The case for instantaneous, and hence cashless, treatment to thousands of road accident victims is self-evident. For it has been established that 50 per cent of fatalities could be averted through intervention in the so-called golden hour immediately after a traffic collision. This is a cause the courts and quasi-judicial bodies have consistently championed. But it has taken the Ministry of Road Transport and Highways nearly 25, distressingly long years to announce that accident victims on the Delhi-Jaipur National Highway would be covered up to a maximum of Rs. 30,000 for their treatment. The Supreme Court’s 1989 ruling is categorical that there is no bar on doctors in private hospitals giving emergency care to a victim, irrespective of whether there is a legal-criminal dimension to the vehicular accident. A doctor’s professional obligation to protect life is absolute, and laws of procedure and regulations will have to give way so as to ensure the survival of an injured person. A 1996 SC judgment alluded to a law in the United States obliging hospitals to stabilise victims in an emergency regardless of insurance cover. Drawing on these pronouncements, the National Consumer Disputes Redressal Commission in 2005 declared that neither payment of fee, nor the absence of consent from the nearest of kin, could be adduced as grounds to deny treatment. A sequel to this ruling was the amendment of the Motor Vehicles Act. The Law Commission’s draft bill of 2006 on the medical treatment of victims of different kinds of accidents, including natural disasters, deserves urgent consideration.
In 2011, as per official figures, some 4.98 lakh road accidents caused 1.42 lakh deaths and injured more than 5 lakh persons, irreversibly disabling many. Investment in state of the art technology to regulate road traffic, strict law enforcement, accent on expanding public transport network and safe pedestrian passages would all go a long way to reduce the number of mishaps. The government should ensure that hospitals participating in the cashless treatment project comply with the recently adopted National Ambulance Code. AIS:125 (Automotive Industry Standard) stipulates minimum provisions and guidelines for ambulances in keeping with global best practices. Standardisation of treatment procedures would ensure that arbitrary caps on cost do not jeopardise the full extent of intervention necessary, and prevent profiteering already rampant in other areas of insurance-based healthcare provision. Such an approach would be in keeping with the spirit of the recommendations of the High Level Expert Group on Universal Health Coverage.