Supreme Court Of India 1996 AIR 550, 1995 SCC (6) 651 13.11.1995 Bench Justices Kuldip Singh, S.C. Agrawal, B.L. Hansaria, JJ. PETITIONER Indian medical association RESPONDENT V.P. Shantha and Ors
Background
Due to the increasing number of medical negligence cases, numerous complaints were filed before the consumer courts seeking compensation under the Consumer Protection Act, 1986. There was ambiguity on the issue of whether doctors, hospitals, and medical practitioners fall within the ambit of ‘service’ as defined in Section 2(1)(o) of the Act, thereby recognizing patients as ‘consumers’ and giving them the right to approach the consumer courts to seek compensation.
These issues were subject to consideration in a series of decisions delivered by various High Courts and National Consumer Courts, which gave contrasting and conflicting interpretations. Many Writ Petitions and Special Leave Petitions were then filed before the Supreme Court against these decisions and judgments.
In 1995, the Supreme Court delivered a historic decision in case of In 1995, the Supreme Court delivered a historic decision in the case of Indian Medical Association v VP Shantha which brought the medical profession within the ambit of a ‘service’ as defined in Section 2(1)(o) of the Consumer Protection Act, 1986 and clarified the earlier decisions.
Facts
- There had been an increase in cases of medical negligence by doctors but a lot of ambiguity in relation to whether the medical services were in fact medical services and came under COPRA 1986.
- It was also ambiguous whether a hospital, a doctor or a medical practitioner came under COPRA 1986.
- Due to no availability of a unanimous and clear cut decision, a lot of Special leave Petitions and Appeals were filed in the Supreme court. A PIL, a writ was filed under section 32 of the Constitution of India to ascertain a proper decision relating to the question raised.
- The arguments that were raised by the respondent were:
1. The first argument was that COPRA deals with occupational services and the medical profession being a professional service should not be covered in this act.
2. Section(1)(g) contains a certain basis on which services can be held to be deficient. But as the basis is limited, these have less application in medical service.
3. Medical services are contract of personal services which are not a part of Section(1)(o) and thus are a part of exclusionary services.
4. Service does not include medical service and is thus not in the purview of the Act. - All the arguments were rejected by the supreme court through the respective reasoning.
5. A medical practitioner should be held liable for negligence when they are negligent and to find out that, Bolam Test insufficient.
6. section 14 (1) (d) includes that the court may award compensation on the basis of the damage suffered by the negligence of the opposite party.
7. There is no master-servant relationship between doctor and patient and thus it will not result in a contract of service.
8. The “inclusionary part” of the definition of service is wider in scope and includes medical services. - In the second issue of the case, three broad categories were laid:
– Services rendered free of charge to everybody, Charges paid by all users, Charges are required to be paid by all person except those, who cannot afford. - To this, the court said that free services do not form services, and the people who pay the full amount come under the Act and be considered as services.
- To the third issue, the court said that the people in the third category who are paying, pay for the non-paying patients too. Thus they become a beneficiary and so come under the scope of the act and are treated as consumers.
Issues before the Court
Whether the services of a medical practitioner can be considered as ‘services’ under Consumer Protection Act, 1986?
Whether hospitals and doctors come in the ambit of the Consumer Protection Act, 1986?
Ratio Decidendi
NCDRC’s order decreed that the doctor–patient relationship is a contract for personal service and it is not a master-servant relationship. A doctor is an independent contractor and the doctor, like the servant, is hired to perform a specific task. However, the master or principal (the hirer) is allowed to direct only what is to be done, and done, and when. The ‘how’ is left up to the specific discretion of the independent contractor (doctor). So, the doctor-patient relationship is a contract for personal service and as such, cannot be excluded from Consumer Protection Act.
The deficiency in service means only negligence in a medical negligence case and it would be determined under Consumer Protection Act, by applying the same test as is applied in an action for damages for negligence in a civil court.
Judgement
The medical profession has been brought under the Section 2(1) (o) of CPA, 1986, and also, it has included the following categories of doctors/hospitals under this Section:
All medical/dental practitioners doing independent medical/dental practice unless rendering only free service.
Private hospitals charging all patients.
All hospitals having free as well as paying patients and all the paying and free category patients receiving treatment in such hospitals.
Medical/dental practitioners and hospitals are paid by an insurance firm for the treatment of a client or employment for that of an employee.
It excuses only those hospitals and the medical/dental practitioners of such hospitals which offer free service to all patients.
As a consequence of this judgment, effectively all private and government hospitals and the doctors employed by them and the independent medical/dental practitioners except primary health centers, birth control measures, anti-malaria drive, and other such welfare activities can be charged under the Consumer Protection Act, 1986.
Conclusion
This landmark decision brought in a significant interpretation of medical negligence liability, by subjecting the medical profession to the Consumer Protection Act. Patients’ rights were recognized through the conferring of consumer status, allowing them to file complaints in cases of deficiency in rendering medical services.
However, this decision has received criticism from the community of medical practitioners for making the medical profession vulnerable to excessive suits, many of which are filed to harass doctors or to evade the payment of medical bills. While it is important to protect the integrity of this profession, the growing cases of medical negligence are a matter of concern. The interpretation of ‘service’ by the Supreme Court seeks to safeguards the interest and welfare of patients, which is paramount.
Reference
