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PETITIONER:

RAKESH CHANDRA NARAYAN

Vs.

RESPONDENT:

STATE OF BIHAR

DATE OF JUDGMENT27/09/1988

BENCH:

MISRA RANGNATH

BENCH:

MISRA RANGNATH

VENKATACHALLIAH, M.N. (J)

CITATION:

1989 AIR 348 1988 SCR Supl. (3) 306

1989 SCC Supl. (1) 644 JT 1988 (4) 233

1988 SCALE (2)965

ACT:

Constitution of India, l950--Article 32--Public

Interest Litigation --Mental Hospital Ranchi--Chief Judicial

Magistrate's report-- Considered--Committee of Management

appointed for the hospital.

HEADNOTE:

A letter petition in regard to the Mental Hospital at

Ranchi was considered as a public interest application

under Article 32 of the Constitution, and the Court called

upon the State of Bihar to file its counter affidavit. At

the same time, the Court directed the Chief Judicial

Magistrate to visit the hospital and submit a report about

the conditions prevailing there. The hospital was in the

sole management of the Health Department of the State of

Bihar. The State of Bihar received financial contributions

from the States of West Bengal and Orissa on the basis of

the number of beds reserved for each State.

The report submitted by the Chief Judicial Magistrate

made a painful reading. In the affidavit submitted by the

State of Bihar it was stated that the Government was aware

of the conditions and had since taken some steps to improve

the working of the hospital, and had also drawn up a scheme

to develop the hospital on the lines of NIMHANS in

Bangalore.

From time to time, the Court had issued directions and

made specific orders regarding provision of better food.

clothing, medical treatment, housing and improvement of

sanitation, etc.

While keeping the matter pending, the Court,

HELD: (1) In a welfare State it is the obligation of

the State to provide medical attention to every citizen.

The State has to realise its obligation and the Government

of the day has got to perform its duties by running the

hospital in a perfect standard and serving the patients in

an appropriate way. [318D-E]

(2) It is clear that inspite of several orders made by

this Court and assurances held out by the State Government

of Bihar. the defects were not being remedied. The awareness

PG NO 307

of the governmental authorities of the sordid situation

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prevailing in the hospital, as admitted in the scheme

furnished to the Court, the non-compliance in an effective

way with the directions made from time to time by the Court

and the general lethargy shown in rising from slumber leaves

a clear impression that the institution cannot be run as a

mental hospital of that magnitude unless there be change in

the administrative set-up, the control is altered and a new

service to patient-oriented thrust given to the institution.

[3I8-C]

(3) The scheme which was furnished to the Court was a

halfhearted one and no attempt therein was made to bring

about any improvement except attending to certain obvious

deficiencies and short- falls. The Court had looked forward

to a scheme of re-orientation which the scheme did not even

remotely touch. [318F-G]

(4) The State Government authorities have not been able

to assess the priorities. There does not seem to be the

slightest interest on the part of the persons handling the

matter, to improve the environment. In these circumstances,

it is difficult to leave the management exclusively to the

Health Department of the State of Bihar if the institution

has to run as a good and useful hospital. Association of the

States of West Bengal and Orissa in the management is likely

to bring about some positive result. It would, therefore, be

much better if a Committee of Management is appointed with

full powers to look after all aspects of the institution.

[319A; B-D]

(5) The Court accordingly constituted a Committee of

Management for the Mental Hospital and gave directions

regarding the financial contribution from the participating

States, and also laid down guidelines regarding the

functioning and management of the hospital. The Court

further directed that the Committee shall take expeditious

steps to explore the possibility of transforming the

hospital into the pattern obtaining in the hospital run by

NIMHANS at Bangalore. [321C-D]

JUDGMENT:

ORIGINAL JURISDICTION: Writ Petition (Civil) No. 339 of

1986.

(Under Article 32 of the Constitution of India)

S.P. Pandey and Mrs Rekha Pandey for the Petitioner.

J.R Dass, D.K Sinha, D Goburdhan and R.K. Mehta for the

Respondent.

