A) ABSTRACT / HEADNOTE

The Supreme Court of India, exercising its suo motu jurisdiction under Article 32 of the Constitution, addressed systemic failures exposed during the COVID-19 pandemic, particularly incidents of fire in dedicated COVID hospitals and deficiencies in treatment, safety, and dignified handling of deceased patients. Triggered by the tragic fire incident at a COVID hospital in Rajkot, Gujarat, which resulted in multiple fatalities, the Court expanded the scope of adjudication to encompass broader public health governance, disaster management, hospital safety compliance, and enforcement of pandemic-related guidelines.

The judgment underscores the constitutional status of the right to health as an integral facet of Article 21, extending beyond mere access to treatment to include affordability, safety, and dignity in death. The Court recognised the pandemic as an unprecedented national crisis akin to a “world war” requiring coordinated action between the Union, States, local administrations, and citizens. It examined affidavits filed by the Union of India and various States, particularly focusing on fire safety audits, issuance and renewal of fire safety No Objection Certificates, hospital inspections, and compliance with advisories issued by the Ministry of Home Affairs.

Significant emphasis was placed on the failure of implementation of Standard Operating Procedures and guidelines under the Disaster Management Act, 2005, leading to avoidable loss of life. The Court issued wide-ranging mandatory directions relating to hospital fire safety, price regulation of private hospitals, enforcement of public health guidelines, crowd management, police deployment, testing transparency, containment strategies, and regulation of political gatherings during elections. The judgment reflects judicial assertiveness in safeguarding public health while reiterating citizens’ constitutional duties during a public emergency.

Keywords:
COVID-19 Pandemic; Right to Health; Article 21; Disaster Management Act, 2005; Fire Safety in Hospitals; Public Health Governance

B) CASE DETAILS

C) INTRODUCTION AND BACKGROUND OF JUDGMENT

The judgment arose during an extraordinary phase of national and global crisis caused by the COVID-19 pandemic. The Supreme Court assumed suo motu cognizance following repeated reports of fatal fire incidents in COVID-19 hospitals, most notably the incident dated 26 November 2020 at Rajkot, Gujarat, which resulted in the death of multiple patients undergoing treatment. The Court treated the incident not as an isolated tragedy but as symptomatic of deeper structural lapses in hospital safety, regulatory oversight, and emergency preparedness.

Earlier fire incidents in hospitals across different States had already exposed serious deficiencies in compliance with fire safety norms, renewal of No Objection Certificates, and enforcement of building and fire service regulations. The Court considered affidavits submitted by the Union of India detailing advisories issued by the Ministry of Home Affairs and compiled status reports from States and Union Territories regarding inspections and corrective measures.

The background also reflects judicial concern over rising treatment costs in private hospitals, inadequate public health infrastructure, and weak enforcement of pandemic guidelines. The Court linked these failures directly to constitutional obligations under Article 21, recognising health as a non-negotiable fundamental right even during emergencies. The pandemic was characterised as a “world war” necessitating government–public partnership and collective discipline.

The proceedings gradually expanded to include issues of public gatherings, political rallies, election campaigns, testing transparency, containment strategies, and enforcement of Standard Operating Procedures. The Court also took judicial notice of public fatigue, frontline healthcare worker exhaustion, and growing public non-compliance despite fines and penalties. The background thus situates the judgment as an exercise in constitutional crisis management through judicial directions.

D) FACTS OF THE CASE

The proceedings originated from a tragic fire accident at a dedicated COVID-19 hospital in Rajkot, Gujarat, on 26 November 2020, which caused the death of several patients. The Supreme Court, by order dated 27 November 2020, took suo motu cognizance of the incident under Article 32, recognising the gravity of repeated hospital fire accidents during the pandemic.

Pursuant to the Court’s directions, the Union of India filed affidavits dated 30 November 2020 and 11 December 2020. These affidavits placed on record a 28 November 2020 advisory issued by the Ministry of Home Affairs to all States and Union Territories. The advisory required comprehensive measures to prevent recurrence of fire incidents, including inspection of hospitals, verification of fire safety No Objection Certificates, and re-inspection of nursing homes.

