Disposed

Thampi Subramanian v. State of Kerala

Kerala HC29 Jan 2021WP(C)/18072/2014

Case brief

AI extract

What is this about?

The Court examined reports on medical staff and patient outturn at Government Taluk Hospital, Karuvelipady. Finding current vacancies negligible, the Court directed higher health authorities to review staff strength norms based on patient load and issue directions if revision is necessary.

What did the court decide?

Directed respondents to review staff strength norms and take action if revision is found necessary.

Thampi Subramanian Vs State of Kerala — Pension and Retirement Benefits | Kerala HC (2021)

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WP(C).No.18072 OF 2014(S) -1-

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IN THE HIGH COURT OF KERALA AT ERNAKULAM

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PRESENT

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THE HONOURABLE THE CHIEF JUSTICE MR.S.MANIKUMAR

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THE HONOURABLE MR. JUSTICE SHAJI P.CHALY

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FRIDAY, THE 29TH DAY OF JANUARY 2021 / 9TH MAGHA, 1942

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WP(C).No.18072 OF 2014(S)

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PETITIONER/S:

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THAMPI SUBRAMANIAN AGED 32 YEARS S/O.SUBRAMANIAN, 18/1172(BO, THAMPI NIVAS, PALLURUTHY, KOCHI-682006).

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RESPONDENT/S:

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1 STATE OF KERALA REPRESENTED BY SECRETARY, DEPARTMENT OF HEALTH AND FAMILY WELFARE, GOVERNMENT SECRETARIAT, THIRUVANANTHAPURAM-695001.

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2 DIRECTOR OF HEALTH DEPARTMENT OF HEALTH AND FAMILY WELFARE, GOVERNMENT SECRETARIAT, THIRUVANANTHAPURAM-695001.

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3 DISTRICT MEDICAL OFFICER DMO DISTRICT GENERAL HOSPITAL CAMPUS, ERNAKULAM, COCHIN-682011.

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4 SUPERINTENDENT GOVERNMENT TALUK HOSPITAL (MAHARAJA'S HOSPITAL), KARUVELIPADY, COCHIN-682005.

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5 MANAGING DIRECTOR KERALA MEDICAL SERVICES CORPORATION, DEPARTMENT OF HEALTH AND FAMILY WELFARE, THYCAUD P.O., THIRUVANANTHAPURAM-695001.

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SRI. SURIN GEORGE IPE, SR GP FOR RESPONDENTS

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WP(C).No.18072 OF 2014(S) -2-

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THIS WRIT PETITION (CIVIL) HAVING BEEN FINALLY HEARD ON 29-01-2021, THE COURT ON THE SAME DAY DELIVERED THE FOLLOWING:

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WP(C).No.18072 OF 2014(S) -3-

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J U D G M E N T

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Dated this the 29^th day of January 2021

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S. Manikumar, C. J.

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Instant writ petition has been filed seeking for the following reliefs:-

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“i) Direct the respondents 1 to 3 to provide sufficient number of doctors and also paramedical staff to the 4^th respondent Hospital, immediately;

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ii) direct the 5^th respondent to provide sufficient quantity of medicines to the 4^th respondent Hospital;

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iii) direct the 3^rd respondent to make arrangement for special camp for the treatment of monsoon related ailments in the 4^th respondent hospital;

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iv) direct the 3^rd respondent to take stock of the situation in 4^th respondent Hospital and suggest remedial action.”

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Contentions have been made on the basis of newspaper report

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that, there are vacancies in the posts of Doctors, Nurses, Nursing Assistants etc., in Government Taluk Hospital (Maharaja's Hospital),

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Karuvelipady, Cochin.

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WP(C).No.18072 OF 2014(S) -4-

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Record of proceedings shows that, on 15.07.2014, a Hon'ble Division Bench of this Court ordered thus:-

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“We have gone through the contents of writ petition. Heard learned counsel appearing for the petitioner. The main concern seems to be deficit of staff, both Doctors and paramedical staff, at Government Taluk Hospital, Karuvelipady, Kochi. The 3^rd respondent, being District Medical Officer, has superviosry powers over 4^th respondent hospital, though there is a separate Superintendent at the Taluk Hospital. We direct 3^rd and 4^th respondents to make general inspection of the situation and a report to be filed by 3^rd respondent before Court by next date of hearing.

