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The Supreme Court has set up a 12-member national task force to revamp the Centre’s formula for allocating medical oxygen to states while also ordering an immediate oxygen utilisation audit in Delhi, which has to get 700 metric tonne (MT) of the life-saving gas every day under the apex court’s orders despite the Union government’s reluctance to give it that much.
As India battles its worst wave of Covid-19 infections that have overwhelmed health care facilities across the country, demand for medical oxygen has soared, and several states have sought more oxygen from the Centre, which is in charge of allocating what has become the most precious medical commodity right now.
A bench of justices Dhananjaya Y Chandrachud and MR Shah emphasised that the existing deficiencies in the oxygen allocation formula required to be rectified by devising a new method on “scientific, rational and equitable basis”.
The task force must take up the “pressing issue of determining the modalities for oxygen expeditiously within a week”, the order passed on May 6 said. It was released on Saturday evening.
The task force, which has a term of six months initially and will include 10 medical experts from across the country for devising a “public health response” mechanism, has been requested to come up with a new formula of oxygen allocation; recommendations for augmentation of oxygen; measures necessary for ensuring the availability of essential drugs; best practices for management and treatment of Covid-19; measures to ensure adequate health care professionals; and outreach of expert medical care to rural areas.
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The task force will submit its recommendations to the Supreme Court and to the Centre, which will have to then take appropriate decisions. The apex court may also pass suitable orders based on these recommendations.
The order said the task force should also facilitate audits to be conducted by sub-groups within each state and Union Territory to scrutinise whether the allocated quantity of oxygen reached states as well as to pin accountability on states regarding its utilisation and distribution to hospitals.
About Delhi, the court reiterated its direction to the Centre to “strictly” keep supplying 700MT oxygen per day pending further orders but at the same time, accepted solicitor general Tushar Mehta’s request for carrying out an audit immediately to ensure that the oxygen was being distributed by the Delhi government in an efficient and transparent manner.
During the proceedings on Friday, while the S-G maintained that Delhi’s requirement was between 500 and 600MT per day and that the deficit in hospitals, if any, was due to the inefficiency and systemic failure on the part of the Delhi government, senior advocate Rahul Mehra, representing the city-state’s government, objected to any such audit for the national capital.
However, the bench has now set up a committee comprising Dr Randeep Guleria (director, All India Institute of Medical Sciences, Delhi), Dr Sandeep Budhiraja (director, Max Healthcare) and one joint secretary-level officer each from the Centre and Delhi government “to ensure a measure of accountability for the proper distribution of oxygen supplies” made available to the city government.
“The purpose of conducting audits is to ensure accountability in respect of the supplies of oxygen provided to every State/UT. The purpose is to ensure that the supplies which have been allocated are reaching their destination; that they are being made available through the distribution network to the hospitals or, as the case may be, the end users efficiently and on a transparent basis; and to identify bottlenecks or issues in regard to the utilization of oxygen,” said the court, adding that the decisions made in good faith by doctors while treating their patients will not be questioned.
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The court, which on Friday pointed out flaws with the Centre’s formula to link allocation of oxygen to only the number of beds in the hospitals of a state and its active cases without paying heed to its requirements for patients at homes and other Covid Care Centres, underscored that the task force should start its exercise regarding oxygen allocation “immediately”.
“It is necessary that an effective and transparent mechanism is set up within the Union government for the purpose of allocating medical oxygen to all States and UTs for being used during the Covid-19 pandemic. This task force would be tasked inter alia with formulating a methodology for the scientific allocation of oxygen to the states and UTs,” said the bench in its order.
The rationale for constituting a task force at a national level, the court said, is “to facilitate a public health response to the pandemic based on scientific and specialised domain knowledge” and to enable the decision makers to have inputs from leading experts for formulation of scientific strategies to deal with an unprecedented human crisis not only for the present problems but by also taking into account the likely future course of the pandemic.
“Estimating projected needs is crucial to ensure that the country remains prepared to meet future eventualities, which will cause a demand for oxygen, medicines, infrastructure, manpower and logistics. The establishment of the task force will provide the Union government with inputs and strategies for meeting the challenges of the pandemic on a transparent and professional basis, in the present and in future,” held the bench.
It asked the Centre, states, agencies as well as private hospitals to render all cooperation to the task force, besides providing complete and real-time data for facilitating its work.
The task force will include Dr Bhabatosh Biswas (former vice-chancellor, West Bengal University of Health Sciences, Kolkata), Dr Devender Singh Rana (chairperson, Sir Ganga Ram Hospital, Delhi), Dr Devi Prasad Shetty (chairperson and executive director, Narayana Healthcare, Bengaluru), Dr Gagandeep Kang (professor, Christian Medical College, Vellore), Dr JV Peter (director, Christian Medical College, Vellore), Dr Naresh Trehan (chairperson and managing director, Medanta Hospital, Gurugram), Dr Rahul Pandit (director, Critical Care Medicine and ICU, Fortis Hospital, Mumbai), Dr Saumitra Rawat (chairman & head, Department of Surgical Gastroenterology and Liver Transplant, Sir Ganga Ram Hospital, Delhi), Dr Shiv Kumar Sarin (head of department of Hepatology, Institute of Liver and Biliary Sciences, Delhi), and Dr Zarir F Udwadia (consultant chest physician, Hinduja Hospital Mumbai).
The cabinet secretary will be the convener and a member of the task force apart from secretary in the ministry of health and family welfare, who will also be a member.
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The bench added that the task force will be at liberty to draw upon the human resources of various ministries, departments and institutions of the central government for consultation and information and may also constitute one or more sub-groups on specialised areas such as infectious disease modelling, epidemiology, virology and critical care, for assisting it before finalising the recommendations.
The court’s order come on an appeal by the central government against initiation of contempt proceedings against it by the Delhi high court on May 4 over deficit in supply of medical oxygen to Delhi.
The bench will take up the matter next on May 17.
Delhi government officials did not respond to requests for comment.
“I think it is good that the SC has stepped in, the pandemic has become a political one-upmanship. All the parties should have been brought together to help people. There is a government that is favouring one state over the other, complete data is not being provided. It is all a disheartening mess. The logistics should be looked at but there shouldn’t be any restrictions on the use of essentials like oxygen,” said Dr T Jacob John, former head of the department of virology at Christian Medical College, Vellore.