The Rajasthan Right To Health Act, 2022

[7 of 2023]

[12th April 2023]

An Act to provide for right to health and to make provisions ancillary, conducive and incidental thereto.

Whereas, the State of Rajasthan aims, to provide protection and fulfilment of rights and equity in health and well-being under Article 47 of Constitution of India and to secure the Right to Health as per the expanded definition of Article 21 of Constitution of India and, also to provide for free accessible to and equality in, health care for all residents of the State with the progressive reduction in out of pocket expenditure in seeking, accessing or receiving health care;

And whereas, the Rajasthan Model of Public Health may usher the State in the era of improved Public Health;

And whereas, every resident of the State of Rajasthan is entitled to enjoy the highest attainable standard of physical, mental, intellectual and social well-being and state of health, which is conducive to living a life in dignity;

And whereas, the right to health is an inclusive right extending not only to timely health care but also to the underlying socio-economic, cultural and environmental;

And whereas, to address the persisting iniquitous accessibility and denials in the matter of healthcare in the State;

And whereas, the Government of Rajasthan is committed to ensure that people's rights to health are realized. The most important stakeholders in fulfilment of right to health are the people themselves. Therefore, people's participation is crucial and critical for realization of people's right to health services;

And whereas, need to set a broad legal framework to ensure availability, accessibility, acceptability, equity and quality comprehensive health care services and functions including powers to respond to public health emergencies. Therefore, be it enacted by the Rajasthan State Legislature in the Seventy-fourth Year of the Republic of India, as follows:-

Section - 1. Short title, extent and commencement

(1)     This Act may be called the Rajasthan Right to Health Act, 2022.

(2)     It shall extend to the whole of the State of Rajasthan.

(3)     It shall come into force on such date as the Government may, by notification in the Official Gazette, appoint.

Section - 2. Definitions

In this Act, unless the context otherwise requires,-

(a)      "accidental emergency" means any unforeseen, unexpected or unintentional occurrence of an event which results in the risk of death or injury to any person and includes road, rail, water or air accident;

(b)      "bioterrorism" means the international use of any microorganism, virus, infectious substance (including toxins), or biological product that may be engineered as a result of biotechnology, or any naturally occurring or bioengineered component of any such microorganism, virus, infectious substance, or biological product to causes, death, disease or other biological malfunction in a human, an animal, a plant, or another living organism;

(c)      "clinical establishment" means establishments defined as a clinical establishment under clause (c) of section 2 of the Clinical Establishment (Registration and Regulation) Act, 2010 (Central Act No. 23 of 2010);

(d)      "designated health care centres" means health care centres as prescribed in the rules;

(e)      "emergency" means accidental emergency, emergency due to snake bite/animal bite and any other emergency decided by State Health Authority;

(f)       "emergency care" means any reasonable measure to render first- aid, advise or assistance to an injured person of an accident or incident of crime or any other emergency;

(g)      "emergency obstetric care" means to treat (and therefore save the life of) a woman experiencing a complication of pregnancy or childbirth;

(h)     "epidemic" means occurrence of cases of disease in excess of what is usually expected for a given period of time and includes any reference to "disease outbreak" nevertheless specifically stated otherwise;

(i)       "first aid" means the immediate basic care given to an injured person of an accident or crash or incident of crime or any other emergency situation so as to stabilise his condition by any person including a medical professional before any decisive treatment;

(j)       "Government" means the Government of Rajasthan;

(k)      "government funded health care services" means the health care services funded and provided by the Government or those provided by the non-government entities but for which Government funds part or whole of the costs of care to some or all patients;

(l)       "health care" means testing, treatment, care, procedures and any other service or intervention towards a preventative, promotive, therapeutic, diagnostic, nursing, rehabilitative, palliative, convalescent, research and/or other health related purpose or combinations thereof, including reproductive health care and emergency medical treatment, in any system of medicines, and also included any of these as a result of participation in a medical research program;

(m)    "health care establishment" means the whole or any part of a public or private institution, facility, building or place, whether for profit or not, that is operated to provide inpatient and/or outpatient health care, and a "public health care establishment" shall accordingly refer to a health care establishment set up, run, financed or controlled by the Government;

(n)     "health care provider" means a medical doctor, nurse, other paramedical professional or other appropriately trained and qualified person with specific skills and licensed or certified relevant to particular health care, nursing, rehabilitation, palliative, convalescent, preventative or other health services, and any reference to "service provider" shall mean the same unless specifically stated otherwise;

