The Supreme Court has issued notices to the Central Government, all States, and Union Territories over the failure of private hospitals built on government land or granted government concessions to provide free medical care to patients from the Economically Weaker Section (EWS) and Below Poverty Line (BPL) families.
A bench comprising Chief Justice BR Gavai and Justices NV Anjaria and Alok Aradhe was hearing a Public Interest Litigation (PIL) filed by social activist and Magsaysay Award recipient Sandeep Pandey. The petition highlights widespread violations by private hospitals that had received land, benefits, or concessions from the government on the condition that they reserve a certain percentage of beds and outpatient services for poor patients at no cost.
Typically, these hospitals were required to allocate 10% of inpatient beds and 25% of OPD consultations free of charge. However, the PIL cites multiple reports and audits showing that hospitals across states including Delhi, Maharashtra, Haryana, Odisha, Telangana, and West Bengal are regularly flouting these rules, while authorities have failed to enforce them.
Quoting a CAG report on Maharashtra, the petitioner noted that only 11 of 113 state-aided trust hospitals were examined, and most were found non-compliant. Prominent institutions such as Bombay Hospital, Lilavati Hospital, Saifee Hospital, and PD Hinduja Hospital, which had received additional Floor Space Index (FSI) under development regulations in exchange for providing 20% free inpatient and 10% concessional OPD care, were instead offering only 10% free IPD and OPD services under a court-approved scheme. The audit also revealed mismanagement of the Indigent Patients’ Fund (IPF), with hospitals like Bethany Hospital under-crediting the fund by ₹1.43 crore.
In Delhi, hospitals such as Indraprastha Apollo were required to keep one-third of their beds for free treatment. Their repeated failure led to the landmark Social Jurist v. GNCTD (2007) judgment, where the Delhi High Court ordered strict penalties later upheld by the Supreme Court. Yet, complaints about denial of services to poor patients persist.
In Haryana, a 2018 legislative committee report revealed that one private hospital provided free treatment to just 118 EWS patients out of 64,000 admissions in 2017, with no monitoring meetings held for nearly a decade. Similarly, a 2013–14 CAG report on Odisha flagged hospitals that received land worth ₹45.68 crore at concessional rates but failed to deliver the promised services. In some cases, land meant for hospitals was diverted for residential and commercial complexes.
The petitioner argues these instances reflect a nationwide governance and enforcement failure, depriving vulnerable communities of their right to healthcare while allowing hospitals to misuse public resources. The PIL seeks:
- Uniform enforcement of free treatment obligations across States/UTs.
- Creation of empowered monitoring bodies with auditing powers and periodic compliance reports.
- Recovery of monetary value for denied free treatment.
- Cancellation or resumption of land allotments in case of repeated violations.
- A centralized digital dashboard displaying real-time free bed availability and compliance status.
- Strict guidelines against discrimination or segregation of EWS patients.
The petition stresses that failure to enforce these conditions violates Article 21 (Right to Life) and breaches public trust since hospitals were given government land and concessions for public benefit.
Taking note of these serious allegations, the Supreme Court has asked the Centre, States, and UTs to submit their responses. It also recalled that in a related case, it had recently directed the Centre and Delhi Government to verify whether Indraprastha Apollo Hospital had complied with free treatment requirements for EWS patients over the past five years.