PG NO 308

The Judgment of the Court was delivered by

RANGANATH MISRA, J. A letter addressed to the learned

Chief Justice of this Court from two citizens of Patna in

regard to the Mental Hospital at Kanke near Ranchi in Bihar

State was considered as a public interest litigation and

registered as an application under Article 32 of the

Constitution. On 7.4.1986, this Court called upon the State

of Bihar to file its counter affidavit and the Chief

Judicial Magistrate of Ranchi or any other Judicial

Magistrate nominated by him to visit the hospital and submit

a report about the conditions prevailing in the Hospital.

The Chief Judicial Magistrate visited the hospital on

8.6.1986, and on several other occasions thereafter and

submitted a detailed report on 15th of July, 1986. He found

that there were 1580 beds. The Hospital was in the sole

management of the Health Department of the State of Bihar.

The State received financial contributions from West Bengal

and Orissa. There is a Managing Committee of the Hospital

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consisting of 14 members in all with the Commissioner of

South Chotanagpur Division as its Chairman. The sanctioned

strength of medical officers was 16 but only 9 had been

filled-up and there were 7 vacancies. In the Hospital the

male patients wing had 10 blocks in all, apart from the

Isolation Ward, the Medical Ward and the Infirmary Ward.

These are in 10 double storied blocks and three single

storied wards in charge of separate doctors. The female

patients' unit consisted of two double storied and two

single storied blocks. Each block had the capacity of 120

patients. Some of the patients had to pay for their

treatment while the treatment to the general category was

intended to be free. All the three residential quarters

within the complex meant for the medical officers were

occupied by others, one by the suspended Superintendent, the

other by the retired Superintendent and the third one was by

the Acting Superintendent. Three doctors were residing in

the quarters meant for non-gazetted officers and the

remaining doctors were staying in private houses at Ranchi

about 11 kilometers away.

The Chief Judicial Magistrate found that there was

acute shortage of water in the Hospital. There was only one

tubewell within the campus located in the male block. There

were five ordinary wells but there was no motor pumps

installed in any one of them. These wells were the only

source of supply of water. Several representations had been

made to the State Government for supplying water on

permanent basis to the Hospital but there was no response

from the Government.

PG NO 309

The Chief Judicial Magistrate was surprised that none

of the toilets within the hospital complex was in order. The

sanitary fittings were not operating having got chocked. The

patients were, therefor, forced to ease themselves in the

adjacent open field. Consequently the environment had become

polluted and unhygienic. Though there were fan points and

even electric fans were hanging from the roof in some

places, no fan excepting the one in the chamber of the

Superintendent was in working condition. He also found that

though there were electric connections with bulbs and tubes

yet light was not available and, therefore, total darkness

prevailed in the campus between dusk and dawn. The

Superintendent explained to the Chief Judicial Magistrate

that the Hospital had no electrician and the Institution had

to depend upon the mercy of the State Electricity Board and

despite correspondence there was no response.

He found that old iron cots had been provided in the

year 1925 and only 300 more had been added by purchase. The

total number of patients were 1580. Most of the iron cots

having been broken were out of use and, therefore, only 300

beds were actually available.

None of the wards had doors and windows in working

condition. The Superintendent pointed to him that he had

made repeated requests to the Public Works Department of the

State Government but no letter had even been acknowledged.

In the absence of device to close the doors and windows

there had been occasions when mentally ill patients had

jumped through the windows or had run out from the rooms. To

meet such situations, the broken cots were mostly used to

block the passages.

The Chief Judicial Magistrate further found that the

mattresses and linen were in very bad shape, he noticed

several patients to be lying on the bare floor; some of the

patients were using a single blanket both as mattress and

cover. Some patients were naked in the absence of clothing

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and others were found wearing torn shirts and pants.

