State Of Punjab & Ors vs Ram Lubhaya Bagga Etc. Etc on 26 February, 1998
is one of the most sacrosanct and a valuable rights of a citizen and equally sacrosanct sacred
obligation of the State, every citizen of this welfare State looks towards the State for it to perform its
this obligation with top priority including by way allocation of sufficient funds. This in turn will not
only secure the right of its citizen to the best of their satisfaction but in turn will benefit the State in
achieving its social, political and economical goal. for every return there has to be investment.
Investment needs resources and finances. So even to protect this sacrosanct right finances are an
inherent requirement. Harnessing such resources needs top priority.
Coming back to test the claim of respondents, the State can neither urge nor say that it has no
obligation to provide medical facility. If that were so it would be ex facie violative of Article 21.
Under the new policy, medical facility continues to be given and now an employee is given free
choice to get treatment in any private hospital in India but the amount of payment towards
reimbursement is regulated. Without fixing any specific rate, the new policy refers to the obligation
of paying at the rate fixed by the Director. The words are;
" .... to the level of expenditure as per the rate fixed by the Director, Health and
Family Welfare, Punjab for a similar treatment package or actual expenditure which
ever is less."
The new policy does not leave this fixation to the sweet will of the Director but it is to be done by a
Committee of technical experts.
" The rate for a particular treatment would be included in the advice issued by the
District/State Medical Board. A Committee of technical experts shall be constituted
by the Director, Health and Family Welfare, Punjab to finalize the roles of various
treatment packages."
No State of any country can have unlimited resources to spend on any of its project. That is why it
only approves its projects to the extent it is feasible. The same holds good for providing medical
facilities to its citizen including its employees. Provision of facilities cannot be unlimited. It has to be
to the extent finance permit. If no scale or rate is fixed then in case private clinics or hospitals
increase their rate to exorbitant scales, the State would be bound to reimburse the same. Hence we
come to the conclusion that principle of fixation of rate and scale under this new policy is justified
and cannot be held to be violative of Article 21 or Article 47 of the Constitution of India.
In Vincent vs. Union of India: AIR (1987) SC 990: " In a welfare State, therefore, it is the obligation
of the State to ensure the creation and the sustaining of conditions congenial to good health..... In a
series of pronouncements during the recent years, this court has culled out from the provisions of
Part- IV of the Constitution, the several obligations of the State and called upon it to effectuate them
in order that the resultant picture by the constitution fathers may become a reality."
The next question is whether the modification of the policy by the State by deleting its earlier
decision of permitting reimbursement at the Escort and other designated hospital's rate is justified
or not? This of course will depend on the facts and circumstances. We have already held that this
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