Forcing Doctors to Work Over 12 Hours a Day is Unconstitutional, Violates Right to Life: Central Administrative Tribunal

Kochi: The Central Administrative Tribunal (CAT), Ernakulam Bench, has ruled that compelling medical officers to work for more than 12 hours within a 24-hour day is a violation of their fundamental right to life under Article 21 of the Constitution. The bench, presided over by Judicial Member P V Asha, directed the state authorities to rationalize the duty hours for doctors at ESI Hospital, Ernakulam, within three months.

The judgment emphasized that prolonged working hours not only infringe upon the doctors' human rights but also compromise the quality of patient care, which is integral to the public's right to health.

Background of the Case

The case was brought forward by Dr. Mohammed Ashraf and other Assistant Insurance Medical Officers at ESI Hospital, Ernakulam. They challenged a system where they were required to work a morning Out-Patient (OP) shift from 8 a.m. to 1 p.m. on the same day they were scheduled for a night shift from 8 p.m. to 8 a.m. This resulted in a total of 17 hours of duty within a 24-hour window.

The applicants argued this practice was discriminatory, pointing out that their counterparts in the Kerala Health Services Department were protected by a government order capping their duty at 12 hours per day.

Arguments Presented

Applicants' Contentions:

* Excessive Hours: The petitioners argued that working 17 hours in a day, even with a seven-hour break, is physically and mentally exhausting and amounts to a violation of their fundamental rights. * Discrimination: They highlighted the disparity with doctors in the Health Services Department, who are guaranteed a maximum of 12-hour workdays.

* Patient Safety: The applicants' counsel, Sri. Kaleeswaram Raj, contended that overworked doctors are more prone to errors, which could adversely affect patient safety and the quality of care. They stressed that the right to health is a fundamental right for patients.

* Violation of Human Rights: The plea cited the Universal Declaration of Human Rights (UDHR), which guarantees the right to rest and leisure and reasonable limitation of working hours.

Respondents' Defence:

* Scarcity of Doctors: The State of Kerala and hospital authorities argued that the two-shift system was necessary due to a shortage of medical officers. They claimed that introducing a third shift or granting a "pre-night off" would create an artificial scarcity of doctors and disrupt hospital services.

* Duty is Not Continuous: The government pleader, Sri. Jibu T.S, asserted that the 17-hour duty was not continuous, as doctors had a seven-hour break between the morning and night shifts.

* Established Practice: The respondents stated that this duty schedule has been in place since the inception of the department and is followed in other ESI hospitals.

Tribunal's Observations and Legal Precedents

The Tribunal firmly rejected the respondents' justifications, finding them insufficient to override fundamental and constitutional rights. Member P V Asha drew heavily on established legal principles and precedents.

• Human Dignity and Right to Life (Article 21): The Tribunal cited the Kerala High Court's landmark judgment in Seenath Beevi v. State of Kerala , which held that compelling nurses to work for 14 hours a day was illegal and unconstitutional. The Tribunal observed:

• > "If a practice is found to be in violation of the fundamental and constitutional rights and contrary to the constitutional obligation of the State, there is no justification in continuing such practice."

• Rejection of Administrative Excuses: The Tribunal dismissed the "scarcity of doctors" and "financial stringency" arguments as unjustifiable reasons to compel long working hours. It held that it is the government's duty to create sufficient posts to meet patient needs.

• > "The respondents are duty bound to protect the health of everyone including the patients as well as Doctors. The patients would be able to avail the qualitative service from the Medical Officers if they are also given sufficient leisure time for which rationalization of duty hours is required."

• Constitutional and International Obligations: The judgment underscored the state's obligation under Articles 38 and 42 of the Constitution to ensure just and humane working conditions, in line with international standards set by the Universal Declaration of Human Rights .

Final Decision

The Central Administrative Tribunal allowed the application and issued a clear directive to the respondents, including the State of Kerala and the Superintendent of ESI Hospital, Ernakulam.

The Tribunal ordered the authorities to ensure that the duty hours of the medical officers are fixed in a manner that they are not compelled to work more than 12 hours within a 24-hour duty day. This change must be implemented within three months from the receipt of the order, bringing the applicants on par with their colleagues in the Health Services Department.