SaveLIFE-Thomson Reuters Foundation report highlights need for a national law on trauma care in India

Non-for-profit Indian road safety watchdog SaveLIFE Foundation, in association with Thomson Reuters Foundation’s TrustLaw Network, has undertaken a global study to report on the prevalence of legal statutes to guarantee emergency medical care as a Statutory Right and the subsequent availability of commensurate systems in the studied countries.

The selected countries include a mix of both developing and developed nations, including the USA, Germany, England and Wales, Malaysia, Australia, Brazil, Japan, Pakistan, and South Africa. The prevalence of such legal guarantees and grassroots systems in India has also been studied and included in the report.

The study investigated five distinct aspects of emergency medical care in these countries:

• Availability of guaranteed/statutory right to emergency medical care.
• Existence of separate federal and state laws and/or guidelines on the right and access to emergency medical care, and the ways in which they are harmonised and enforced.
• Status of emergency medical care funding, including state, insurance, and privately-sourced funding.
• Mechanisms at the Federal and State level to regulate referrals at hospitals/trauma care centres, and established protocols.
• Specific guidelines/regulations to address traumatic injuries on highways.

The legal comparative research for the report has been prepared by SaveLIFE Foundation with support from four international law firms’ part of the TrustLaw Network.

As per the report, while high-income countries such as Australia and Japan have partial-written statutes guaranteeing right to emergency medical care, their strong, well-established universal trauma care access systems ensure that a robust emergency response framework is available to the citizens. The United States, and England and Wales, also have written statues to ensure universal access to trauma care for their respective citizens. Most developing countries covered in this report have enshrined trauma care in their statutory provisions even as they continue to build the mechanisms required to implement care systems on the ground.

The report states that although India does not have legislative statutes guaranteeing emergency medical care as a right, court judgments have sought to interpret emergency medical care as a right. The said judgements, however, neither prescribe basic minimum standards for various facets of emergency medical care nor outline punitive measures for violation of such a right.

According to Piyush Tewari, CEO and Founder, SaveLIFE Foundation said, “Trauma care helps preserve our fundamental right to life, but delivery of such care requires a system with interlinked sub-systems and uniform standards. Such standards can very well be established without an explicit ‘Right to Trauma Care’ law but a legislation would ensure that a framework to establish such standards and systems exist with appropriate authority, accountability, and long-term sustainability.

According to the report, despite landmark judgments like Parmanand Katara v. Union of India and Paschim Banga Khet Mazdoor Samithi v. State of West Bengal by the honourable Supreme Court of India that highlight the importance of inclusion of emergency medical care in Article 21 of Indian Constitution, emergency medical care has not as yet been standardised across the country.

Furthermore, the 2021 report published by the NITI Aayog and AIIMS highlights the state of emergency medical care with alarming numbers such as 98.5% of ambulance runs transporting only dead bodies; 90% of ambulances functioning without any equipment including oxygen; 95% of ambulances having untrained personnel; most emergency department (ED) doctors having no formal training in trauma care and 30% mortality due to delay in emergency care.

“The ‘Right to Education Act, 2009’ is a classic example of how legislation can spur the creation of systems to ensure that the country progresses ahead. This report documents the precedent of such actions taken by high as well as low- and middle-income countries. We hope that it will motivate a much-needed discourse amongst all stakeholders, with saving lives being at the front and centre of all discussions,” Tewari added.

Link to the full report - Global Comparative Research on Right to Emergency Medical Care