Supreme Court Order on Safety, Working Conditions and Protection of Doctors and Healthcare Professionals
On 20 August 2024, the Supreme Court of India passed an order in suo motu proceedings, SMW (Crl.) No. 2/2024, In Re: Alleged Rape and Murder Incident of a Trainee Doctor in R.G. Kar Medical College and Hospital, Kolkata and Related Issues. The Court highlighted serious concerns relating to institutional safety standards in the healthcare sector and constituted a National Task Force to formulate recommendations and protocols.
Institutional safety concerns highlighted by the Supreme Court
The Supreme Court referred to the ground realities faced by medical professionals and set out a non-exhaustive list of concerns affecting safety, dignity and working conditions in healthcare establishments.
- Doctors and other medical professionals posted on night duty often lack adequate resting spaces, including separate duty rooms for male and female professionals.
- Interns, residents and senior residents may be required to perform extremely long shifts without adequate sanitation, nutrition, hygiene or rest, and there was concern over the absence of a uniform national protocol.
- Insufficient security personnel leave doctors, interns, nurses and other staff vulnerable when dealing with unruly attendants and unrestricted access to healthcare facilities.
- Medical facilities may lack adequate toilets for healthcare professionals.
- Hostels or accommodation may be situated far from hospitals without adequate transport, particularly for professionals travelling at night.
- Healthcare establishments may lack sufficient or properly functioning CCTV cameras to monitor entry, exit and sensitive areas.
- Patients and attendants may have unrestricted access to sensitive areas such as ICUs and doctors' resting rooms.
- There may be inadequate screening for arms and weapons at hospital entrances.
- Hospitals may contain poorly lit or unsafe spaces.
- Medical professionals are often required to act as both medical and emotional caregivers without adequate supportive facilities or communication-skills training.
- Emergency wards and ICUs may face a higher risk of violence because of the severity and emotional nature of medical situations handled there.
National Task Force constituted by the Supreme Court
The Supreme Court constituted a National Task Force (NTF) to formulate effective recommendations addressing the safety, working conditions and well-being of medical professionals and other related concerns identified in the order.
The action plan was to be considered under two principal heads: prevention of violence, including gender-based violence, against medical professionals; and development of an enforceable national protocol for dignified and safe working conditions for interns, residents, senior residents, doctors, nurses and all medical professionals.
Measures for preventing violence and ensuring security
Security in medical establishments
- Classify hospital departments and areas according to the risk and possibility of violence, with enhanced security in high-risk areas such as emergency rooms and ICUs.
- Introduce baggage and person-screening systems at hospital entrances to prevent arms from being carried into medical establishments.
- Prevent intoxicated persons from entering hospital premises unless they are patients.
- Train hospital security personnel in crowd management and in dealing with grieving persons.
Infrastructure and safe working conditions
Resting rooms and duty rooms
The order contemplated separate resting and duty rooms in each department for male doctors, female doctors, male nurses and female nurses, together with a gender-neutral common resting space. Such rooms should be well ventilated, have adequate bed space and drinking-water facilities, with restricted access supported by security devices.
Technology, lighting and CCTV
The Court identified the need for technological measures to regulate access to critical and sensitive areas, including biometric or facial-recognition systems, adequate lighting throughout hospitals and medical-college campuses, and CCTV cameras at entrances, exits and corridors leading to patient rooms.
Night transport
Where hostels or accommodation for medical professionals are situated away from the hospital, the order contemplated transport between 10 p.m. and 6 a.m. for professionals wishing to travel between their place of stay and the hospital.
Counselling, training and employee safety committees
The proposed measures also included trained social workers for grief and crisis counselling, workshops for doctors, nurses, helpers and other employees, and Employees Safety Committees comprising doctors, interns, residents and nurses to conduct quarterly audits of institutional safety measures.
The order also referred to considering additional institutional-safety requirements as part of healthcare accreditation standards and to the possibility of establishing police posts in medical facilities according to factors such as footfall, bed strength and available facilities.
Prevention of sexual violence against medical professionals
The Supreme Court noted that the Sexual Harassment of Women at Workplace (Prevention, Prohibition and Redressal) Act, 2013 applies to hospitals and nursing homes, including private healthcare providers. The order emphasised the requirement for an Internal Complaints Committee in hospitals and nursing homes and referred to the employer's duties under Section 19 of the 2013 Act.
These duties include taking steps towards a safe workplace and organising awareness and sensitisation programmes. The order also contemplated a 24-hour helpline and emergency-distress facilities for medical professionals at every medical institution.
The National Task Force was requested to submit an interim report within three weeks and its final report within two months from the date of the order.
Information sought from States, Union Territories and the Central Government
The Court directed State and Union Territory Governments, through their Health and Family Welfare Secretaries, and the Central Government through the Union Health Secretary, to collate information from hospitals under their respective control on institutional safety and working conditions.
- Number of security personnel employed at each hospital and department.
- Whether baggage and person-screening mechanisms exist at hospital entrances.
- Number and departmental distribution of resting and duty rooms.
- Facilities available in resting and duty rooms.
- Extent of public access to hospital areas and applicable security restrictions.
- Availability, number and location of CCTV cameras.
- Training provided to medical professionals for handling the grief of patients and families.
- Availability and number of social workers trained in grief counselling.
- Existence of police posts within hospital or medical-college premises.
- Whether an Internal Complaints Committee under the 2013 workplace sexual-harassment law has been constituted.
- Whether the employer has discharged the duties prescribed under Section 19 of the 2013 Act.
The order required the data to be tabulated and filed by the Union Government with an affidavit within one month.
Download Supreme Court Order dated 20 August 2024
This page is a redrafted presentation of the Supreme Court order dated 20 August 2024 and is intended for general legal information.