Mosquito nets were not available pillows were not provided

and the patients were left to their fate. The Chief Judicial

Magistrate noticed marks of buy bitings as also mosquito

biting on the body of the patients. In the absence of

clothing the patients were forced to wear the same shirt and

pant for four to six weeks without a wash on account of

unavailabiliy of water. The Superintendent told the Chief

Judicial Magistrate that Government of Bihar had sanctioned

Rs. 3 a day per patient for the two meals and breakfast and

it was wholly inadequate. The Managing Committee had

recommended for sanction of Rs. 10 per patient per day but

PG NO 310

there had been no response. The diet as prescribed included

an egg, 250 gms. of milk every day and meat and fish, once

in a week, but in the absence of appropriate funds those had

been discontinued for years.

The Chief Judicial Magistrate having visited the place

on several occasions noticed that there was no account of

the stock of medicines; life-saving drugs were not stored

properly in the absence of a refrigerator. The instruments

were not in working condition and the employees meant for

working the instruments were idlying away their time. The

patients were now referred to Medical College Hospital at

Ranchi for X-ray and E.C.G. as and when necessary. Many of

the patients told the Chief Judicial Magistrate that they

had not been getting any medicine for months together.

The Chief Judicial Magistrate had noticed that

several doctors were not available in the Hospital for days

together. Some of the patients in the wards complaind to him

that the doctor was not visiting the ward even for one hour

in a week; he carne across a weak and emaciated patient who

told him that he had not been given any food for two days on

the plea that he was suffering from diarrhoea and he had not

even been given any treatment. C)n the 11th of July, 1980,

when he visited the Hospital along with the local Additional

District Magistrate? he found not a single doctor on duty

though that was the time when all the doctors, were supposed

to be on duty within the campus. Though this was the actual

position. the attendance register showed all the doctors to

be present as required according to the duty chart .

The Chief Judicial Magistrate collected the death rate

from the Superintendent for the period between 1977 and 1986

which are as per the particulars given below:

-------------------------------------------

Year Male Female Total

-------------------------------------------

1977 38 11 49

1978 72 12 84

1979 74 31 l05

1980 66 24 90

1981 39 33 172

PG NO 311

1982 173 50 231

1983 87 44 131

1984 152 94 246

1985 90 69 159

From

1-1- 1986

30-6- 1986 49 25 74

In Paragraph 28 of the Report the Chief Judicial Magistrate

stated:

"This chart clearly shows abrupt rise in the graph of

death rate after 1980. 1984 was the most unfortunate year

for Arogyashala, when maximum escapes and deaths took place.

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Mass scale escapes and deaths of patients in 1984 is said to

be the result of internal politics in the Arogyashala

campus, for which, the then Superintendent and Dr. Durga

Bhagat and Deputy Superintendent. Dr. B.B. Singh are said to

be largely responsible."

The Magistrate further reported that the present acting

Superintendent had failed to improve the administration. He

lacked adequate control over his colleagues and the staff.

The out-going Superintendent residing within the campus was

inciting the people and the acting Superintendent was

gradually losing his grip and control over the

administration. The innocent, miserable and vioceless

patients were the victims of the situation. The practice

prevailing in the Hospital had been that the Superintendent

alone was competent to admit patients and as such the

guardians and attendants of the patients seeking admission

into the Hospital had been exploited by a group of persons

friendly with the Superintendent and those who did not come

to terms with the Superintendent had been denied the

benefits of the Hospital. This led to friction and

unpleasant relationship. He recommended that a non-medical

man, if possible, a retired army officer or a District Judge

could be posted as the head of the Hospital to take control

and tone up the deteriorating situation. He found that a

large garden was attached to the Hospital but on account of

the all-pervading mismanagement there was no return but one

Dr. Buxy had recently been put in charge of the garden and

had improved the same.

Last of all in his report he adverted to the fact that

some petients who had recovered--and their number he found

was about 300, being both men and women--were not in a

position either to return to their take to any employment in

the absence of any facility. He found that these persons who

PG NO 312

no more required treatment should be removed from the

Hospital so that there would be room available for patients

who required treatment; unnecessary expenditure on such

large number of people could be avoided and the standard of

discipline within the Institution could be improved and

there could be a general toning up of the atmosphere.

