GARG, J. - (1.) THIS writ petition under Article 226 of the Constitution of India has been filed by the petitioner on 5. 1. 2001 against the respondents with the prayer that by an appropriate writ, order or direction, the respondents be directed to reimburse all the expenses incurred by the petitioner on treatment of his Coronory Artery By Pass Surgery as Escort Heart Institute and Research Centre, New Delhi and all other ancillary tests performed by him at various Labs and Hospitals.
(2.) THE case of the petitioner as put forward by him in this writ petition is as follows :- THE petitioner is a member of Rajasthan Administrative Service and presently, he is working as Land Settlement Officer, Jodhpur. When the petitioner got himself checked at Government Mahatma Gandhi Hospital, Jodhpur, he was found suffering from Cardiac trouble and he was advised for stress thallium and since that facility was not available in the State of Rajasthan, the petitioner went to Delhi. A copy of the prescription dated 17. 1. 2000 by Dr. Sanjeev Sanghvi is marked as Annex. 1. THE further case of the petitioner is that at Delhi he had to undergo various tests for test of Stress Thallium and the petitioner was found suffering from two vessal disease and his left artery was 99% blocked. THE Coronary Angiography Reports of the petitioner dated 31. 1. 2000 by Dharma Vira Heart Centre, Sir Ganga Ram Hospital, New Delhi are marked as Annex. 3 and Annex. 4. THEreafter, the petitioner had to rush to the Escort Heart Institute and Research Centre, Delhi and he sent a message by fax on 1. 2. 2000 through Annex. 5 to Mahatma Gandhi Hospital, Jodhpur. On 4. 2. 2000, a Medical Board of doctors of Mahatma Gandhi Hospital, Jodhpur was constituted and the petitioner was advised for the coronary artery by pass surgery for which he was referred to All India Institute of Medical Sciences, New Delhi, but the petitioner insisted that he might be allowed to get his treatment at Escort Heart Institute and Research Centre, Delhi and for that, it was advised by the Medical Board that he would get reimbursement equivalent to All India Institute of Medical Sciences, as per Government order. THE further case of the petitioner is on 4. 2. 2000 his By Pass Surgery was performed at Escort Heart Institute and Research Centre, Delhi and for that, certificate Annex. 6 may be referred to. THE petitioner was discharged from Escort Heart Institute and Research Centre, Delhi on 10. 2. 2000 and a certificate to that effect is marked Annex. 8. THEreafter, the petitioner submitted all the bills for by pass surgery performed at Escort Heart Institute and Research Centre, Delhi and also bills of relevant tests performed by him, before the concerned authorities for reimbursement and they are marked as Annex. 9, Annex. 10 and Annex. 11 and the said bills are still pending with the respondents and no order for reimbursement of bills has been passed so far. Hence, this writ petition with the prayers as stated above. A reply to the writ petition was filed by the respondents and their case is that the matter in the case of the petitioner is under consideration and is in the process, but the petitioner has invoked the writ jurisdiction of this Court pre-maturely. THE further reply of the respondents is that as per the Raj Civil Service (Medical Attendance) Rules, 1970 (hereinafter referred to "as the Rules of 1970") and particularly Rules 6 and 7 with Appendix-II clearly provide that expenditure incurred on medical treatment is reimbursable only if a case is duly authorised/sanctioned by the competent authority. Furthermore, if the patient is required to be treated outside the State, in that case, he could get himself treated at the Institution/hospital mentioned in the Appendix-II appended to the Rules of 1970. Since the petitioner had moved to Escort Heart Institute on his own will though he was advised for treatment at All India Institute of Medical Sciences, Delhi, therefore, he was not entitled to reimbursement for the treatment which he had undergone at Escort Heart Institute and Research Centre, New Delhi. Hence, the writ petition filed by the petitioner be dismissed. I have heard the learned counsel appearing for the petitioner and the learned counsel appearing for the respondents and gone through the materials available on record. So far as the question that the petitioner was heart patient since 1999 and his coronary angiography was performed in Sir Ganga Ram Hospital on 31. 1. 2000, and his coronary artery by-pass surgery was performed at Escort Heart Institute and Research Centre, New Delhi on 4. 2. 2000 is concerned, there is no dispute on that point and for that, certificate Annex. 8 dated 7. 2. 2000 issued by the Escort Heart Institute and Research Centre, New Delhi may be referred to. There is also no dispute on the point that Medical Board of the Government Mahatma Gandhi Hospital, Jodhpur referred the case of the petitioner to All India Institute of Medical Sciences, Delhi, though at that time, the petitioner insisted that he might be allowed to get treatment at Escort Heart Institute and Research Centre, New Delhi. The question for consideration is whether in the above facts and circumstances, the expenses incurred by the petitioner for his By Pass Surgery at Escort Heart Institute and Research Centre. New Delhi may be reimbursed to him or not.
