Hospital Administration
Editor: Dr Narinder Kumar, MD (AIIMS, New Delhi)
Constitution of India
Structure of the Indian Constitution
The structure of the Indian Constitution reflects its inherent intention to embrace federalism. This is evident in the clear demarcation of powers between the Union (Central) and State governments. The Seventh Schedule of the Constitution details this division under three lists: Union, State, and Concurrent.
Union List: It enumerates subjects on which only the central government can make laws. This list includes matters of national importance such as defense, atomic energy, and foreign affairs.
State List: It lists subjects on which only the state government can legislate. These typically include topics more relevant at the state level, such as police, agriculture, and public health.
Concurrent List: It consists of subjects on which both the central and state governments can legislate. In case of a conflict between central and state laws on the same subject, the central law prevails.
The Indian Constitution also envisages a clear separation of powers between the three branches of government: the Legislature, Executive, and Judiciary.
Legislature: The Indian Parliament, a bicameral legislature consisting of the Rajya Sabha (Council of States) and the Lok Sabha (House of the People), is responsible for law-making.
Executive: The President of India is the head of the Executive branch. The Council of Ministers with the Prime Minister as its head aids and advises the President in exercising his functions.
Judiciary: The Supreme Court of India is the apex judicial authority, tasked with upholding the Constitution and administering justice in the country.
Fundamental Rights in the Indian Constitution
Fundamental Rights are the cornerstone of the Indian Constitution. They represent the basic human rights that are universally recognized and are crucial for the development of the individual and the preservation of human dignity. The Fundamental Rights are enshrined in Part III of the Indian Constitution, extending from Article 12 to 35.
Right to Equality (Articles 14-18): This includes equality before the law, prohibition of discrimination on grounds of religion, race, caste, sex or place of birth, and equality of opportunity in matters of public employment. It also includes the abolition of untouchability and titles.
Right to Freedom (Articles 19-22): These articles guarantee six freedoms, including speech and expression, assembly, association, movement, residence, and profession. It also includes protection in respect to conviction for offences, protection of life and personal liberty, and protection against arrest and detention in certain cases.
Right Against Exploitation (Articles 23-24): These rights prohibit trafficking, forced labour, and the employment of children in hazardous work conditions.
Right to Freedom of Religion (Articles 25-28): These provisions ensure freedom of conscience and free profession, practice, and propagation of religion. They also provide for freedom to manage religious affairs, freedom from paying taxes for the promotion of any religion, and freedom from attending religious instruction.
Cultural and Educational Rights (Articles 29-30): These protect the rights of any section of citizens with a distinct language, script, or culture to conserve the same. It also grants all minorities, religious or linguistic, the right to establish and administer educational institutions of their choice.
Right to Constitutional Remedies (Article 32): This right enables individuals to approach the Supreme Court for the enforcement of the Fundamental Rights.
Aspects Related to Health
The Indian Constitution, while not explicitly listing health as a fundamental right, emphasizes the state's role in ensuring the health of its citizens. This is particularly evident in the Directive Principles of State Policy and various judicial interpretations.
Directive Principles of State Policy: Article 47, a key directive principle, mandates that the state work to improve public health, and bring about prohibition of substances harmful for health except for medicinal purposes. Although the Directive Principles are non-justiciable, they guide the formulation of laws and policies.
Right to Health: Indian courts have interpreted the Right to Life under Article 21 to include the right to health. This has been upheld in numerous judgments, including the landmark case of Parmanand Katara vs Union of India, where the Supreme Court held that the right to health was integral to a dignified life.
Healthcare Legislation: The Constitution has been instrumental in shaping health policy in India. The Epidemic Diseases Act, 1897; the Mental Health Act, 1987; and more recently, the Ayushman Bharat Scheme, 2018, have all been influenced by constitutional principles.
Public Health and State Responsibility: As health is a state subject, states have significant autonomy in healthcare legislation. However, the central government can also legislate on health issues under specific circumstances, such as during an epidemic.
In conclusion, the Indian Constitution, while not expressly mentioning health as a fundamental right, has paved the way for a comprehensive legal and policy framework aimed at achieving public health goals in the country. The cooperative efforts of both state and central governments, guided by the constitutional principles, are crucial for these goals' successful realization.