Along with the report he gave various relevant details

in the annexures. Annexure -11 is a list of criminal

patients who had come from different jails for treatment and

had been declared fit for discharge.

We may refer to the cue of one Rupa Santhal. This person

was admitted to the Hospital on 28.9.1947 at the instance of

the Superintendent of Chittagang Hill Tract Jail, where on

being convicted by the Deputy Commissioner of Chittagang

Hill Tract for an offence punishable under Section 326 IPC,

he had been imprisoned for undergoing the sentence.

Obviously he could not have been detained in jail for 41

years for the offence under Section 326 IPC. Several letters

were sent from the Hospital but there was no response. We

may also refer to the case of Madhu Mahanta who was admitted

to the Hospital on 15.11.1950 at the instance of the

Superintendent, District Jail, Keonjhar in the State of

Orissa. He had been convicted under Section 302 IPC and was

languishing in the Hospital for 36 years though he had been

cured several years back. The Magistrate has given a list of

13 persons of this category.

We are astonished that even when prisoners are

transferred for treatment from jails where they were

undergoing sentences of imprisonment, no follow-up action

has been taken from the jails on their own and even when the

Hospital authorities had required the prisoners to be taken

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back no response has been made. This only exhibits total

callousness. We have given sumptuous extracts from the

report of the Chief Judicial Magistrate with a view to

bringing out as clear a picture as possible of the shocking

and savage conditions that prevail in the mental hospital.

There can be no two opinion that the hospital was in a

shape- a shade worse than Oliver Twist's Orphanage. From all

accounts, perhaps. many of zoos housing animals have better

conditions than those that prevail in this hospital. While

the mentally-ill require a soothing environment for

treatment, as psychatrists say, the State of Bihar as

converted what was once a prestigious mental hospital Into a

den to house about sixteen hundred patients. The reports of

the Chief Judicial Magistrate gives the reader the feeling

of a medieval torture- house. On 11.8.1986, the Court

noticed the report and observed:

PG NO 313

"The report makes a painful reading and shows how badly

is this institution managed and in what in human condition

the patients are made to live & work there. It is surprising

that the State of Bihar has allowed this institution to de-

generate into the present condition. It is necessary that

immediate steps should be taken to improve the functioning

of this institution in all respects. We would therefore

direct the Chief Secretary and Health Secretary to the

Government of Bihar to file affidavit or affidavits putting

forth a definite scheme for improving the working of the

Institution and for remedying the drawbacks and deficien-

cies pointed out in the report, including the neglect of

patients by the Medical Superintendent attached to the

Institution. This matter must have urgent priority since it

concerns the well-being of the mentally handicapped. We

would therefore direct that the affidavit be filed within

three weeks from today setting out a time bound programme

for improving the functioning of the Institution. We would

like to observe that the Chief Judicial Magistrate has made

an excellent job of the task assigned to him and we express

our sense of appreciation for the work done by him. These

observations may be sent to the High Court of Patna and the

Chief Judicial Magistrate".

On 1.9.1986, the Health Secretary filed a short

affidavit together with a scheme for the improvement of the

Hospital. The opening words of the scheme have to be quoted

to be believed:

"The Government of Bihar are aware of the conditions

prevailing in the Mansik Arogyashala, Kanke, and the

Government for sometime in past have been discussing

measures to be taken for improvement of the same. The

subject was discussed by the representatives of the State of

Bihar with the members of the Planning Commission at a

meeting held at New Delhi in the month of january, 1986, and

accordingly it is contemplated to develop the Mansik

Arogyashala, Ranchi on the lines of NIMHANS in Bangalore

The scheme indicated that a letter had been written to the

Director, NIMHANS at Bangalore for information on 17th of

April, 1986, i.e. 4 1/2 months before the scheme was filed

PG NO 314

in this Court. There is no indication as to what was

received from the Director or as to what further follow-up

action was taken during the 4 1/2 months. The scheme

indicated that out of 16 sanctioned posts three posts were

earmarked for West Bengal Government and were vacant; out of

13 posts, 9 had been filled up and 4 were vacant and were to

be filled-up by October, 1986. The scheme admitted with

reference to the water supply system that the internal

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system was choked and was not functioning. In the year 1985-

86, Rs.10 lakhs had been sanctioned for renovation of water

supply system and the Public Health Engineering Department

could utilise only Rs.61,000 during the financial year;

therefore, the balance amount of Rs.9,39,000 was again to be

sanctioned in the year 1986-87.