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Pursuant to which, a memo dated 21.07.2014 has been filed by the Senior Government Pleader, along with a report of the District Medical Officer (Health), Ernakulam, the 3^rd respsondent. Report of the District Medical Officer, the 3^rd respondent, is reproduced hereunder:-

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“In compliance with the direction issued by this Honourable Court on 15.7.2014, I visited Government Maharaja's Taluk Hospital, Karuvelippady on 16.7.2014 at 9 am. I verified the staff strength of the said hospital. The vacancy position of Medical Officers and other Staffs of the hospital as on 16.7.2014 is produced along with this report, for kind perusal of this Honourable Court.

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WP(C).No.18072 OF 2014(S) -5-

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The total sanctioned strength of Doctor in the said hospital is 15. Out of which four Doctors are on contract appointment and one is on working arrangement from Taluk Hospital, Palluruthy, During my visit on 6.7.2014, 5 doctors were on casual leave, one doctor was on night off and the other on prenight off. On perusal of the attendance register of Medical Officers and Staff it was noticed that two Medical Officers, Anaesthetist and Surgeon were on duty in operation theatre. One contract Medical Officer was performing casualty duty. The RMO in the Hospital is on Maternity leave. Junior Consultant (Medical) is on commuted leave for 50 days. Senior Consultant (Ophthalmology) is posted on working arrangement at District Hospital, Aluva as there is no Ophthalmologist in the said Hospital. The Dental Surgeon is attending Dental OP Wing. The Superintendent of the Hospital also attended outpatients whenever it is found necessary. During the inspection, the Paediatrician was taking rounds among in-patient and he started attending out-patients from 9.30 am onwards. During my inspection, I could find about 30 patients waiting in the queue to meet the Medical Officers in the outpatient wing. The Paediatrician after completing the rounds in the inpatient wing started attending the patients. In the inspection, it was revealed that there is laxity on the part of the Superintendent in arranging duty since leave was granted to many of the doctors on the same day. It is primarily the responsibility of the Superintendent to carry out the day-to-day functioning of the hospital smoothly.

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I have visited every ward and the hospital premises and the total hygiene and infrastructure facilities were found to be

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WP(C).No.18072 OF 2014(S) -6-

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satisfactory. No complaints were raised by any of the inpatients or any other lower grade staffs.

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It is submitted that when shortage of Medical Officers was experienced in the said hospital earlier, prompt action was taken to appoint doctors on adhoc basis The permanent vacancies have already been reported to the Director of Health Services.

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It is also submitted that prompt steps have been taken to fill up the vacancies of the paramedical staffs in the hospital. 7 vacancies of staff nurse were filled up on the basis of the advise by Public Service Commission by issuing posting orders from this office as per Order No A5/3584/14 dated 17.7.2014. Steps will be taken for filling up the remaining vacancies urgently. One staff nurse has been engaged through National Rural Health Mission.

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Out of the 9 vacancies of Hospital Attendants, 4 attendants were appointed through Hospital Management Committee. Moreover, the other 5 vacancies were filled up vide Order No.A3/21136/12 dated 17.7.2014 by giving posting to 5 part-time contingent employees, who were promoted as Hospital Attendant

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It is also submitted that the vacancies of Nursing Assistant will be filled up before 21.7.2014 by giving promotion to Hospital Attendant Grade-II. Further, I have already addressed the Employment Exchange to furnish list of candidate for appointing as Hospital Attendant Grade-ll on a provisional basis.

