States and Union Territories are running out of beds for the patients of Covid -19 infection
Even as I draft this despatch, States and Union Territories (UTs) which are reporting very high numbers of COVID-19 infections are allegedly running out of beds for infected people who need urgent medical attention. The media is reporting case after case of ailing individuals breathing their last waiting for admission to a designated COVID treatment hospital. The family of the deceased allege, the hospitals refuse admission, whereas the hospitals counter them claiming, the patient was found dead on arrival or that they did not admit the patient because the infection was not detected by their own testing centre. There are media reports of COVID designated hospitals refusing treatment for non-COVID ailments resulting in the death of the patient. Similarly, there are other reports of deaths caused by the novel Corona virus because the patient was taken to a hospital that was not officially designated as a COVID treatment centre. Amidst all of this confusion, India was recently elected to head the Executive Board of the World Health Organisation.
Is accurate and updated information about every COVID hospital and treatment centre designated across the country accessible to everybody in the public domain at the click of a button? Unfortunately, the answer is a deafening "NO".
In one of its orders released Friday (05 June, 2020) , the Central Information Commission (CIC) has issued an advisory to the Union Ministry of Health and Family Welfare (MoHFW) to fill this information gap in the battle to combat COVID-19 by proactively compiling and publishing a list of all COVID treatment facilities designated across the country.
During the Lockdown 1.0 announced by the government in March 2020, I did not file any RTI application. I took this decision because I did not want to impose an additional burden on an already embattled administration. However, when the country entered into Lockdown 2.0, it became apparent that governments were sliding back to the age of sharing information on a "need to know" basis which characterised independent India's governance until 12th October 2005 when The Right to Information Act (RTI Act) came into force.
After learning from media reports and friends that COVID infected people were having difficulties finding the locations of the designated COVID hospitals, I rummaged through MOHFW's website and its newly set up COVID resource page for a consolidated list of such hospitals. There was none that I could find.
The RTI Intervention
Perturbed by this absence of information about designated COVID hospitals and treatment centres on the webpage of MoHFW, I filed my first RTI application during Lockdown 2.0. On 17th April, 2020, I submitted a formal request through the RTI Online Facility asking MoHFW for the following information:
"1) The district-wise number of hospitals and healthcare facilities called by any other name, designated as COVID-19 treatment centres as on date;
2) The postal addresses and telephone numbers of the hospitals and healthcare facilities referred to above;
3) The criteria applied for determining whether or not a hospital or a healthcare facility should be designated as a COVID- 19 treatment centre;
4) The district-wise names of hospitals and health care facilities whose designation as COVID-19 treatment centres has been withdrawn as on date; and
5) The reasons for withdrawing the designation of every hospital and health care facility referred to at para no. 4 above."
As all the information described above directly concerns the life and liberty of individuals across the country, I requested MoHFW to publicise the information within 48 hours of receipt of this request by uploading the same on their official website under Section 4(1) of the RTI Act with intimation of the relevant URL(s) to me by email. Click here to read the RTI application.
MoHFW, DGHS and ICMR play football with the RTI application
I waited in vain for a week for MoHFW's reply. Instead of sending a substantial reply, MoHFW's Central Public Information Officer (CPIO) transferred the RTI application to the Directorate General of Health Services (DGHS) and the Indian Council for Medical Research (ICMR). Neither public authority sent me any reply subsequently. Meanwhile the COVID-19 infection rate was rising steadily. Click here to read more.
Click here to read the complaint submitted to the CIC.
Additional submissions made to the CIC
Multiple CPIOs replied after the complaint was submitted to the CIC. On 20th May, 2020, I sent an additional submission to the CIC updating them about the developments in my case along with the replies received from the public authorities named immediately above. I put forth the following points:
1) that my RTI application was being transferred from one public authority to another without providing substantial information;
Click here to read more.