The lavatories and bathrooms were not in working

condition as accepted and the scheme proposed that the

Superintendent of the Hospital is to supervise the sanitary

system.

In regard to electricity it was indicated that the

electric fittings, fixtures and other equipments would be

replaced by March, 1987 which meant six months beyond the

date when the scheme was framed. It was proposed that a 100

KV Generator set was to be installed. In regard to cots and

mattresses it was stated that 400 of them would be acquired

in the year 1986-87 and the remainder in the year 1987-88.

It was stated that the doors and windows required total

replacement and it was indicated that Rupees six lakhs were

sanetioned during the financial year for repair work. In

regard to diet it was indicated in the scheme:

"In the State of Bihar, the rate of the diet per patient for

the hospital is Rs.3.00 per day except the T.B. patient to

whom the rate of diet is Rs.4.15 per day. In the year 1986-

87, rate of diet per patient has been increased to Rs.3.55.

The Superintendent of Kanke hospital has been directed to

improve dietary management".

It was admitted that E.C.G. machine was out of order and

efforts would be made to instal the machine in the financial

year. It was also proposed in the scheme that there would be

a regular Superintendent posted soon. In regard to supply of

medicines it was stated that the prescribed rate was Rs.1.00

per patient per day and it has been increased to Rs.1.90 per

patient per day from 1986.

PG NO 315

On 20th of October, 1986, this Court made the following

order:

"1. In respect of each patient in the Ranchi Mansik

Arogayashala the daily allocation for diet will be increased

from the existing inadequate articles of that value shall be

supplied to each patient.

2. Arrangements should be made forthwith to supply

adequate quantity of pure drinking water to the hospital, if

necessary, by engaging water tankers to transport potable

water from outside.

3. Immediate arrangements should be made for the

restoration of proper sanitary conditions in the

lavoratories and bathrooms of the hospital.

4. All patients in the hospital who are not at present

having mattresses and blankets should be immediately

supplied the same within 15 days from today. Such of the

patients who have not been given cots should also be

provided cots within six weeks from today so that no patient

shall be thereafter without a cot.

5. The ceiling limit at present invogue in respect of

cost of medicines allowable for each patient will stand

removed, with immediate effect and the patients will be

supplied medecines according to the prescription made by the

doctors irrespective of the costs.

6. The State Government shall forthwith take steps to

appoint a qualified Psychiatrist and a Medical

Superintendent for the hospital and they should be posted

and takecharge in the Institution within six weeks from

today.

The Chief Judicial Magistrate, Ranchi to whom a copy of

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this order will be forwarded by the Registry shall visit the

hospital once in 3 weeks and submit quarterly reports to

this Court as to whether the aforesaid directions given by

us are being complied with."

On 20th of November, 1986, the Health Secretary gave a

report as to programme relating to aspects covered by the

scheme. It indicated that no reply had been received from

NIMHANS and therefore, an officer had been sent from Bihar

PG NO 316

to obtain the information. The medical officers against the

vacant posts had been posted; water supply and electricity

were yet to be attended to. The repair to the building was

in progress and other aspects were yet to be attended. A

Superintendent in the rank of Civil Surgeon had been posted.

The Chief Judicial Magistrate furnished a further report

in December, 1986. While he noticed certain improvements, he

pointed out that there were 400 female patients and there

was only one lady doctor in the Hospital. There was no lady

Psychiatrist or Psychologist. The Superintendent had written

to the Government about it but there has been no response.