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WP(C).No.18072 OF 2014(S) -7-

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8 It is submitted that Karuvelippady Government Maharaja's Taluk Hospital in Western Kochi is a 220 bedded hospitals, which was upgraded to a Taluk Hospital in the year 2008

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The details of patients attended in the inpatient / outpatient wing during the period from April to June 2014 is as given below:

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Month	O.P.	I.P.
April	15,890	389
May	17,277	446
June	23,467	441

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On an average 630 patients are attended as outpatient and 81 as inpatients every day. As part of preventing the deceases during Monsoon season, fever clinics are started in the hospital. No shortage of medicine was noticed during the inspection. During the inspection, I could notice that there is some lapse on the part of the Superintendent in maintaining the attendance of Medical Officers punctually and properly and strict direction were issued to her in this regard. It is also submitted that a memo has been issued to the Physician on 16.7.2014 who was absenting from duty on the pretext of availing casual leave, compensatory holiday, night off, weekly off etc. without obtaining permission from the Superintendent.

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It is further submitted that in the monthly review meeting of Medical Officers standing instructions have been given not to attend rounds duty at the same time by all Medical

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WP(C).No.18072 OF 2014(S) -8-

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Officers in the institution, which result in disruption of outpatient service.”

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When the matter came up on 21.01.2021, we orally directed

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Mr. Surin George Ipe, learned Senior Government Pleader, to submit the details on the current state of affairs, staff strength, and turn out statistics of the patients, at Government Taluk Hospital (Maharaja's Hospital), Karuvelipady, Cochin.

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Pursuant to the above direction, a report has been submitted

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by the District Medical Officer (Health), Ernakulam, and the same is reproduced hereunder:-

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“Taluk Hospital Karuvelipady, which is popularly known as Maharajas Taluk Hospital is situated in the West Kochi area. This Taluk level Govt Hospital in having a sanctioned bed strength of 220 and have a landed property of 3 1/2 acre. The other details are enumerated below

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A. Existing & proposed Infrastructure facilities

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The following infrastructure facilities are available and are continuing as such

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Out Patient Department

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Inpatient Department (including surgical, medical, ortho wards, both female and male)

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Casualty

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Medical ICU

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Operation Theatre (with C-arm facility), Post OP Ward

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Dental Department

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Pay Ward (Govt. Pay Ward)

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Laboratory (with fully automatic biochemistry analyser)

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X Ray (with Radiography)

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Eye operation Theatre & Ward

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Mortuary

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Canteen

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Medicine Store

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Medical Record Library

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The following services of specialties has been sanctioned by the Government and are available in this hospital

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General Medicine

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General Surgery

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Ortho paediatrics

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Ophthalmology

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Paediatrics

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Anaesthesia

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Dermatology

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Dental

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Besides the following services has also been offered to general public by the hospital

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Pay Ward Services

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Lab Services

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X Ray Service, ECG Services

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Ambulance Service

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Palliative Services

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KASP insurance Scheme

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RBSK/ Arogyakiranam Programme

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NCD Clinic

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MMPP Clinic

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It is submitted that Government vide GO (RT) No. 3699/2018/H&FWD dtd. 15.12.2012 has given administrative sanction for the project of "Development of Govt Maharajas Hospital Karuvelipady" under KIIFB funding Scheme and entrusted M/s Kerala State Housing Board as special purpose vehicle for implementing project KIIFB vide its order no. HFW002-13/APR-3/2020/KIIFB dtd. 28.10.2020 has given approval for the above project at a cost of Rs. 29.67 crore (Rupees Twenty Nine Crore & Sixty Seven Lakh only) and sanctioned fund for the same. Copy of the sanctioned order and detailed project report is attached herewith for ready reference. The authorities has started preliminary works for executing the above project. The project sanctioned envisages construction of a multi specialty building which will have the following infra structural facilities.