(o)      "informed consent" means consent given, specific to a proposed health care without any force, undue influence, fraud, threat, mistake or misrepresentation and obtained after disclosing to the person giving consent, either for himself, or in representative capacity wherever it is necessary, all material information including costs, risks, benefits and other significant implications of, and alternatives to, the proposed health care in a language and manner understood by such person;

(p)      "outbreak" means an epidemic limited to a localized increase in the incidences of a disease;

(q)      "Panchayati Raj Institutions" means institutions of local selfgovernment established under any of the States Panchayati Raj laws, at village, block, or district levels, like Gram Panchayat, Panchayat Samiti, or Zilla Parishad, or by whatever other name called, and any reference to "PRI" shall mean the same;

(r)      "prescribed" means prescribed by rules made under this Act;

(s)      "public health" means the health of the population, as a whole, especially as monitored, regulated, and promoted by the Government;

(t)       "public health institution" means governmental organizations that is operated or designed to provide in-patient or out-patient treatment, diagnostic or therapeutic, interventions, nursing, rehabilitative, palliative, convalescent, preventative, promotive, medical research program or other health services to public;

(u)     "public health emergency" means an occurrence or imminent threat of illness or health conditions that-

(a)      is believed to be caused by any of the following:-

(i)       bioterrorism,

(ii)      the appearance of a novel or previously controlled or eradicated infectious agent or biological toxin,

(iii)     a natural disaster,

(iv)    a chemical attack or accidental release,

(v)      a nuclear attack or accident; and

(b)      poses a high probability of any of the following harms:-

(i)       a large number of deaths in the affected population; or

(ii)      a large number of serious or long-term disabilities in the affected population; or

(iii)     widespread exposure to an infectious or toxic agent that poses a significant risk of substantial future harm to a large number of people in the affected population;

(v)      "regulations" means the regulations made by the Authorities under this Act;

(w)     "resident" means an ordinary resident of the State of Rajasthan;

(x)      "rules" means rules made under this Act;

(y)      "stabilise" means the rendering of any immediate emergency care of the injured person as may be necessary to assure within reasonable medical probability, that no material deterioration of the condition of such injured person is likely to result from or occurred during the transfer of such injured person from one hospital to another, where such appropriate facilities are available to render the requisite treatment;

(z)      "social audit" means the audit conducted by the community using the social dimension; and

(za) "transfer or transport" means the movement (including the referral) of an individual outside a hospitals facilities at the direction of any designated health care provider or hospital but does not include an individual who has been declared dead or leaves the facility without the permission of the health care provider attending him.

Section - 3. Rights to health

Every resident in the State of Rajasthan shall have the following rights:-

(a)      to have adequate relevant information about the nature, cause of illness, proposed investigations and care, expected results of treatment, possible complications and expected costs;

(b)      to avail free OPD services, IPD services consultation, drugs, diagnostics, emergency transport, procedure, and emergency care as provided by all public health institutions accordantly to their level of health care as may be prescribed by rules made under this Act;

(c)      to have emergency treatment and care for accidental emergency, emergency due to snake bite/animal bite and any other emergency decided by State Health Authority under prescribed emergency circumstances, without prepayment of requisite fee or chargesincluding prompt and necessary emergency medical treatment and critical care, emergency obstetric treatment and care, by any public health institution, health care establishment and designated health care centres, qualified to provide such care or treatment accordantly to their level of health care, promptly as prescribed or as per guidelines and in a case of medico-legal nature of case, no health care provider or health care establishment shall delay treatment merely on the grounds of receiving police clearance or a police report:

Provided that after proper emergency care, stabilisation and transfer of patient, if patient does not pay requisite charges, healthcare provider shall be entitled to receive requisite fee and charges or proper reimbursement from State Government in prescribed manner as the case may be.