(3.) THE Hon'ble Supreme Court in Surjit Singh vs. State of Punjab (1), has observed as follows:- " It is otherwise important to bear in mind that self preservation of one's life is the necessary concomitant of the right to life enshrined in Article 21 of the Constitution of India, fundamental in nature, sacred, precious and inviolable. THE importance and validity of the duty and right to self- preservation has a species in the right of self defence in criminal law. Centuries ago thinkers of this Great Land conceived of such right had recognized it. Attention can usefully be drawn to versus 17, 18, 20 in Chapter 16 of the Garuda Purana (A dialogue suggested between the Divine and Garuda, the bird) in the words of the Divine :. . . . . . " Thus, from the above observations of the Hon'ble Supreme Court, it is clear that right to preserve health and obtain necessary medical aid in furtherance of self preservation is part of right to life. A Division Bench of this Court in Shankerlal vs. The State of Rajasthan and Ors. (2), after considering various authorities came to the following conclusions in respect of medical reimbursement :- (i) That Escort Heart Institute and Research Centre, New Delhi has been recognised as a referral Hospital for treatment of Heart ailment of Govt. servants including members of their families outside the State of Rajasthan and the name of this institution was inserted vide FD Office Memorandum No. F. 12 (12) FD (Gr. 2)/82 dated 24. 8. 89 by inserting entry No. (viii) under heading (d) `complicated heart surgery cases' as the last para of Finance Department Memorandum No. F 12 (1)FD (Gr. 2)/89 dated 21. 2. 1989. (ii) That the plea that because the petitioner-appellant has not obtained a certificate before availing the benefit of treatment in an approved Hospital outside the State of Rajasthan under Rule 7 (1) of the Rules, he is not entitled to any reimbursement cannot be sustained in the very nature of the facts and circumstances of the present case where it was physically impossible for the petitioner-appellant to have obtained a certificate from any authority at Delhi that such facility is not available within the State of Rajasthan. (iii) That if two Institutions/hospitals at one station have been identified as having facility of specialised treatment, to which reference can be made for medical attendance and treatment of a Government servant posed within the State of Rajasthan or to any member of his family for treatment of such disease and the government servant or any member of his family while spending time outside State at such place in the contingency mentioned under rule 6, suffers from such disease, he is entitled to avail treatment at either of the two institutions which are recognised for such specialised treatment. In such circumstances, it is not required that he should secure a certificate of non-availability of such treatments at any Govt. Hospital in Rajasthan, nor such a plea can be entertained that for availing treatment at any one of such institution at the same station, he has to avail a certificate of non-availability of treatment of any Govt. hospital of that place. (iv) That it would be strange proposition to accept that the petitioner ought to have obtained a certificate from Ali India Institute of Medical Sciences, New Delhi which itself is a recognized institution outside State for being referred to another approved Institution viz. Escort Heart and Research Institute, New Delhi for specialized treatment in Heard Surgery case that facility is not available at all India Institute of Medical Sciences, New Delhi and he should avail such a facility of treatment at Escort Heart and Research institute, New Delhi. (v) That we cannot loose sight of factual situation in the AIIMS New Delhi i. e. with respect to the number of patients received there for heart problems. In such an urgency one cannot sit at home and think in a cool and claim atmosphere for getting medical treatment at a particular hospital or wait for admission in some Government medical institute. In such a situation, decision has to be taken forthwith by the person or his attendants if precious life has to be saved. (vi) That the claim could not be denied on the ground that because the petitioner instead of waiting in queue and spending time in seeking a clarification from a local hospital has decided to act with promptitude in the interest of self preservation by taking his wife immediately to an institute approved by the State Govt. ;