Delhi Govt vs LG: Will Delhi COVID patients pay the price of opening of hospitals for all?
While opening up hospitals for all might look like a humanitarian decision, it could end up jeopardising the entire health infrastructure if the facilities are not ramped up accordingly. By July end, Delhi alone is projected to have 5.5 lakh COVID patients.
In the middle of a global pandemic, the national capital is witnessing a political slugfest. By overturning the Arvind Kejriwal government’s order, Lieutenant Governor Anil Baijal has jumped into the tug of war between the Centre and the Delhi government. It goes without saying that he is fighting the war on behalf of the Centre.
The fast increasing COVID-19 cases in the capital forced the Aam Aadmi Party-led government to reserve hospitals – including the private ones – exclusively for Delhi residents. However, it was not applicable to the hospitals that are under the control of the Central government.
The order attracted sharp criticism from the Opposition parties, including the Bharatiya Janata Party and the Congress. Arvind Kejriwal himself received flak from a number of people who dubbed the order as “divisive” and discriminatory in nature.
On Tuesday, moments before the state disaster management authority (DDMA) meeting, Delhi Health Minister Satyendar Jain made a surprising admission. He subtly stated that the community spread of COVID-19 has begun in the national capital as the infection history of 50 per cent patients could not be traced. He maintained, however, that it is upto the Centre as to whether they want to declare it or not.
Jain and Deputy Chief Minister Manish Sisodia attended the DDMA meeting chaired by LG Baijal. The showdown between the two power centres in Delhi went along expected lines. When Sisodia and Jain stepped out of the meeting, they said that the LG has refused to reconsider his decision of overturning the Delhi government’s hospital reservation order.
Dy CM Sisodia, sharing the COVID growth rate projections, said that Delhi will have 1 lakh COVID cases by June 30 and that the numbers will reach 5.5 lakh towards the end of July.
He emphasised that these growth rate projections were based on Delhi COVID patient data and that the numbers could further spike as the LG has opened Delhi hospitals to everyone.
Sisodia escalated the rift by placing the ball firmly in the Centre’s court. “Who will take the responsibility? Who will arrange the beds for the Delhi COVID patients and additional COVID patients coming from other states?,” he questioned.
Meanwhile, after the meeting, LG Baijal also underlined that he has directed that “admission of eligible COVID positive patients (are) to be ensured as per protocol.” He further said that the stakeholders have been asked to “conduct thorough contact tracing of affected persons and testing as per ICMR guidelines for COVID-19 testing without any deviation.”
The Raj Niwas made it clear that Delhi’s hospitals will admit everyone and also dismissed Health Minister Jain’s claims of community spread in Delhi.
Notably, LG Baijal had, while striking down Kejriwal’s hospital reservation order, said that denying medical treatment on the grounds of not being a Delhi resident is “impermissible”, whilst citing the Delhi High Court verdict.
Meanwhile, Delhi CM Kejriwal had gone into self-isolation. On Tuesday evening, he tested negative for COVID-19. Earlier on Monday, reacting to Baijal’s decision he had said, “LG’s order has created a big problem and massive challenge for Delhi residents” as it would be an uphill task to arrange medical facilities for patients coming from across the country.
LG साहिब के आदेश ने दिल्ली के लोगों के लिए बहुत बड़ी समस्या और चुनौती पैदा कर दी है— Arvind Kejriwal (@ArvindKejriwal) June 8, 2020
देशभर से आने वाले लोगों के लिए करोना महामारी के दौरान इलाज का इंतज़ाम करना बड़ी चुनौती है।शायद भगवान की मर्ज़ी है कि हम पूरे देश के लोगों की सेवा करें।हम सबके इलाज का इंतज़ाम करने की कोशिश करेंगे
Return of the slugfest?
LG Baijal’s decision to block the Kejriwal administration’s order could just be the beginning of another long drawn out battle between the Secretariat and the Raj Niwas.
The AAP, during its first tenure, had locked horns with two LGs; first Najeeb Jung and then Baijal. Kejriwal, his government and his party had fought a battle on all fronts – through the administration, in the court, and on the streets. The ugliest chapter of the rift between the elected government and the Centre’s appointee possibly took place when Kejriwal, along with his cabinet ministers, staged a sit-in dharna inside the Raj Niwas in July 2018.
While the Delhi CM was sitting in a dharna inside the LG House, AAP had mobilised thousands of volunteers outside. This protest set the stage for the demand of full statehood for Delhi and reducing the powers vested with the LG’s office.
