Full Judgment
IN THE HIGH COURT OF KERALA AT ERNAKULAM
PRESENT THE HONOURABLE MR. JUSTICE ANIL K. NARENDRAN & THE HONOURABLE MR. JUSTICE G. GIRISH THURSDAY, THE 7TH DAY OF MARCH 2024 / 17TH PHALGUNA, 1945 DBP NO. 19 OF 2024 GURUVAYUR DEVASWOM - MATTER PERTAINING TO THE AYURVEDA HOSPITAL, WHICH IS MANAGED BY GURUVAYUR DEVASWOM. PETITIONER: SHIJI DEVARAJ VETTIYARA HOUSE, MULLASSERY P.O., PIN-680 509 RESPONDENTS:
1 STATE OF KERALA REPRESENTED BY THE SECRETARY TO GOVERNMENT, REVENUE (DEVASWOM) DEPARTMENT, GOVERNMENT SECRETARIATE, THIRUVANANTHAPURAM - 695001. 2 COMMISSIONER GURUVAYUR DEVASWOM, GOVERNMENT SECRETARIATE, THIRUVANANTHAPURAM, PIN - 695001. 3 GURUVAYUR DEVASWOM MANAGING COMMITTEE GURUVAYUR DEVASWOM, GURUVAYUR, PIN - 680101, REPRESENTED BY ITS ADMINISTRATOR 4 THE DISTRICT MEDICAL OFFICER (ISM) DISTRICT MEDICAL OFFICE, PALACE ROAD, PATTURAIKKAL, THRISSUR, KERALA - 680020.
*ADDL.R5 #(MEDICAL OFFICER IN-CHARGE), MELPATHOOR MEMORIAL AYURVEDA HOSPITAL, GURUVAYUR ALTHARA PONNANI ROAD, NORTH NADA, GURUVAYUR, PIN - 680101 *SUO MOTU IMPLEADED AS ADDITIONAL 5TH RESPONDENT VIDE ORDER DATED 08/02/2024 IN DBP.NO.19/2024 #THE DESCRIPTION OF ADDL.R5 - CHIEF MEDICAL OFFICER - CORRECTED AS PER ORDER DATED OTHER PRESENT: -2- SRI S.RAJMOHAN - SR GOVERNMENT PLEADER; SRI T.K.VIPIN DAS - STANDING COUNSEL- GURUVAYUR DEVASWOM MANAGING COMMITTEE THIS DEVASWOM BOARD PETITION HAVING COME UP FOR ADMISSION ON 07.03.2024, THE COURT ON THE SAME DAY DELIVERED THE FOLLOWING: -3-
ORDER
Anil K. Narendran, J.
This DBP is registered suo motu, vide proceedings dated 06.02.2024, based on a complaint dated 01.02.2024 made by a devotee of Lord Guruvayurappan, pointing out various irregularities in the Ayurveda Hospital managed by Guruvayur Devaswom Managing Committee. In that complaint, certain allegations have been made against a Nursing Assistant by name, M. Manoj Kumar.
2. On 08.02.2024, when this DBP came up for consideration,
the learned Senior Government Pleader entered appearance for respondents 1, 2 and 4 and the learned Standing Counsel for Guruvayur Devaswom Managing Committee for the 3rd respondent and also for additional 5th respondent. By the order dated 08.02.2024, this Court directed the 4th respondent District Medical Officer (ISM), Thrissur, to conduct an enquiry into the facts pointed out in the complaint dated 10.10.2023 and submit a report before this Court by 13.02.2024. The additional 5th respondent Medical Officer-in-charge, Melpathoor Memorial Ayurveda Hospital, was directed to render necessary assistance to the 4th respondent in the enquiry to be conducted in terms of this order.
3. On 13.02.2024, when this matter came up for consideration,
the learned Senior Government Pleader has made available for the perusal of this Court, the enquiry report dated 12.02.2024 of the 4 th -4- respondent District Medical Officer. Paragraph 2 of that report regarding Medicine Stock Register, reads thus;
“2. Medicine Stock Register Expired medicines included Vyoshadi Kashayachoornam-51 kgs, Nirgundyadi Kashayachoornam-37 kgs, Indukantham Kashayachoornam 12kgs, Dasamoolakaduthrayam Kashayachoornam 5 kgs, and nearly expiring medicine (2/2024) Nisakathakadi Kashayachoornam 21 kgs are kept in the hospital. It is kept to get replaced by Oushadhi and the steps for the same has been taken. It is seen that 2 kgs of expired Indukantham Kashayachoornam had been made Kashaya and distributed to patients on 6/3/2023. In this regard, Dr. Prathibha has stated that she has already noticed and therefore, the Kashaya was prepared only after checking the quality of the powder and after the preparation, it was checked by tasting. Medical Officer, Dr. K.K. Sasi has also given the same statement. In any case, it is wrong to distribute the expired medicines to the patients. No scientific quality analysis has been done except for tasting.”