CIC's Advisory to MoHFW
The CIC conducted the hearing on 1st June, 2020 through a whatsapp call. Five CPIOs representing all the Respondent Public Authorities including the hospitals to which my RTI application was transferred were also present. All of them denied that their units had a comprehensive list of hospitals and treatment centres designated for the purpose of treating COVID-19 infected patients. They pleaded ignorance about the source of information that the two Union Ministers mentioned in their write-up and meetings. Expressing its displeasure at this state of affairs, the CIC advised MoHFW as follows:
"...the Commission advises the Secretary, M/o H&FW to designate an officer of an appropriate seniority as a Nodal Officer to examine the matter and suo motu disclose the information sought in the RTI application on the website of the Public Authority within a period of 15 days from the date of receipt of this order in the larger public interest."
In support of its advisory the CIC reasoned as follows:
"Having heard all the parties and on perusal of the available records, the Commission at the outset was appalled to learn that basic information pertaining to the District Wise Designated COVID treatment centres could not be provided to the information seeker by any of the Respondents. As per the provisions of the RTI Act, 2005, the CPIO acts as the pivot for enforcing the implementation of the RTI Act, 2005 and it is their responsibility to facilitate flow of information instead of simply shifting the onus of disclosing the same to other Public Authority/ officials. In the present instance none of the Respondent disclosed the information or made an effort to assist the information seeker in obtaining the information on a very sensitive matter which certainly pertains to the interest of the public at large..."
To what extent the MoHFW will comply with this advisory will be closely watched in the coming weeks.
Random survey of COVID-related websites of States and UTs
Meanwhile, after receiving the CIC's decision, I randomly surveyed COVID-related websites and webpages of 21 State Governments and the administration of two UTs (23 out of 36 jurisdictions) across India's geographical regions to locate COVID hospital-related information. My preliminary findings are given below:
The Government of the National Capital of Delhi's (GNCTD) web portal leads to a list - "dashboard style." Very useful information about hospital-wise availability of beds is updated here every day. But having lived in Delhi for more than three decades, even I could not quite figure out which hospitals were being referred to by abbreviations such as- "SGRH City", "DCBH" or "HAHC" included in this list without Googling them. This list does not mention their addresses or telephone numbers. Next I looked up the website of the Health Department of Punjab. Click here to read more.
Chhattisgarh Government's Health Department website displays names of the designated COVID hospitals with details of available facilities but no contact details or status updates are provided. Click here to read more.
Bihar's dedicated COVID webpage only has district-wise helpline numbers. I could not find a list of COVID hospitals on this page or on the website of the Health Department or that of the Bihar Health Society. Click here to read more.
Next I looked up Assam's Health Department. The website of their National Health Mission programme has district-wise lists of COVID dedicated hospitals and treatment centres. Click here to read more.
Next I looked up the dedicated COVID webpage of the Health Department of my home State of Karnataka. District-wise details of designated hospitals and various categories of treatment centres have been displayed along with postal addresses and contact numbers and number of beds, but without status updates. Click here to read more.
Much like with my RTI intervention regarding data collected about migrant workers stranded across the country, I did not ask for copies of official records. One person accessing such information is of little use to others. Instead I sought proactive disclosure of information in this case also, so that every interested person may access it sitting at home or in office. During lockdowns proactive information disclosure works to everybody's best interests. However, given the fact that RTI is a deemed fundamental right it is important for all States and UTs to ensure access to information in a uniform manner. Some States like Karnataka and Gujarat are much more advanced than others as they proactively disclose even mobile phone numbers of the designated COVID healthcare facilities. Telangana has used Google Mapping effectively to help people find their way to such facilities with the help of their smartphones. Other surveyed States and UTs are parsimonious with the quantity and quality of information they display on their websites. MP performs much worse than most other States surveyed here, as does J&K. There is an urgent need to develop templates for information disclosure for use across the country so that comprehensive information is made available to people in a uniform manner. I hope MoHFW's compliance with the CIC's latest directive will be a step in that direction.