IN THE HIGH COURT OF HIMACHAL PRADESH, SHIMLA CWP No.1763 of 2002 Decided on : June 25, 2008 State of H.P. and another …Petitioners. Versus Tek Chand and another …Respondents. Coram The Hon’ble Mr. Justice Surjit Singh, Judge. The Hon’ble Mr. Justice Surinder Singh, Judge. Whether approved for reporting?1 No. For the Petitioners : Mr. P.M. Negi, Deputy Advocate General. For the Respondents : None. Surjit Singh, Judge( Oral ) This writ petition has been filed by the State of Himachal Pradesh and Director, Health Services, for quashing the order dated 19th September, 2001, of State Administrative Tribunal, whereby, allowing the original application of respondent No.1, writ petitioners have been directed to pay to the said respondent a sum of Rs.33,007/-, on account of difference between the expenses incurred by the said respondent on his treatment and the amount reimbursed to him, under the orders of petitioner No.2. 2. Respondent No.1 is an employee of the Government of Himachal Pradesh. In the year 1998, he was serving as a Superintendent in the Office of Chief Medical Officer, Mandi. He suffered from some heart ailment, which Whether reporters of the local papers may be allowed to see the judgment? …2… required immediate medical treatment that was not available in the State. The Chief Medical Officer reported to the Director, Health Services, that respondent No.1 required immediate treatment for his ailment and sought permission to send him to Batra Hospital at New Delhi, for treatment. Since the matter was of emergent nature, respondent No.1 went to Delhi in anticipation to the grant of permission of the Director, Health Services, and got himself treated. Record of treatment kept by Batra Hospital indicates, that initially treatment of PTCA and stenting was unsuccessful and, therefore, it had to be repeated. Respondent remained under treatment from 6th April, 1998 to 10th April, 1998. A sum of Rs.1,44,809/- was incurred by the said respondent on treatment at Batra Hospital. He submitted reimbursement claim to petitioner No.2, i.e. Director, Health Services, seeking reimbursement of the entire amount spent by him on treatment. Petitioner No.2 reimbursed his claim to the extent of Rs.1,11,802/- only, on the ground that at the relevant time Batra Hospital was not recognized by the State Government for treatment of its employees, suffering from heart ailments and, therefore, the amount of claim was to be restricted to the amount which the All India Institute of Medical Sciences (AIIMS) at New Delhi would have charged. 3. Respondent No.1 filed an application before the Tribunal seeking reimbursement of the claim in full and prayed for a direction to the writ petitioners to pay the remaining …3… amount of Rs.33,007/-, together with interest at the rate of 12 per cent per annum. 4. Writ petitioners took the stand before the Tribunal that since Batra Hospital was not recognized by the Government for treatment of its employees, at the relevant time, respondent No.1 was not entitled to the reimbursement of his claim in full, but only to the extent, the AIIMS would have charged him for his treatment, in question. It was stated that Batra Hospital had been recognized by the State Government only in November, 1998, i.e. much after respondent No.1 underwent the treatment. 5. Tribunal, vide impugned order, has directed the writ petitioners to pay the difference between the amounts spent by respondent No.1 and reimbursed to him by the State Government, with the following reasoning: “I) It has been informed by the learned counsel for the applicant that keeping in view the large number of cases involving Cardiac Treatment and waiting period involved in All India Institute of Medical Sciences, the Govt. of Himachal Pradesh had earlier recognised Escorts Heart Institute Delhi for treatment of the State Government employees. The last order in this behalf was issued on 6.5.1996 which gave the entire package for such treatment. Later, on the same consideration, Batra Hospital was recognised w.e.f. November 6, 1998. Thus it has been recognised by the State Government that the facilities available All India Institute of Medical Science were not sufficient or readily available as were required by the employees of Himachal Pradesh Government. II) As Annexure-P/2 filed by the Misc. Application shows, the medical Specialist had described the case of the applicant as of emergent nature and on that basis, the Chief …4… Medical Officer Mandi on the advice of Medical Specialist, referred the case to Director Health Services for permission/ex- post facto permission for treatment of the applicant at Batra Hospital. This reference was made on March 20, 1998 whereas permission was accorded on August 29, 1998 (Annexure-PA). Thus the permission for treatment at Batra Hospital restricting the charges to All India Institute of Medical Sciences charges was issued after almost five months from the date of reference. A Cardiac patient whose condition has been described as emergent on March 20, 1998, cannot wait till August 29, 1998 for the permission. Under bonafide belief that permission would be accorded in view of the fact that facilities were not available at Mandi, the applicant got himself admitted in the Hospital on April 6, 1998 and the Hospital without wasting any time, gave the necessary treatment including Angioplasty within three days to the applicant. This shows that the patient could not have waited for permission and perhaps for his turn for treatment at All India Institute of Medical Sciences. III) That the discharge summary Annexure-:C shows that patient had developed some complication by Acute closure which was promptly treated by repeat PTCA and deploying another stent. The rates as applicable at the All India Institute of Medical Sciences to which the reimbursement has been restricted, covers normal case of Angioplasty. In the present case the Batra Hospital must have charged for repeat PTCA and deploying of another stent. This fact has not been taken into account by the respondents while dealing with the case.” 6. We see no merit in the present writ petition, in view of the reasoning recorded by the Tribunal in its aforesaid order, which has been reproduced hereinabove. We fully endorse the aforesaid reasoning of the Tribunal, particularly the reason that when the Director, Health Services, i.e. …5… petitioner no.2, had been approached on 20th March, 1998 by the Chief Medical Officer to accord permission for referring respondent No.1 to Batra Hospital, he (Director, Health Services) kept the matter pending with him upto 29th August, 1998, on which date he accorded the permission, with the condition that the claim for the reimbursement will be restricted to the amount chargeable by AIIMS for similar treatment. Had the Director, Health Services, taken the decision on the reference of the Chief Medical Officer made on 20th March, 1998, promptly and conveyed the same to respondent No.1, through the Chief Medical Officer, the respondent might not have opted for treatment at Batra Hospital, even at the risk of his life. 7. In addition to the aforesaid reasons given by the Tribunal for allowing the Original Application of respondent No.1., we find from the record of the present writ petition that there are instructions, probably adopted by the Government of Himachal Pradesh, to the effect that where facilities for treatment of a particular ailment are not available in the State, full reimbursement of charges is permissible, provided the Director of Health Services certifies that such facilities are not available in the State. Writ petitioners have themselves placed reliance upon such instructions (Annexure P-2) forming part of O.M. No. S.14021/5/88-MS, dated 17th October, 1988, issued by the Government of India, Ministry of Health and Family Welfare. According to these instructions, full reimbursement of medical charges is permissible where the …6… facility for treatment is not available in the State and the Director of Health Services of the concerned State certifies to this effect. From the fact of placement of reliance upon this document by the writ petitioners, we assume that these instructions have been adopted by the State Government. Admittedly, facilities for the treatment of ailment, respondent No.1 had been suffering from, was not available in the State at the relevant time. Therefore, the Director Health Services ought to have issued a certificate to this effect and allowed the reimbursement of the claim in full. 8. In view of the abovestated position, the writ petition is dismissed. Writ petition stands disposed of. ( Surjit Singh ), J June 25, 2008(sd) ( Surinder Singh ), J