On 14th of September, 1987, the Court noticed the fact

that the State of West Bengal was in huge arrears in the

matter of payment of contribution to the running of the

Hospital. Counsel for State of Bihar had agreed to send

details of the arrears to the State of West Bengal within a

fortnight and the Court directed the West Bengal Government

to pay the same.

The State of West Bengal filed its affidavit through the

Joint Secretary in the Department of Health and Family

Welfare. The affidavit while accepting the fact that 38% of

the seats in the hospital were reserved for West Bengal

alleged that in the absence of furnishing of proper accounts

by the State of Bihar, the payment of contribution had not

been made in time by the State of West Bengal after 1979-80.

It agreed to pay Rs.20 lakhs during the year and the balance

in suitable instalments in future.

The State of Orissa has pointed out in its affidavit

that it has been regularly paying its contribution of Rs.3

lakhs and was not in arrears.

The Deputy Director (Medical) Health Services,

Government of Bihar filed an affidavit claiming that the

rate of diet had been enhanced with effect from 1.12.1986

and in diet all the patients were provided rice, bread, dal,

vegetable, egg, milk, loaf, biscutt, tea, fruit . Fish, meat

and chicken were being provided alternatively thrice a week.

Old Pipe lines had been replaced and the flow of water was

increased; storage facility for water had been arranged.

Medicine as per requirement is being provided without

refering to any ceiling limit. new X-ray machine has been

purchased; the old E.C.G. machine has been condemned and a

new one has been purchased. One of the petitioners filed an

affidavit denying many of the aforesaid claims. On 14th of

March, 1988, this Court made the following order:

PG NO 317

"We have perused the affidavit filed by Shri Subodh

Chandhra Naryayan, one of the petitioners, wherein several

allegations of mismanagement have been made. It has also

been alleged that in spite of the direction of this Court

that the daily diet expenses should be Rs.10 per patient

actually Rs.7 is being spent and though this Court had

directed that there should be no ceiling of expenses for

medicines beyond Rs.2 per patient is not being issued. We

are of the view that copy of the affidavit should be sent to

the Chief Secretary, State of Bihar with a direction that he

would personally look into the matter and should send a

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report within four weeks. "

A report, beyond the time indicated in the order dated

14th of March, 1988, was furished by the Chief Secretary and

the same was covered by an affidavit of the Joint Secretary

of Department of Health and Family Welfare of the State

Government. The Chief Secretary reported:

"The entirc hospital complex is spread over a sprawling

area. The buildings are old. but they have been extensively

repaired and white-washed. Many old cots. matresses linen

etc. have been replaced by new ones. Government has spent

several lakhs of rupees on improvements in the running of

the Agrogyashala during the last two years. In course of my

visit, l did not find that patients were being given

inadequate food or medicine.''

He also found that the toilets had not been attended to,

the position of water supply was not satisfactory, the

automatic boiler had not yet been repaired or replaced. The

Court's Order of 14th of March, 1988, indicated that the

affidavit filed by Subodh Chandra Narayan containing several

allegations of mismanagement was to be forwarded to the

Chief Secretary and with reference to the allegations

therein, he was to send his report. We do not find that the

report of the Chief Secretary covers all the aspects. The

hospital authorities would not, in their own interests, be

too ready to expose their own deficiencies during the visit

of the Chief Secretary. Therefore, to have been satisfied

and to report that during his visit he did not find any

patient being given inadequate food or medicine is no

appraisal of the situation. The fact that lakhs of rupees

had been spent on improvement is indeed of no consequence

PG NO 318

until the Agorgyashala is restored to acceptable hospital

standards. The report gives us a feeling that the Chief

Secretary was more conscious about the expenditure made by

the State Government than assessing the actual situation.

From his report, however, it is clear that inspite of

several orders made by this Court and assurances held out by

the State Government of Bihar, the defects were not being

remedied. The awareness of the governmental authorities of

the sordid situation prevailing in the hospital, as admitted

in the scheme furnished to this Court, the non-compliance in

an effective way with the directions made from time to time

by this Court and the general lethargy shown in rising from

slumber leaves a clear impression in our mind that the

institution cannot be run as a mental hospital of that

magnitude unless there be change in the administrative set-

up, the control is altered and a total new service to

patient-oriented thrust given to the institution.

