<p class="bodytext">The Supreme Court has done well to reprimand senior health officials for adopting a “casual approach” towards its order on uniform guidelines for patient management in Intensive Care Units (ICUs) and Critical Care Units (CCUs) in hospitals. It has directed top officials from 28 states and UTs to appear before it on November 20 with “personally affirmed show-cause affidavits” explaining why contempt action should not be taken against them for their laxity. In 2016, the apex court, acting on a petition, recognised the need for guidelines in the treatment of patients in ICUs and CCUs. A committee formed by the central government informed the Court that the guidelines could not be framed without inputs from the states. Model guidelines formulated by the central government in 2023 could not be finalised without the states’ recommendations, since health is a state subject, and these recommendations also needed to be specific to the needs of the states. Most of the states failed to submit their reports on the matter, despite repeated directions from the Court.</p>.<p class="bodytext">ICUs and CCUs are integral to the functioning of emergency care in hospitals and need a standardised and comprehensive set of guidelines. These guidelines are critical at a time when healthcare infrastructure is found wanting in most parts of the country, and the number of people involved in accidents and suffering from serious ailments is rising. Facilities for advanced treatment are not available in many towns and villages. There are many states without Level 1 trauma centres. Apart from the shortcomings in critical care infrastructure, hospitals are being reported for admitting patients in ICUs and CCUs when they can provide the required care in their standard facilities. The Court’s intervention was aimed at formulating a standardised procedure for the functioning of care units, apart from determining admission norms and grading the units based on the hospital’s capacity and patient volume. These are important parameters that contribute to the overall effectiveness of critical care in hospitals.</p>.Cooperative law: A case for reform.<p class="bodytext">The guidelines formulated by the central government addressed some of the issues, such as inconsistencies in the admission criteria. They defined the level of illness that demands admission to the ICU and laid down the admission and discharge criteria. Only eight states and UTs are reported to have taken note of them and made some progress in implementation. Framing effective guidelines on the matter without the states’ involvement will be difficult. The Court’s rap will, hopefully, lead to a positive outcome.</p>
<p class="bodytext">The Supreme Court has done well to reprimand senior health officials for adopting a “casual approach” towards its order on uniform guidelines for patient management in Intensive Care Units (ICUs) and Critical Care Units (CCUs) in hospitals. It has directed top officials from 28 states and UTs to appear before it on November 20 with “personally affirmed show-cause affidavits” explaining why contempt action should not be taken against them for their laxity. In 2016, the apex court, acting on a petition, recognised the need for guidelines in the treatment of patients in ICUs and CCUs. A committee formed by the central government informed the Court that the guidelines could not be framed without inputs from the states. Model guidelines formulated by the central government in 2023 could not be finalised without the states’ recommendations, since health is a state subject, and these recommendations also needed to be specific to the needs of the states. Most of the states failed to submit their reports on the matter, despite repeated directions from the Court.</p>.<p class="bodytext">ICUs and CCUs are integral to the functioning of emergency care in hospitals and need a standardised and comprehensive set of guidelines. These guidelines are critical at a time when healthcare infrastructure is found wanting in most parts of the country, and the number of people involved in accidents and suffering from serious ailments is rising. Facilities for advanced treatment are not available in many towns and villages. There are many states without Level 1 trauma centres. Apart from the shortcomings in critical care infrastructure, hospitals are being reported for admitting patients in ICUs and CCUs when they can provide the required care in their standard facilities. The Court’s intervention was aimed at formulating a standardised procedure for the functioning of care units, apart from determining admission norms and grading the units based on the hospital’s capacity and patient volume. These are important parameters that contribute to the overall effectiveness of critical care in hospitals.</p>.Cooperative law: A case for reform.<p class="bodytext">The guidelines formulated by the central government addressed some of the issues, such as inconsistencies in the admission criteria. They defined the level of illness that demands admission to the ICU and laid down the admission and discharge criteria. Only eight states and UTs are reported to have taken note of them and made some progress in implementation. Framing effective guidelines on the matter without the states’ involvement will be difficult. The Court’s rap will, hopefully, lead to a positive outcome.</p>
