Thread by @barandbench

A Division Bench of Delhi High Court begins hearing appeal against order which stayed Delhi Govt's decision to reserve 80% ICU beds in more than 30 private hospitals for #COVID19 patients.

@CMODelhi @LtGovDelhi

In September, a Single Judge Bench of Justice Navin Chawla had stayed the decision on the ground that prima facie, it was arbitrary, unreasonable and violative of Article 21 of the Constitution.

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Delhi Government's appeal is being heard by a Division Bench of Justices Hima Kohli and Subramonium Prasad.

#ICUbeds #COVID19

@LtGovDelhi @CMODelhi

Court asks as to why short written submissions were sent by the Respondent, Association of Healthcare Providers, to the court master late at night.

Don't take for granted our court mastesr: Court

This is not an adversarial litigation. The decision is only for two weeks and we will review it. There is a lot of pressure for ICU beds : ASG Sanjay Jain for Delhi Govt

There is a heavy demand for ICU beds in private hospitals. Only 33 private hospitals were chosen out of 115 private hospitals with ICU beds: Jain

What is the rationale? How did you select these 33? : Court

Based on location.. they are spread across the city : Jain

Did you do a random selection or did you study the infection density etc? : Court

Situation has changed.. how many are in the central district which has the most cases? : Court

Non of the private hospitals are before court : Jain

You've argued maintainability before the Single Judge. We are on interim relief: Court

What is the area which covers central district? Tell us the number of Pvt hospitals: Court

We will have Ganga Ram, HASC Pusa Road, DLK.. : Jain

How have you done your exercise? Have you seen the population density and extent of infection? One of the petitioners Rakesh Malhotra had to go all the way to Dwarka for his treatment : Court

These 33 hospitals were picked up for this purpose only.. idea was .. : Jain

What was tha rationale? How did you pick these? : Court

On everyday basis, real time data was analysed. These 33 hospitals had substantial beds : Jain

What are HDU? : Court

High dependency units: Jain

Your order is outdated. Situation has changed from September. Yardstick will not be the same : Court

It has become more relevant: Jain

The situation today is much more concerning.. the office of cmo has forwarded yesterday's order to the Disaster management authority: Jain

Instead of 80% for 33 hospitals, why don't you spread it over to all .. the reservation percentage will come down : Court

1742 is the 80% ICU beds: Jain

#COVID19

All private hospitals have dedicated 1831 beds for COVID patients. 1238 beds were given by the 33 private hospitals before the decision, on their own. 1742 will be reserved by them if the decision is implemented: Jain

What is the balance ICU beds available in other remaining hospitals? : Court

2080 ICU beds in 80 hospitals : Jain

What kind of exercise did you do to exclude them? Why didn't you not include them and bring down the percentage? : Court

It's not that they are not giving beds to #COVID19 patients: Jain

Non COVID ICU beds as on 11/11/2020 are used either for planned surgery or emergency. Planned can be deferred. Total occupancy is only 74%: Jain

We may consider reserving more beds in remaining hospitals: Jain

Have you done a geographical check? Have you mapped Delhi? You have done Sero Surveillance : Court

As regards Central Delhi, hospitals taken already have a large number of beds. The government facilities are also there: Jain

We will look into it immediately and address, augment the situation for Central Delhi: Jain

Why such knee jerk reactions.. numbers are far higher than September.. : Court

We can always be wise in hindsight.. : Jain

It can't be accepted as an argument. Be cognizant of the situation ona min to min basis: Court

I'm saying evaluate this notification in today's touchstone and not September: Jain

People are having to travel from one end of Delhi to other.. if beds are reserved across, this situation will not arise : Court

It is spread all over the city. These hospitals have larger ICU beds. Patients prefer these reserved hospitals over others. If beds are already occupied by non COVID patients, you don't have to throw them: Jain

We will give wide publicity to these hospitals. We want to take care of the current situation. : Jain

Which hospital did you exempt from the list ? It's Hindu Rao hospital: Court

Empower me today to deal with this dynamic situation .. empower me for 15 days. I will take instructions on Hindu Rao Hospital and Central Delhi : Jain

If we have fallen short, we will immediately take care: Jain

Delhi Govt has to be more alive to the situation which the whole city can see for itself: Court

There will be a meeting of the Disaster management authority to take stock of the situation: Jain

You have been pushed into it.. you would have done it yourself. You are doing everything under the sun to unlock everything: Court

Unlock norms are spelt out by national disaster management authority. We have to seek instructions from Central Government too : Jain

If some shortcomings are there, it ought not eclipse the current situation: Jain

What weighed with you when you exempted Hindu Rao? Radha Swami facility also has ICU beds : Court

Hindu Rao is an MCD hospital and there were issues of strike by doctors due to non payment of salaries: Adv Sanjoy Ghose for Delhi Govt