4. The general findings and comments in the last paragraph of the report dated 12.02.2024 read thus;
“General Findings and comments: Melpathur Memorial Ayurveda Hospital, under Gurvayoor Devaswam Board is functioning in a decrepit building due to age. The facility does not admit patients and only OP is functioning from 8 a.m. to 1 p.m. and that too is inadequate even to function as a dispensary. This building does not have -5-
basic facilities like token system, OP ticket counter, pharmacy (medicine dispensing) counter. Only two doctors have examination rooms in this building. Additional room constructed for 3rd doctor does not directly open to this building, hence, there is safety problem during off peak hours. There are not enough storerooms to keep the medicines under lock and key. As there is no medicine counter, medicine is dispensed by pulling a table across the entrance door through which staff from all sides pass to sign their attendance etc. The dilapidated and dangerous condition of the building has also been pointed out by the Kerala State Audit Department. Currently, there is no qualified pharmacist. Nursing assistants are dispensing the medicines as per doctor's prescriptions. Nursing assistant is a promotion post of sanitation worker which needs minimum educational qualifications. Many of the medicines offered by KAL which are used in this hospital have their names in English. So, it is necessary to appoint a qualified pharmacist, as nursing assistants may not be able to read doctor's prescriptions or identify 'look alike', 'sound alike’ medicines and distribute accurately. Renovation and modernization of this hospital, which is relied upon by thousands of devotees of Lord Guruvayoorappan (as Guruvayoor temple is one of the largest temples in Kerala), needs to be done at the earliest.”
5. By the order dated 13.02.2024, the learned Senior Government Pleader was directed to place on record the enquiry report dated 12.02.2024 along with a memo. -6-
6. On 14.02.2024 when this matter came up for consideration,
the learned Standing Counsel for Guruvayur Devaswom Managing Committee submitted that based on the report dated 02.11.2023 of the Deputy Administrator, on the complaint made by Sri.K.V.Lenin, a temporary employee in Melpathoor Memorial Ayurveda Hospital, against Sri.M.Manoj Kumar, the Nursing Assistant, an Internal Complaints Committee has already been constituted. After considering the submissions made at the Bar, this Court passed an order dated 14.02.2024. Paragraphs 7 to 9 of that order read thus:
“7. Insofar as the deficiencies in the Ayurveda Hospital pointed out in the enquiry report dated 12.02.2024 of the 4 th respondent District Medical Officer, the learned Standing Counsel would submit that the Deputy Administrator (Administration) has already been directed to conduct an enquiry and submit a report on the above aspects, which will be placed before the meeting of the Guruvayur Devaswom Managing Committee in its next meeting, which is scheduled to be held on 19.02.2024.
8. Having considered the materials on record and also the
submissions made at the Bar, we deem it appropriate to direct the 3rd respondent Managing Committee to take immediate steps to rectify the deficiencies pointed out in the report dated 12.02.2024 of the 4th respondent District Medical Officer. Expired medicines and other objectionable articles shall be removed from the hospital forthwith. The decision taken by the Managing Committee based on the report to be submitted by the Deputy Administrator -7-
(Administration) shall be placed before this Court on the next posting date.
9. It is for the additional 4th respondent Medical Officer- in-
charge to conduct another inspection in the Melpathoor Memorial Ayurveda Hospital of Guruvayur Devaswom Managing Committee, after ten days, to ensure that the directions contained in this order are complied with.
7. On 01.03.2024, the learned Senior Government Pleader
submitted that in terms of the directions contained in the order dated 14.02.2024, the 4th respondent District Medical Officer (ISM) has conducted an inspection in Melpathoor Memorial Ayurveda Hospital of Guruvayur Devaswom Managing Committee on 29.02.2024. The report of the 4th respondent is being produced along with a memo.