In a welfare State--and we take it that the State of

Bihar considers itself to be one such--it is the obligation

of the State to provide medical attention to every citizen.

Running of the mental hospital, therefore, is in the

discharge of the State's obligation to the citizens and the

fact that lakhs of rupees have been spent from the public

exchequer (perhaps without or inadequate return) is not of

any consequence. The State has to realise its obligation and

the Government of the day has got to perform its duties by

running the hospital in a perfect standard and serving the

petients in an appropriate way. The reports and affidavits

of the Government of Bihar and its officers (not the reports

furnished to the Court by the judicial officers) have not

given us the satisfaction of the touch of appropriate

sincerity in action.

The scheme which was furnished to the Court was a half-

hearted one and no attempt therein was made to bring about

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any improvement except attending to certain obvious

deficiencies and shortfalls. The hospital has been in

existence from pre-independence period. There have been

epoch making breaks--through in the field of psychiatry and

treatment of psychiatric patients. The approach to mental

health and the techniques of psychiatry have changed.

Psychologists have developed their art and their tools. The

method of care ar d attention for the mentally-ill has also

undergone a sea change. When we had called upon the State of

Bihar to give a scheme for improving the conditions of the

hospital, this Court had not intended a scheme for removing

the deficiencies in the old hospital; we had really intended

to look forward to a scheme of re-orientation which the

scheme did not even remotely touch except to say that

NIMHANS at Bangalore has contacted.

PG NO 319

The state Government authorities have not been able to

assess the priorities. Provision of beds, though the scheme

indicated had to be fully made by end of March, 1988, the

report of the Chief Secretary and the accommpanying

affidavit have not cleared that position. Provision for

electricity and water has taken too long, though both are

basic necessities of life. The fact that the existing

lavatories have taken more than two years to repair is a

slur on the administration. There does not seem to be the

slightest interest on the part of the persons handling the

matter, to improve the environment. In these cir-

cumstances, it becomes difficult for the Court with any

sense of confidence to leave the management to the Health

Department of the State of Bihar if the institution has to

run as a good and useful hospital.

We are cognizant of the position that it is difficult

for the Court to monitor the management of a hospital--

particularly when it is located a thousand kilometres away;

but since there have been some improvements with the Court's

intervention, to get out of the picture at this stage would

only mean that the situation will again deteriorate no

sooner the Court's attention is withdrawn. As we have

already pointed out mere restoration of the hospital to its

old position would only bring into existence an archaic

institution sans modernism. In our opinion, it will be much

better if a Committee of Management is appointed with full

powers to look after all aspects of the institution. It is

appropriate to take note of the position that this

institution receives contribution from two other States. 38

% of these beds, being about 600, are reserved for the State

of West Bengal and the Government of West Bengal is to pay

for the same. Similarly 75 beds are reserved for the State

of Orissa and a sum of Rs. 3 lakhs is payable by the Orissa

Government. There is no reason why the management of the

hospital should be left exclusively to the Health Department

of State of Bihar and the participating Governments should

not be associated in such management. Taking note of the

performances of the State administration of Bihar in regard

to the hospital we are of the view that association of the

States of West Bengal and Orissa in the management is likely

to bring about some positive result. We would, accordingly,

constitute a Committee of Management for the Mental Hospital

in the manner indicated below.

Chairman--A consenting sitting Judge of the Patna High

Court, Ranchi Bench, to be nominated by the Chief Justice of

Patna High Court.

PG NO 320

Members

(1) Commissioner of Ranchi Division.

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(2) Station Commander, Ramgarh area, Ranchi.

(3) Secretary of Health, Bihar Government.

(4) Secretary of Health, West Bengal Government.

(5) Secretary of Health, Orissa Government.

(6) Deputy Commission of Ranchi.