We were told salaries were paid in September. That's another litigation: Court

What about Radha Swami facility?: Court

There are 10k beds. Not all are functional because less than 2k people have come : Jain

2k beds are functional because we've not had more than this number there. 200 are oxygenated beds: Jain

What about transportation? Why don't you transport patients from overflowing govt hospitals to the facility ? How many have you transferred? : Court

What have you done to divert overflow from govt hospitals to Radha Swami hospital? : Court

These are the class of people who are dependent on you: Court

I will have to get thr figures: Jain

Which way are you going? Take it as curiosity of the Court and not criticism: Court

We are not letting private hospitals off the hook : Court

It is not idle curiosity. What kind of due diligence did you do to say only these 33 hospitals were needed .. there is a complete change in circumstances in Delhi : Court

You are sticking to your guns according to September order. according to us the order is outdated: Court

Hospitals run themselves on commerical logic.. they have bills to pay and they have duty to State also. But why did you choose to not pick the 82 remaining hospitals: Court

Not saying that you cannot formulate a policy but we're asking how : Court

Take a passover and get all the information : Court

Nobody is against the State. Others also have to chip in including the Respondents. These questions that we are asking will also be asked by the Single Judge : Court

Please satisfy our judicial conscience. Please take a passover: Court

Matter to be taken up in some time.

Hearing resumes.

Keep in mind that you're addressing the court on health of citizens: Court tells Senior Adv Maninder Singh for Association of Healthcare Providers.

It's not adversarial: Singh

We can begin now or we can wait if you are still seeking instructions: Court

We need five more mins: Jain

Hearing to resume in five minutes.

Bench joins the hearing.

In Central Delhi, 6 hospitals are included: Jain

Ganga Ram city, BLK, St Stephen's, Tirathram, Parmanand .. Apart from six, there are five more in central Delhi : Jain

For these 6 .. allocated COVID ICU beds is 212 out of 456 beds. After reservation, 365 would go to #COVID: Jain

Because of doctor strike, Hindu Rao was not chosen and 30 patients were shifted out: Jain

The strike has been recalled to the best of our knowledge: Court

We will ask. As regards Radha Swami, it is a COVID care centre not an ICU centre. Some beds have oxygen facility..govt will not take more than a day to operationalize all the beds : Jain

Occupancy has always remained below 2k. If required, entire 10k beds can be operationalized : Jain

For Radha Swani, 20 dedicated ambulances are there: Jain

Over and above, Delhi govt is ensuring 600 ambulances: Jain

Further steps are being taken .. a notification was issued to ensure that even if one COVID bed is available, private hospitals will not refuse admission to COVID patients : Jain

My instructions are that there may again be a strike in Hindu Rao : Jain

33 hospitals were chosen on three factors. Largest chunk of ICU beds ie 2217 beds was available with them.. Others have 1051 ICU beds: Jain

Why couldn't you evenly divide? : Court

The remaining hospitals have lesser number of ICU beds and they would not be able to treat non COVID patients. There is absence of facility for segregation also : Jain

Some have been asked to reserve 20% , some have been asked to reserve 40% : Jain

They have dedicated 1238 as against 1742 : Jain

For remaining hospitals, they are on their own reserved 620 beds.. whatever was possible as per their capacity: Jain

Large number not people go by name of the hospital. People prefer Max, then Gangaram and Apollo These 33 hospitals are the preferred choice of people: Jain

These hospitals have the possibility of extension of ICU facility also because of their size: Jain

Adequate number of beds for non COVID patients can be accommodated.. : Jain

To sum up, we are praying that in the current scenario when 8k patients are being added every day.. people are hunting for beds in preferred hospitals.. we are not trying to impose..: Jain

Court may allow us this window for two weeks : Jain

What is your response for 15 days: Court asks Senior Adv Maninder Singh who appears for Association of Healthcare Providers.

This cannot be allowed: Singh

There was no data shown when the stay order was passed. All data given today orally is contrary to the affidavit: Singh

The figure given today for 80% beds is 1742. It is only 1515 on affidavit: Singh

Total says 1841. 80% is 1473. As per chart given, the availability in 33 hospitals is 1238: Singh

At any given point of time, two factors are there. There are emergency patients who occupy 20-30 % ICU beds. 20-25% is occupied by existing patients : Singh

So 50% is required by non COVID emergency patients: Singh

We are in an appeal. Your defence is in the writ. We are only on interim arrangement. You will go back to single judge: Court

Without compulsion of the order 60-70% beds are being given to COVID patients: Singh

If there is a critical patient who goes to one of these 33 hospitals and even if there is a reserved bed vacant, he will not get it : Singh

I cannot deny ICU bed to a similarly critical non COVID patient: Singh

I follow this 80% today.. I will have to keep ICU bed vacant to wait for COVID patients: Singh.

