Introduction
In a significant ruling clarifying the scope of regulatory powers under healthcare laws, the Supreme Court of India has held that the Commission constituted under the West Bengal Clinical Establishments Act, 2017 (WBCE Act) is empowered to adjudicate complaints relating to “deficiency in patient care service” and to award compensation, even if such complaints arise from medical treatment provided by hospitals.
The judgment draws an important distinction between medical negligence, which falls within the jurisdiction of State Medical Councils, and deficiency in patient care service, which can be examined by the statutory Commission under the WBCE Act. This ruling strengthens patient protection mechanisms and clarifies overlapping jurisdictions under healthcare regulatory frameworks.
Background of the Case
The case arose from a complaint filed by Kousik Pal, whose mother was admitted to a private hospital in West Bengal for five days. On the advice of the primary consultant, she was referred to another hospital. The discharge summary, prepared by another doctor, recorded that her condition was “stable”. However, within hours of her transfer, she passed away.
Alleging negligence, improper diagnosis, and unethical conduct, the petitioner approached the Commission established under the WBCE Act, 2017.
Findings of the Commission Under WBCE Act
In 2018, the Commission examined the complaint and made crucial findings:
- The description of the patient’s condition as “stable” at the time of transfer was erroneous.
- Two doctors involved in the treatment were found unqualified to hold the posts they occupied, namely:
- Head, Non-Invasive Department
- ECG Technician
- The medical courses pursued by these doctors were not recognised by the concerned Medical Council.
The Commission held that these factors amounted to deficiency in patient care service and unethical trade practice, though it expressly refrained from recording any finding on medical negligence, recognising that negligence complaints fall within the domain of the West Bengal Medical Council (WBMC).
Accordingly, the Commission directed the hospital to pay ₹20 lakhs as compensation to the petitioner.
Proceedings Before the High Court
Single Judge’s Decision
The hospital challenged the Commission’s order before the Calcutta High Court. A Single Judge upheld the Commission’s findings, holding that:
- The Commission had jurisdiction to examine whether doctors employed by the hospital possessed the requisite educational qualifications.
- The findings were limited to deficiency in patient care service and not medical negligence.
Division Bench’s Reversal
However, a Division Bench of the High Court overturned the Single Judge’s decision and the Commission’s order, holding that:
- There was no material to establish a nexus between the hospital’s conduct and the patient’s death.
- Only the State Medical Council could examine whether a doctor was qualified to claim specialist status.
- Medical negligence and deficiency in patient care are “inextricably mingled”, and therefore, the Commission lacked jurisdiction.
Aggrieved by this reversal, the petitioner approached the Supreme Court.
Supreme Court’s Ruling
A Bench comprising Justice Sanjay Karol and Justice Manoj Misra set aside the Division Bench’s judgment and restored the findings of the Commission.
Key Observations
The Supreme Court made several important observations:
- Clear Distinction Between Negligence and Deficiency in Service The Court rejected the argument that medical negligence and deficiency in patient care are inseparable. It held that:
“The Commission expressly states that they are not entering into the question of negligence. What it had done was consider a complaint of deficiency in patient care service.”
- Scope of Section 36 of WBCE Act Section 36, which provides for the establishment of the Commission, uses the term “supervision”. The Court held that supervision necessarily includes:
- Ensuring that medical personnel employed in clinical establishments possess valid education and certification
- Verifying compliance with statutory norms and ethical standards
- Interpretation of Section 38 While Section 38 provides that medical negligence complaints are to be dealt with by State Medical Councils, this does not bar the Commission from examining:
- Deficiency in service
- Unethical practices
- Misrepresentation of staff credentials
- Jurisdiction to Award Compensation The Court affirmed that once deficiency in service is established, the Commission is statutorily empowered to award compensation.
Rejection of Division Bench’s Reasoning
The Supreme Court categorically disagreed with the Division Bench’s view that only the Medical Council could examine the qualifications of doctors. It clarified that:
- The Commission did not conduct disciplinary proceedings against doctors.
- It only assessed whether the hospital, as a clinical establishment, complied with statutory requirements relating to staffing.
- Such examination is well within the Commission’s supervisory powers.
Significance of the Judgment
1. Strengthening Patient Rights
The ruling reinforces patient remedies against hospitals for systemic failures, even when medical negligence per se is not established.
2. Regulatory Accountability of Hospitals
Hospitals can no longer evade responsibility by claiming that all issues fall exclusively within the jurisdiction of Medical Councils.
3. Clarity on Overlapping Jurisdiction
The judgment draws a clear functional distinction:
- Medical Councils → Professional misconduct and negligence of doctors
- Clinical Establishment Commissions → Deficiency in service, unethical practices, and institutional lapses
4. Impact on Healthcare Litigation
The decision is likely to influence:
- Consumer and medical jurisprudence
- Interpretation of similar clinical establishment laws across States
- Increased accountability of private hospitals in India
Conclusion
The Supreme Court’s ruling in Kousik Pal v. State of West Bengal & Ors. marks a crucial development in healthcare regulation. By affirming the powers of the Commission under the WBCE Act to adjudicate deficiency in patient care service and award compensation, the Court has ensured that patients are not left remediless due to technical jurisdictional barriers.
At the same time, by maintaining a clear boundary between medical negligence and deficiency in service, the judgment preserves the specialised role of Medical Councils while empowering regulatory bodies to ensure ethical and lawful functioning of clinical establishments.
This decision will have far-reaching consequences for hospital accountability and patient protection in India’s healthcare system.
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