In another stand-off, Jung had blocked the bills passed by the Delhi assembly. The transfer posting of officers without the AAP government’s approval kept triggering the tussle between the LG and the CM between 2015 and 2019.
The Supreme Court 2018 order brought some much-needed relief for the AAP government. It put an end to the intervention of the LG’s office in their day-to-day administrative work.
Importantly, the Lok Sabha debacle forced AAP to re-strategise its relationship with Prime Minister Narendra Modi, the Centre, and the LG’s Office. After winning the 2020 assembly election, both Kejriwal and LG Baijal worked to reduce the possibility of conflict.
However, the Delhi government’s hospital reservation order has reopened the battleground. The AAP government’s argument, as to how it will cater to the patients coming from other states, remains unanswered.
Morality vs pragmatism: Can Delhi’s healthcare bear the additional load of COVID patients from other states?
The flak that the Kejriwal government has faced over the hospital reservation order was based more on moral grounds. The order aimed at denying treatment to non-Delhiites was discriminatory.
The erstwhile order said that all hospitals operating in the national capital – except those under the Centre’s control – would be reserved for bonafide Delhi residents only. This would have denied medical treatment to patients from other states of the country. The order also had the potentials of disenfranchising students, daily wage workers, and other marginalised groups who live in Delhi but don’t have a proof of address to show. These people could be living in rented rooms and apartments and contributing to the wellbeing of Delhi’s economy, but might not have any documents to prove that they are residents of the national capital.
However, in the government’s defence, it had made allowances for the treatment of those who could show a letter posted to a Delhi address, besides a range of other documents.
On moral grounds, denying medical treatment on the basis of whether one is a bonafide resident or not – that too during a pandemic – must be impermissible. There is no denying that such decisions are capable of risking hundreds of lives at a time of emergency.
If the trend is followed by other states, it could lead to a complete breakdown of health services across the country.
However, a closer and more pragmatic reading of the situation might give a different understanding of the situation. Hospitals in Delhi witness a large influx of patients from neighbouring districts, such as those located in West Uttar Pradesh and Haryana’s Faridabad, Gurugram, Sonipat and adjoining districts. It also sees patients pouring in from other states of the country. Even when the situation is normal (i.e. not a pandemic), the lack of decent health infrastructure in these areas places an additional burden on Delhi’s hospitals.
Like any other state in the country, Delhi prepared to cater to the COVID-19 patients being traced within its own state boundaries. Despite the lockdown measures and efforts such as Operation SHIELD to reduce the spread of the deadly virus in the containment zones, Delhi continues to be the third-worst COVID-hit state. It has over 230 containment zones.
Opening up the Delhi hospitals to treat everyone will increase the pressure on an already overburdened health infrastructure.
According to Dy CM Sisodia, the COVID growth rate projections of Delhi show that the cases are doubling every 12-13 days. He said that in the DDMA meeting it was agreed that by June 30 Delhi will have 1 lakh COVID cases and will require 15, 000 beds.
Further expanding on the projections, he said that Delhi will have roughly 2.25 lakh cases and will need 33,000 beds by July 15.
By the end of July, Delhi is projected to record 5.5 lakh cases. “By July 31st, we will need 80,000 beds,” Sisodia said.
All these projections are Delhi COVID patient data. Until June 8, nearly 30,000 COVID cases were traced in the national capital.
Importantly, as per the Delhi government application, Delhi has 8,872 beds in total – including those in private hospitals - reserved for COVID patients. A little over 4000 of these beds are free today. Of the 509 ventilators, 320 are occupied.
If patients from other states start rushing to the national capital, the number of unoccupied beds and ventilators will start dwindling. If the health infrastructure is not ramped up accordingly, the system is likely to collapse.
It is important to note that Delhi is only preparing beds for around 14 per cent of the total COVID patients expected by the end of July. If the state government fails to prepare for the fluctuating patient rush, both patients from within Delhi and from outside Delhi will have to pay the price.
"(ML) Khattar and Yogi (Adityanath) governments have failed. Their health infrastructure has collapsed. As cases are increasing in adjoining districts such as Noida, Ghaziabad, Gurugram, the BJP has made the LG overturn the (Kejriwal government) order. It has been done on the instructions of the BJP," AAP MP Sanjay Singh said after attending the all-party meeting at the Raj Niwas.
Meanwhile, Adesh Kumar Gupta, Delhi BJP president, said that almost all parties agreed that the Kejriwal government's decision of not testing asymptomatic people and reserving beds for Delhi residents was wrong.