Explanation.- A medico-legal case means any medical case whichhas legal implications, either of a civil or criminal nature, and includes but is not limited to cases relating to accidents, assault, sexual assault, suicide, attempt to murder, poisoning, injuries on account of domestic violence, injuries to workers during course of employment, in some of which the service provider may be required to prepare documents in compliance with demands by an authorised police-officer or Magistrate;

(d)      to have the right to avail free health care services from public health institution, health care establishment and designated health care centres in the prescribed manner and subject to be terms and conditions specified in the rules;

(e)      to have access to patient records, investigation reports and detailed itemized bills of treatment;

(f)       to know the name, professional status and job chart of the person who is providing health care;

(g)      to informed consent prior to specific tests or treatment (e.g. surgery, chemotherapy etc.) from all health care establishments;

(h)     to confidentiality human dignity and privacy during treatment at all health care establishments;

(i)       to the presence of female person, during physical examination of a female patients by a male practitioner;

(j)       to choose alternative treatment available at any health care establishments;

(k)      to have treatment without any discrimination based upon illness or conditions, including HIV status or other health condition, religion, race, caste, sex, age, sexual orientation or place of birth of any of them at all health care establishments;

(l)       to have information about the rates or charges for each type of service provided and facilities available;

(m)    to choose source of obtaining medicines or tests at all health care establishments;

(n)     to patients education about health condition;

(o)      to safe and quality care according to standards prescribed for the health care establishments;

(p)      to referral transport by all health care establishments, whether public or private, in the prescribed manner;

(q)      to have treatment summary in case of a patient leaving health care establishment against the medical advice;

(r)      to be heard and seek redressal in case of any grievance occurred during and after availing health care services;

(s)      to avail free transportation, free treatment and free insurancecoverage against road accidents at all health care establishments accordantly to their level of health care available in the health care institution for emergency care, first aid or stabilize and transfer as per guidelines with appropriate financial provisions by State Government in the prescribed manner and subject to the terms and conditions specified in the rules; and

(t)       to obtain treatment records and information from the treating health care establishments to seek second opinion from another health care professional or health care establishment.

Section - 4. Responsibilities, Rights and Duties

(1)     Residents and patients shall have the responsibilities and duties towards healthcare establishments and healthcare workers as adopted by the National Human Rights Commission in the prescribed manner and as specified in the rules.

(2)     Health care providers and establishments will have rights and responsibilities visà -vis patients in the prescribed manner as specified in the rules.

Section - 5. Obligation of Government

The Government shall have the following general obligations, by enhancing the quantum of the resources in time bound realization of health and well-being of every resident in the State:-

(a)      to formulate and prescribe a model of public health known as "Rajasthan Model of Public Health";

(b)      to make appropriate provision in the State budget;

(c)      to develop and institutionalize Human Resource Policy for Health to ensure availability and equitable distribution of doctors, nurses and other ancillary health professionals and workers at all levels of healthcare as may be prescribed;

(d)      to set up the quality audit and grievance redressal mechanisms as may be prescribed;

(e)      to align all health services and schemes to strengthen a system of health services to empower and make residents aware for preventive, promotive and protective health care, not merely an absence of disease;

(f)       to lay down standards for quality and safety of all levels of health care as may be prescribed;

(g)      to make availability of Government funded healthcare services as per distance or geographical area or considering population density which includes health care institutions, free medicine, test and diagnostics of notified items and ambulance services as per standards as may be prescribed;

(h)     to ensure that there is no any direct or indirect denial to anyone for any government funded health care services at such Public Health Care Institutions and designated health care establishment and such guaranteed services as may be prescribed;

(i)       to mobilize resources and frame plans or policies to carry out obligations under this Act;

(j)       to set up co-ordination mechanisms among the relevant government departments to facilitate nutritionally adequate and safe food, adequate supply of safe drinking water and sanitation;

(k)      to institute effective measures to prevent, treat and control epidemics and other public health emergencies; and

(l)       to take appropriate measures to inform, educate and empower people about health issues.

Section - 6. Constitution of State Health Authority

The Government shall, by notification in the Official Gazette, constitute two independent bodies known as the State Health Authority for logistical grievances and State Health Authority for treatment protocols.

(i)       State Health Authority for logistical grievances State Health Authority for logistical grievances consisting of the following members, namely:-

(a)      An Officer of Indian Administrative Service, not below the rank of Secretary to be appointed by the State Government - Ex-officio Chairperson;

(b)      Vice- Chancellor of RUHS, Jaipur - Ex-officio Member;

(c)      Joint Secretary, Medical and Health - Ex-officio Member Secretary;

(d)      Director, Medical and Health - Ex-Officio Member;

(e)      Commissioner, Medical Education - Ex-Officio Member;

(f)       Principal, SMS Medical College, Jaipur - Ex-Officio Member;

(g)      A nominee of Ayush Department from Director Ayurveda, Homoeopathy, Unani on rotation basis - Ex-Officio Member;

(h)     Two Members, nominated from Indian Medical Association Rajasthan State - Member.