(7) Principal of the Ranchi Medical College.

(8) District Judge, Ranchi.

(9) Superintendent of the Hospital.

The Commissioner of Ranchi Division and the Station

Commander shall be Vice-Chairmen and in the absence of the

Chairman, shall in the order indicated act as Chairman when

any of them too is absent. The Superintendent shall act as

the Secretary. We hope and expect that the concerned

Governments and authorities would accord the necessary

consent/permission to the nominated officers to act on the

Committee and the Committee would be able to have its first

meeting in the first half of November, 1988. The Committee

should meet every month in the first six months with a view

to removing the defects and deficiencies within a time

frame--say of six months at the most and for reviewing the

improvements in the conditions of the hospital. If it is

satisfied that the situation has improved, the meetings

thereafter may be quarterly. The Commissioner of the Ranchi

Division shall make a monthly report with in 2 weeks of the

end of every month about the state of the hospital during

the first year and such reports as and when received by the

Registry should be placed before the Court.

The State of West Bengal is in arrears in regard to its

contribution for several years. Though counsel for the State

of Bihar had undertaken to furnish accounts, the same has

not yet been done. The Committee shall ensure that the

accounts are furnished to the State of West Bengal by the

15th of December, 1988. In its affidavit, the State of West

Bengal has indicated that it would pay Rs.20 lakhs out of

the dues during the current financial year and would pay the

balance in suitable instalments. As the improvement to the

hospital would involve huge expenditure, we direct the State

PG NO 321

of West Bengal to pay Rs.50 lakhs out of its dues by 31st of

March, 1989 and the balance amount shall be paid in two six-

monthly instalments, one by 30th of September, 1989, and the

other by 31st of March, 1990. The Government of West Bengal

and the Committee shall ensure that this time- frame is

adhered to. The entire arrears collected from the West

Bengal Government shall be earmarked for development of the

hospital to be expended in the manner approved by the

Committee and no portion thereof would be otherwise spent.

We are of the view that if the hospital is transformed

into a better one, just as the hospital run by NIMHANS at

Bangalore, the quality of the hospital would improve and the

patients would have the benefit of modern scientific

treatment. The Committee shall, therefore, take expeditious

steps to explore the possibility of transforming the Mental

Hospital at Ranchi into the pattern obtaining in the

hospital run by NIMHANS at Bangalore by taking such steps as

are necessary and furnish a report to this Court by the end

of February, 1989 when that question will have to be

considered by this Court after hearing the concerned State

Governments and the parties. The State of Bihar shall

provide a basic fund of Rs.50 lakhs in the year ending 31st

of March, 1989, to be spent for improvement of the Hospital

in the manner approved by the Committee and in case the

Committee is of the view that further funds are necessary,

it would be open to the Committee to make a report to this

Court whereupon appropriate directions shall be given.

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There have been repeated allegations that the lady

patients who have already been cured are not being released

from the hospital. At one stage the explanation offered by

the hospital authorities and the State administration was

that the relations, even though notified, are not taking

them back. The hospital is not a place where cured people

should be allowed to stay. It is, therefore, necessary that

there should be a rehabilitation centre for those who after

being cured are not in a position to return to their

families or on their own seek useful employment. The

Committee shall, therefore, take immediate steps to have a

rehabilitation centre at a convenient place around Ranchi

where appropriate rehabilitation schemes may be operated and

the patients after being cured, irrespective of being male

or female, if they are not being taken back by the members

of their families could be rehabilitated. The funds made

available to the Committee may be utilised for such purpose.

PG NO 322

We must reiterate that Court-monitoring of an

institution like the present one is indeed difficult but we

cannot close the proceedings at this stage for the reasons

we have already indicated. Parties including the Committee

shall have liberty to move this Court from time to time. We

make it clear that the directions regarding payment of the

funds are pre-emptory in nature and no application for

modification thereof shall be entertained.

This matter shall be deemed to be pending to deal with

the various reports from the Committee and for purposes of

giving other directions.

C R.S.S.