States were directed to submit compliance reports. These reports revealed that while inspections had been undertaken and shortcomings identified, audits remained incomplete and enforcement uneven. Several hospitals lacked valid or renewed fire safety clearances. The Union further directed States to align local building bye-laws and fire service regulations with the Model Bill on Maintenance of Fire and Emergency Services, 2019.

The State of Gujarat filed a separate affidavit outlining steps taken, including appointment of nodal fire safety officers and audits of certain COVID hospitals. The State also notified the appointment of Justice D.A. Mehta to inquire into fire incidents at Shrey Hospital, Ahmedabad, and Uday Shivanand Hospital, Rajkot.

Beyond hospital safety, the Court examined widespread violations of pandemic guidelines, unauthorised gatherings, political rallies, inadequate policing, and insufficient testing transparency. The Election Commission of India’s guidelines for election campaigns during COVID-19 were placed on record. The Court noted the failure of implementation rather than absence of norms as the primary cause of pandemic escalation.

E) LEGAL ISSUES RAISED

i. Whether the failure to ensure fire safety in COVID hospitals violates the right to life and health under Article 21?
ii. Whether States and Union Territories discharged their statutory obligations under the Disaster Management Act, 2005?
iii. Whether lack of enforcement of SOPs and guidelines justified judicial intervention under Article 32?
iv. Whether unaffordable treatment costs in private hospitals infringe the constitutional right to health?
v. Whether political gatherings and public assemblies during the pandemic required stricter regulatory oversight?

F) PETITIONER / APPELLANT’S ARGUMENTS

The proceedings being suo motu, submissions were primarily made by the Union of India and States. The learned Solicitor General submitted that immediate steps were undertaken following the Rajkot incident and that advisories had been issued to prevent recurrence. It was contended that inspections, audits, and data collection were underway and that States had been directed to report compliance.

G) RESPONDENT’S ARGUMENTS

Various States submitted affidavits detailing inspections, appointment of nodal officers, and corrective actions. The State of Gujarat highlighted the constitution of an inquiry commission and compliance with Union advisories. The States contended that the unprecedented nature of the pandemic strained existing infrastructure, though efforts were ongoing to strengthen compliance.

H) RELATED LEGAL PROVISIONS

i. Article 21, Constitution of India
ii. Article 32, Constitution of India
iii. Disaster Management Act, 2005
iv. Election Commission of India Guidelines on COVID-19 and Elections (2020)

I) JUDGMENT 

The Supreme Court held that right to health is inseparable from the right to life under Article 21. The Court observed that fire incidents in hospitals reflected administrative negligence and lack of enforcement. It issued binding directions mandating appointment of nodal fire safety officers in every COVID hospital and monthly fire audits by district committees.

The Court directed immediate action against hospitals lacking valid fire safety NOCs and ordered States to cooperate with inquiry commissions. It emphasised that affordable treatment is a constitutional obligation and that States may regulate private hospital charges under the Disaster Management Act.

The judgment strongly criticised lax enforcement of SOPs and ordered strict action irrespective of status or position of violators. Directions were issued regarding police deployment, regulation of gatherings, transparency in testing data, weekend curfews, sealing of containment zones, and grievance redressal mechanisms.

The Court adopted Election Commission guidelines for political gatherings and mandated State enforcement. It reiterated citizens’ fundamental duties to comply with public health norms, stating that individual negligence infringes the rights of others.

a) RATIO DECIDENDI

The core ratio lies in the affirmation that public health governance during a pandemic falls squarely within constitutional scrutiny. Failure to ensure hospital safety, affordability of treatment, and enforcement of disaster guidelines constitutes a direct violation of Article 21. Judicial intervention is justified where executive implementation collapses.

b) OBITER DICTA

The Court remarked on public fatigue, frontline worker exhaustion, and moral responsibility of citizens. It described the pandemic as a collective battle requiring discipline and cooperation beyond legal enforcement.

c) GUIDELINES

The Court issued detailed operational guidelines relating to hospital audits, crowd control, curfews, containment zones, police deployment, regulation of private hospitals, grievance mechanisms, and election-related gatherings.

J) REFERENCES

a) Important Cases Referred

• In Re: Proper Treatment of COVID-19 Patients and Dignified Handling of Dead Bodies in the Hospitals Etc., [2020] 13 S.C.R. 762

b) Important Statutes Referred

• The Constitution of India

• The Disaster Management Act, 2005