(ii)      State Health Authority for Treatment Protocol State Health Authority for Treatment Protocol consisting of the following members, namely:-

(a)      Vice Chancellor of RUHS, Jaipur - Ex-officio Chairperson;

(b)      Joint Secretary, Medical and Health - Ex-officio Member Secretary;

(c)      Principal, SMS Medical College, Jaipur - Ex-officio Member;

(d)      Member nominated by State Government from Principals of any other Medical Colleges - Ex-officio Member;

(e)      A nominee of AYUSH Department from Director Ayurveda, Homoeopathy, Unani on rotation basis - Ex-officio Member;

(f)       Two Members, nominated from Indian Medical Association Rajasthan State - Member.

Section - 7. Functions of the State Health Authorities

(1)     The State Health Authority for logistical grievances shall carry out the following functions:-

(a)      to advise Government regarding State health goals and get these included in the mandate of Panchayati Raj Institutions and urban local bodies;

(b)      to advise Government regarding state level strategic plans for implementation of Right to Health as provided under this Act, including action on the determinants of healthy food, water and sanitation;

(c)      to advise Government regarding a comprehensive written State Public Health Policy for prevention, tracking, mitigation, and control of a public health emergency as well as situations of outbreak or potential outbreak in the State;

(d)      to monitor the preparedness of the State for management of public health emergencies;

(e)      to develop mechanisms and systems for regular medical, clinical, and social audits for good quality of health care at all levels;

(f)       to constitute one or more committees/scientific panels/technical panels for the efficient discharge of its functions as and when required;

(g)      to hear all appeal against decision of District Health Authority related to logistical grievances;

(h)     to ensure quality and cost effective health and diagnostic services by health sector; and

(i)       to carry out other functions as may be prescribed.

(2)     The State Health Authority for Treatment Protocol shall carry out the following functions:-

(a)      to advise the Government on any matter concerning public health, including preventive, promotive, curative, and rehabilitative aspects of health and occupational, environmental, and socio-economic determinants of health;

(b)      to develop mechanisms and systems for regular medical, clinical, and social audits for good quality of health care at all levels;

(c)      to constitute one or more committees/scientific panels/technical panels for the efficient discharge of its functions as and when required;

(d)      to hear all appeal against decision of District Health Authority for Treatment Protocol;

(e)      to ensure quality and cost effective health and diagnostic services by health sector; and

(f)       to carry out other functions as may be prescribed.

Section - 8. Meeting of State Health Authorities

(1)     The State Health Authority shall meet at least once in six months, by giving such reasonable advance notice to its members and shall observe such rules of procedure regarding the transaction of business at its meetings as may be prescribed by rules made under this Act:

Provided that if, in the opinion of the Chairperson, any business of an urgent nature is to be transacted, he may convene a meeting of the Authority at such time as he thinks fit.

(2)     The meetings of the Authority and the mode of transaction of business at such meetings, including quorum etc., shall be governed by such regulations as may be prescribed.

Section - 9. Constitution of District Health Authority

(1)     The Government shall constitute an independent body as District Health Authority, within one month from the date of constitution of State Health Authorities.

(2)     The District Health Authority shall consist of the following members, namely:-

(a)      The District Collector - Ex-Officio Chairperson;

(b)      Chief Executive Officer, Zila Parishad (IAS/RAS) - Ex-Officio Co-Chairperson;

(c)      Principal of Medical college or his nominee not below the rank of Sr. Professor Ex-Officio Member;

(d)      Deputy Chief Medical and Health Officer - Ex-Officio Member Secretary;

(e)      District Ayurveda Officer - Ex-Officio Member;

(f)       Two Members, nominated from Indian Medical Association, Rajasthan State - Member.

Section - 10. Functions of District Health Authority

The District Health Authority shall carry out the following functions:-

(a)      to ensure implementation of the policies, recommendations, and directions of State Health Authority;

(b)      to formulate and implement strategies and plans of action for the determinants of health, especially food, water, sanitation, and environment;

(c)      to formulate a comprehensive written plan for prevention, tracking, mitigation, and control of a "public health emergency", as well as situations of "outbreak" or "potential outbreak" in the district based on State Plan;

(d)      to coordinate with the relevant government departments and agencies to ensure availability and access to adequate and safe food, water and sanitation throughout the district;

(e)      to organize hearing of the beneficiaries coming to the hospital once in three months with a view to improve the health care services;

(f)       to involve the communities as active co-facilitators articulating their needs, helping in identification of key indicators and creation of tools for monitoring, providing feedback as well as validating the data collected by these methods;

(g)      to investigate and decide the complaints received by it under section 11; and

(h)     to carry out such other functions as may be prescribed.

