Uttar Pradesh chief minister Yogi Adityanath had in 2017 promised “Ram Rajya”, or the equivalent of an ideal state. Three years on, Allahabad High Court has observed that the healthcare system in the smaller cities and villages of the state was “Ram bharose”, or at God’s mercy.

The bench of Justices Siddharth Varma and Ajit Kumar made the observation on Monday while going through a report submitted by the government on doctors at the state-run LLRM Medical College in Meerut failing to identify a deceased Covid patient and disposing of the body as that of an unidentified person.

The court said: “If this is the state of affairs of treatment at a medical college in a city like Meerut, then the entire medical system of the state pertaining to smaller cities and villages can only be taken to be like the famous Hindi saying: ‘Ram bharose’.”

The high court, which had been hearing a PIL on the coronavirus spread and the condition of quarantine centres in BJP-ruled Uttar Pradesh, had on May 11 directed a probe when a lawyer had informed it that he had seen social media claims of a patient missing from the medical college since April 22.

The government probe revealed that the patient was Santosh Kumar, 64, who had been shifted to LLRM Medical College from the district hospital in Ghaziabad on April 21. Kumar, who had been kept in an isolation ward at the medical college, died the next day, following which the body was disposed of as that of an unidentified person as no doctor or other staff could identify him. Neither had any admission entry been made.

“If doctors and paramedical staff adopt such a casual approach and show carelessness in the performance of their duty, then it is a case of serious misconduct because it is something like playing with the lives of innocent people. The state needs to take stern action against those responsible,” the court observed.

According to the government’s report, Kumar fainted in the hospital washroom between 7pm and 8pm on April 22. Dr Tulika, a junior resident doctor on night duty, had deposed before the government committee that the Covid patient was lifted onto a stretcher and efforts were made to revive him, but he passed away.

“By the time the efforts were being made, the morning team (of doctors) had arrived. However, it was admitted that the team in-charge who was on night duty, Dr Anshu, was not present,” the bench stated in the written observation.

“Dr Tanishq Utkarsh (another doctor) got the body removed from the place and all efforts to identify the person went in vain…. The dead could not be identified. Thus, it was taken to be a case of unidentified body and even the team that was on night duty could not recognise it and so the body was packed in a bag and disposed of,” the court added.

“From the narration of facts, as have emerged from the inquiry, it comes out to be a case of high degree of carelessness on the part of the doctors who were on night duty. It is quite surprising that Dr Tanishq Utkarsh and his team that was on duty at the time of admission of the patient on April 21 could not identify the person,” the bench said.

Going through another report submitted by five district magistrates, the court said: “We have no hesitation in observing that the health infrastructure is absolutely insufficient in city areas to meet the requirements of the city population and in the rural areas the community health centres are virtually lacking in respect of life-saving gadgets.”

The court directed the state government to provide sufficient healthcare infrastructure in compliance with its earlier direction.

Multiple news reports have highlighted that the rural health infrastructure in Uttar Pradesh is in a shambles, reeling from lack of proper treatment, doctors, medicines and oxygen amid the pandemic. The entire country and the world have watched in horror as thousands of bodies have been dumped in rivers, including the Ganga, and on banks as deaths have allegedly gone uncounted and families have failed to even ensure proper cremation with crematoriums overflowing and unscrupulous elements looking to fleece the bereaved.

On Monday, the high court expressed dissatisfaction with the punishment handed to the errant doctors and paramedical staff at the Meerut medical college. Their annual increments have been withheld.

“We are not satisfied with the way the state has dealt with this issue. A patient is admitted to a hospital in the absolute care of doctors and paramedical staff…. The state needs to take stern action against those responsible, maybe they are the highest in the ranks. It should compensate the dependents who have suffered the irreparable loss because of such carelessness,” the court said.

Reacting to the lack of adequate healthcare facilities, the court gave the example of Bijnore. The court said that the urban population of the district as per the 2011 census was 9,25,312, which must have gone up 25 per cent by 2021, yet it did not have a Level-3 hospital that has ventilator facilities.

The three government hospitals in Bijnore have a total of only 150 beds, five BiPAP machines and two high-flow nasal cannulas.

The rural population of the district was around 27,55,000,according to the 2011 census. Yet, there are only 30 beds in the 10 community health centres taken together.

“Meaning, one CHC can cater to the needs of only 0.01 per cent of the population and there is no BiPAP machine or high-flow nasal cannula available,” the court said, while also pointing to the shortage of oxygen concentrators and cylinders.

The court directed the state government to constitute a three-member public grievance committee in every district. The complaints received by the committees will be discussed with the district nodal officer appointed by the state government, and each and every grievance will have to be redressed within 24-48 hours.

The court suggested that big business houses that take benefits under taxation laws by donating to religious organisations may be asked to divert their funds for the procurement of vaccines.

Every nursing home or hospital that has more than 20 beds should set aside at least 40 per cent for intensive care units, the court said. Every nursing home and hospital that has more than 30 beds must have an oxygen production plant, the court added.

Every second and third-ier town of Uttar Pradesh should be provided with at least 20 ambulances and every village should be given at least two ambulances having intensive care unit facilities, the court suggested while fixing May 22 as the next date of hearing.

Additional reporting by PTI