8. Along with a memo dated 02.03.2024 of the learned Senior Government Pleader, the report of the 4th respondent District Medical Officer is placed on record, which reads thus:
“Enquiry report submitted by the District Medical Officer, Indian Systems of Medicine, Thrissur as directed by the Hon.High Court in DBP 19/24 dt.14/02/2024 Pursuant to the order dated 14/02/2024 DBP No.19/24 of the Hon’ble High Court an enquiry was conducted by Dr. Preethi Jose, District Medical Officer (I/C), Indian Systems of Medicine, Thrissur on 29/02/2024 at Guruvayur Devaswan Ayurveda Hospital, Dr.Mary Sebastian, Chief Medical Officer, Ramavarma District Ayurveda Hospital, Thrissur, Sri Rajkumar M, Senior Superintendent, DMO Office (ISM) Thrissur, Section Clerk Sri. Anishkumar CA assisted District -8-
Medical officer(I/C), Indian Systems of Medicine, Thrissur for the enquiry which started at 10 am. The details are furnished below: The team examined the steps taken by the Devaswam to resolve the irregularities mentioned in the investigation report submitted by the DMO (ISM) in the High Court in connection with the case filed by Shiji Devaraj regarding various irregularities in the Guruvayur Devaswam Ayurveda Hospital and whether the instructions of the court were followed. Expired medicines: It has been seen that the expired medicines were removed from the institution and kept under lock and key in another building attached to the hospital. These medicines were supplied by Oushadhi and eventhough necessary steps had been taken for getting them replaced, they were not yet got replaced by Oushadhi. Attendance Register: It was understood that the Deputy Administrator has been tasked to submit a report as to what should be done by the Devaswam to resolve the various anomalies in the hospital. As per the report given by the Deputy Administrator (Administration) it is seen that the Guruvayur Devaswam Managing Committee in its meeting held on 19/02/2024 has taken a decision as no. 5 to seek explanations from medical officer Dr. Prathibha, and nursing assistant Sri. Manojkumar who were responsible for corrections in attendance register. Moreover the System Administrator (EDP) has been instructed to install the Punching Attendance System in the hospital within two weeks time. It is also seen that the Managing Committee decided to instruct the Assistant -9-
Manager to visit the hospital daily to bring the official and administrative matters into the attention of Administrator and Managing Committee. Infrastructure: The hospital still functions in an old, dilapidated building. Medical Officer informed that pursuant to the instruction from Managing Committee, Executive Engineer (civil) visited the hospital and initiated steps for the maintenance work at hospital. A proposal for a new 15 bedded hospital with sufficient posts has been already under consideration of Devaswam. Medicines worth Rs. 20,00,000 (Rupees Twenty lakhs) is supplied here per year. A store room sufficient to keep this medicines under lock and key is lacking. Likewise, at present the medicine dispensing system restricts the freedom for moving inside the hospital. Hence these factors need urgent attention while doing maintenance work. It is noticed that the overall cleanliness of the hospital has improved.”
9. Heard the learned Senior Government Pleader for respondents 1, 2 and 4, the learned Standing Counsel for Guruvayur Devaswom Managing Committee for the 3rd respondent and the additional 5th respondent.
10. During the course of arguments, the learned Standing
Counsel for Guruvayur Devaswom Managing Committee would submit that a punching machine has already been installed in Melpathoor Memorial Ayurveda Hospital, which will be functional within a period of one week, in order to ensure that there is proper attendance for medical -10- and para-medical staff. As suggested by the 4th respondent District Medical Officer (ISM), various measures have already been taken to ensure that the Ayurveda Hospital (presently a dispensary) is working in a proper manner. Having considered the materials on record and also the submissions made at the Bar, we deem it appropriate to dispose of this DBP by directing the 3rd respondent Guruvayur Devaswom Managing Committee to take necessary steps to ensure proper functioning of Melpathoor Memorial Ayurveda Hospital. The Deputy Administrator shall conduct periodical inspections in the Ayurveda Hospital. It would be open to the 4th respondent District Medical Officer to conduct inspection in case there are any complaints regarding the functioning of Melpathoor Memorial Ayurveda Hospital run by the Guruvayur Devaswom Managing Committee. The Managing Committee shall take necessary steps to provide proper facilities in the Ayurveda Hospital, which is presently functioning as a dispensary, and the proceedings now initiated against the staff in that hospital shall be proceeded with, in accordance with law, to ensure that similar instances are not repeated in the hospital in future. Sd/- ANIL K. NARENDRAN, JUDGE Sd/- G. GIRISH, JUDGE das