Section - 11. Grievances Redressal Mechanism

(1)     The Government shall prescribe Grievances Redressal Mechanism for health care establishment, health care provider and residents, within six months from the date of commencement of this Act.

(2)     The rules prescribed under sub-section (1) shall include the following, namely:-

(a)      any person (resident of the state) having any grievance relating to the Right to Health may make a written complaint to the Incharge of the concerned Health Care Institution in prescribed manner with all relevant documents within 15 days of cause of action.

(b)      if the complaint is not resolved by concerned Health Care Institution within 3 Days, the complaint shall be forwarded to Member Secretary of District Health Authority within territorial jurisdiction.

(c)      the District Health Authority shall take appropriate action on the complaint within 30 days of its receipt and communicate the same to the complainant. While enquiring into the complaint the District Health Authority may invite the complainant and representative of concerned health care provider/establishment and try to resolve the complaint; and

(d)      in case the grievance is not resolved within 30 days by the District Health Authority, the complaint shall be forwarded to the State Health Authority immediately after the expiry of the aforesaid period of 30 days.

Section - 12. Powers of the State Health Authority and District Health Authority

(1)     For purposes of carrying out the inquiry under this Act, the State Health Authority or District Health Authority, as the case may be, may nominate one or more persons or committees from the subject speciality, in the prescribed manner, for the efficient discharge of its functions.

(2)     The State Health Authority or District Health Authority, as the case may be, shall have the power to require any person to furnish information on such matters as may the subject matter of the inquiry and any person so required shall be legally bound to furnish such information.

Section - 13. Appeal

Any person aggrieved by an order of the District Health Authority passed under the provisions of this Act may file an appeal in the prescribed manner to the State Health Authority within 30 days from the date of the order.

Section - 14. Penalties

Any person who knowingly contravenes any provision of this Act or any Rule made thereunder shall be punishable with a fine up-to rupees ten thousand for the first contravention, and up-to rupees twenty-five thousand for the subsequent contraventions.

Section - 15. Protection of action taken in good faith

No suit, prosecution or other legal proceeding shall lie against the State Government or the Chairpersons or members of the State Health Authority and District Health Authority or any members or officers of the committee appointed by the said authorities or any other employee or officer acting under the direction of the said Authorities, for anything which is in good faith done or intended to be done under this Act or the rule made thereunder.

Section - 16. Power to make regulations

The Authorities may, with the previous approval of the Government, by notification in the Official Gazette, make regulations consistent with this Act and the rules for carrying out the purposes of this Act.

Section - 17. Power of State Government to make rules

(1)     The State Government may, by notification in the Official Gazette, make rules to carry out the provisions of this Act.

(2)     Every rule made under this Act shall be laid, as soon as may be after it is so made, before the House of the State Legislature, while it is in session, for a period of not less than fourteen days which may be comprised in one session or in two or more successive sessions and if before the expiry of the session in which it is so laid or of the sessions immediately following, the House of the State Legislature makes any modification in the rule or resolves that the rule should not be made, the rule shall thereafter have effect only in such modified form or be of no effect, as the case may be, so, however, that any such modification or annulment shall be without prejudice to the validity of anything previously done thereunder.

Section - 18. Application of other laws not barred

The provisions of this Act shall be in addition to, and not in derogation of, any other law for the time being in force.

Section - 19. Power to remove difficulties

(1)     If any difficulty arises in giving effect to the provisions of this Act, the State Government may, by order, published in the Official Gazette, make such provisions not inconsistent with the provisions of this Act as may appear to be necessary for removing the difficulty:

Provided that no such order shall be made under this section after the expiry of two years from the commencement of this Act.

(2)     Every order made under this section shall be laid, as soon as may be after it is made, before the House of the State Legislature.

Section - 20. Saving

Any rules, regulations, guidelines or orders made or issued in respect of providing any health care facilities, whether free or otherwise, to the residents of the State shall be deemed to have been made or issued under this Act and shall remain in force until they are repealed, modified or replaced in exercise of the powers conferred under this Act.