The Supreme Court has established minimum standards for the creation and operation of intensive care units (ICUs) across the country. This directive requires states and union territories to adopt guidelines developed by a committee of distinguished medical professionals. The court has set a deadline of nine months for implementation of these standards.
The guidelines prescribe a minimum timeline of three months for providing emergency equipment (ventilators, defibrillators, ECG machines), bedside utilities (monitors, oxygen supply, electrical outlets, IV pumps, etc), besides lab services and imaging facilities (X-ray, ultrasound) in proximity to the ICU. The guidelines require health care personnel, comprising ICU specialists, trained doctors, nurses, and allied health professionals, if not available, to be recruited within six months. The court asked additional solicitor general Aishwarya Bhati, amicus curiae advocate Karan Bharihoke, and Dr Nitish Nayak, who was part of the committee along with other doctors, to examine the compliance reports and give their comments to the court. The court cautioned the states to be realistic as it would not grant time more than what is required. The court directed that the three-month, six-month, and nine-month time frames be strictly followed.
The guidelines, which were placed before the court by the Union health ministry, prescribe minimum standards on infrastructure, equipment and personnel for a basic ICU (Level 1) followed by specialised services forming the Level 2 and Level 3 in multi-specialty hospitals and institutions of excellence. It lays down that a Level 1 ICU should preferably be under the care of a specialist with a National Medical Council recognised postgraduate degree (MD or DNB) in anesthesiology, medicine, pulmonary medicine, paediatrics, or emergency medicine. If such a person is not available, a physician dealing with emergency medicine or a general surgeon could be in charge of a Level 1 ICU. The court reduced the time frame to nine months and directed states and union territories to submit status reports of compliance by November 5. Some states informed the court that setting up Level 1 ICUs across hospitals in remote and hilly areas will require time.
The bench said it will consider granting an extension of time in such special cases provided they offer a further realistic timeline for compliance with the court’s orders. “Any laxity on part of the hospitals may result in the court taking a strict view against the defaulting party.”