It is misleading.. there was no consideration at initial stage. Now it is matter of optics because numbers are increasing: Singh

What is the great magic in 80% figure? : Singh

They will explain all this before the single judge. We want to ask you if they have filed this document (on data) before the single judge? : Court

We will permit them to file anything apart from the counter to justify the 80%: Court

Percentage is non material, vacancy is the question: Singh

Have any non patients died because of denial of bed? There is a possibility and not that they have died : Court

Singh shares more data on ICU beds.

Today vacant beds for COVID is 520 and 405 for non COVID : Singh

Shortage can be met by augmentation and not that you can snatch from one category: Singh

Augmentation is long term. We are on short term right now : Court

If doctors are not paid, you we destroying a facility: Singh

That's Municipal Corporation hospital : Court

Addition of beds is not just putting beds but also other infrastructure: Singh

Augmentation is not that you take away..clear violation of art 21: Singh

Singh reads the order in question.

Most hospitals have no space to increase the number of beds : Singh

They say it's non adversarial but our representation was not decided till date : Singh

Is there a nodal officer to coordinate between the various hospitals to have some play in the joints?: Court

Nodal officers are in every hospital: Jain

They are not for this purpose: Court

Immediate instructions can be given: Jain

Our figure is different because hospitals have augmented ICU beds and children's beds are also being considered: Jain

If a hospital has more than 20% non COVID patient, they need not be moved: Jain

But thereafter it has to be reserved for COVID patient: Court

You can't admit COVID patient along with non COVID patient: Court

The segregation has to be complete.. you will infect everyone : Court

Yes, Non COVID has to be seperated from COVID: Jain

In most hospitals, ICU beds are together and segregation is not possible: Singh

We have to go the extra mile for segregation: Jain

There is a a turnover period .. it is w dynamic figure: Jain

For dynamic figure, you have to be flexible: Court

If it's ba policy with logic and rationale.. we can review it. We are saying that you create some play in the joints: Court

Your health desk is managed by clerical staff. What is your constructive input. Court is not a health expert: Court

Jain acknowledges the concerns qua non COVID patients.

If a patient suffering from heart attack comes to the hospital, will you deny him a bed which is lying vacant? : Court

We can't give it to him because it will be in COVID patients area : Jain

Can you give on affidavit that all these 80% beds are in segregated COVID area? : Court

Yes, COVID ICU beds will be physically segregated: Jain

There is a nodal officer who will supervise it: Jain

This will create a chaos: Singh

There is nothing on affidavit. Everything is across the bar : Singh

Whenever segregation is possible, it is possible.. : Singh

Give us the figure: Court

Court begins dictating the order.

Court records the order passed by Delhi Govt on reservation of ICU beds.

Court records the stay order passed by Single Judge.

Court further records that the Delhi govt also moved an appeal before the Supreme Court.

Supreme Court expressed a view that parties will request the DB will take up the LPA .. pursuant to the order.. it was marked to this court: Court

Court records the submissions made by the parties.

Situation is dynamic is Delhi. Delhi Govt must keep its hand on the pulse to be able to cope up with the situation: Court

A blanket order on reservation of 80%ICU beds in 33 hospitals may not be in the best interest of non COVID patients: Court

#COVID19

A special secretary, health is being appointed : Jain

He has been designated. For every hospital there is a nodal officer: Jain

One nodal officer can monitor 1-2 hospitals. How many nodal officers are there: Court

There is one nodal officer for each hospital and then one for each district: Jain

What is his power? : Court

Thanedari on doctors cannot be allowed: Singh

If there is no reservation, it is the hospital's discretion. Segregation is being monitored on daily basis: Jain

Court records the submission.

If such a network is available, these nodal officers are in a position to relax the norm of 80% for these hospital without strictly adhering to the Delhi Govt decision: Court

No person in a health emergency can be allowed to run from pillar to post when there is a bed available: Court

If required, how do I admit a non COVID patient: Jain

Just gather the data for the past two weeks : Court

Actual occupancy was much lesser than the non reserved beds : Jain

Court records the submission.

In view of the present situation in Delhi, the spiralling cases and the ground reality which is different from how it was when the stay order was passed, the stay order on reservation is vacated : Court

Court directs Delhi Govt to file an additional affidavit on material information before the Single Judge.

Respondent to reply to it.

Matter listed before Single Judge on November 26.

Make sure that none of you take an adjournment.. the 80% order will continue till then : Court

Hearing adjourned.

Delhi High Court vacates stay on reservation of 80% ICU beds for Covid-19 patients in 33 private hospitals

reports @aditi2118

#Covid_19 #DelhiHighCourt

@CMODelhi @LtGovDelhi

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