving soldiers to vote at their place of posting in the coming Lok Sabha elections.

The prevailing security environment calls for strong measures to upgrade the country’s defence preparedness in terms of manpower, equipment and weapon systems. Equally important are measures to keep the soldier’s morale high.

Source: Frontline