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Ground Floor - Casulty with Traumacare, OP Department (14 consulting room with associated facilities) Minor OP, X Ray room, doctors room, nurses room

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1^st floor - Laboratory, Blood storage unit, OPD, Dialysis Unit, Staff Room

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2^nd floor - Male/Female ward (for ortho, medicine, surgery department), Pay ward, isolation ward

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3^rd floor - Preparation cum holding room, Operation theatre (3 Nos.), CSSD, Store, recovery, step down ICU

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4^th floor - Pay ward, Nursing station, store, laundry area

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Terrace floor - Stair room, machine room, OHT

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The overall equipments and instruments needed for the above mentioned facilities will also be provided under the project. As per the detailed project report the following amenities will also be made available

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Vehicle parking facility

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New internal roads

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Sewage treatment plant

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Power laundry

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Waiting & refreshment area for both patients and bystanders

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Landscaping

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B. Existing Staff strength Details as on 22.01.2021

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Category of post	Sanctioned Strength	In position	Vacancy
Superintendent	1	1	0
Consultant – 4
Ortho	1	1	0
Surgery	1	0	1
Opthalmic	1	1	0
Medicine	1	1	0
Jr. Consultant - 8
Medicine	1	1	0
Surgery	1	1	0
Anaesthetist	1	1	0
Paediatrician	1	1	0

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WP(C).No.18072 OF 2014(S) -12-

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Opthalmologist	1	1	0
Ortho	1	1	0
ENT	1	1	0
Dermatology	1	1	0
RMO	1	1	0
Assistant Dental Surgeon	1	1	0
CasualtyMedical Officer	4	4	0
LaySecretary& Treasurer	1	1	0
NursingSuperintendent Gr. I	1	0	1
NursingSuperintendent Gr. II	1	1	0
Store Superintendent	1	1	0
Pharmacist Store Keeper	1	1	0
Head Nurse	9	9	0
Staff Nurse	28	27	1
Optometrist	1	1	0
Pharmacist	3	3	0
Dental Hygenist	1	1	0
Radiographer	2	2	0
X Rayattender	1	1	0
Head Clerk	1	1	0

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C. Turn out Statistics

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The hospital has the following turn out statistics for the month of December 2020.

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Total no OP - 17993 (Male-7950 Female-7374 Children- 2669)

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Total no. IP - 56 (Male – 42, Female-9, Children-5)

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Total no, of surgeries conducted - 18 (Surgery -12, Ortho- 6)”

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Going through the above, we are satisfied that, adequate

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workers / nurses / staff are provided in the Government Taluk Hospital (Maharaja's Hospital), Karuvelipady, Cochin, and that, there is no vacancy in any post, except one post of staff nurse.

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Secretary to the Government, Department of Health and

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Family Welfare, Government Secretariat, Thriuvananthapuram, the 1^st respondent, and Director of Health, Department of Health and Family Welfare, Government Secretariat, Thiruvananthapuram, the 2^nd respondent, are directed to consider, as to whether, there is any requirement for revision of staff strength, taking note of the number of patients in IP / OP, and the norms prescribed by the Medical Council of India, or such other competent authority, for fixation of staff strength in hospitals, and if found, take appropriate action.

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With the above directions, writ petition is disposed of.

S.MANIKUMAR

CHIEF JUSTICE

Sd/-

SHAJI P.CHALY

JUDGE

///TRUE COPY/// P. A. TO JUDGE

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APPENDIX

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PETITIONER'S/S EXHIBITS:

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EXHIBIT P1 TRUE COPY OF THE PAPER REPORT APPEARED IN THE MALAYALA MANORAMA DAILY DT.27-62014. EXHIBIT P2 TRUE ENGLISH TRANSLATION OF EXT.P1. EXHIBIT P3 TRUE COPY OF THE OP TICKET NO.65525 ISSUED FROM THE R4 HOSPITAL DT.5-72014. EXHIBIT P3(a) TRUE ENGLISH TRANSLATION OF EXT.P3. EXHIBIT P4 TRUE COPY OF THE JUDGMENT IN PACHIN BANGA KHET MAZDOOR SAMITY AND OTHER VS.STATE OF WEST BENGAL AND ANTOHER1996 AIR SC 2426 PUBLISHED IN AIR SUPREME COURT SOFTWARE.

Thampi Subramanian v. State of Kerala

Case brief

What is this about?

What did the court decide?

Thampi Subramanian v. State of Kerala

Case brief

What is this about?

What did the court decide?

What the court decided

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