A LEGAL argument that Fiji’s public hospitals cannot demand upfront payment from urgent or poor patients before providing necessary treatment has been accepted by the Supreme Court.
Lawyer Niven Padarath advanced the argument while representing Rajesh Chandra, administrator of the estate of his late son, in proceedings against the permanent secretary for Health, Ministry of Health and attorney-general.
At the heart of the case was a critical question: can a patient be admitted to a public hospital because their condition is urgent, but then effectively be denied the treatment they need because they cannot pay?
Mr Padarath argued that such an interpretation would undermine the protections contained in the Public Hospitals and Dispensaries Act.
His argument arose from the circumstances surrounding Mr Chandra’s son, who suffered from chronic kidney disease and needed short-term dialysis to keep him alive long enough to travel to India for further testing and treatment.
Justice Terence Arnold, in the August 28 Supreme Court ruling, recorded that Mr Padarath challenged the distinction drawn between admission and treatment.
“For the Petitioner, Mr Padarath argued that the Court of Appeal had over-emphasised the distinction between admission and continued treatment in its reasoning,” Justice Arnold said.
Mr Padarath submitted that the legislation was intended to ensure people admitted because of urgency or poverty could obtain not simply a hospital bed, but medical care and treatment.
His argument highlighted what he considered a fundamental inconsistency: a hospital could not demand money from an urgent or poor patient as a condition of admission, only to demand payment immediately afterwards before treating them.
The Supreme Court accepted his interpretation.
“I agree with the interpretation of the provisions advanced by Mr Padarath,” Justice Arnold said.
The significance of that finding extends beyond the individual circumstances of the case.
The court concluded that people admitted because of urgency or poverty cannot be required to make an upfront payment or provide a payment guarantee for treatment.
In Mr Chandra’s case, the court found short-term dialysis was available and would have prolonged his life sufficiently for him to travel to India.
He did not receive it because he could not afford to pay.
The Supreme Court allowed the appeal and sent the case back to the High Court for damages to be assessed.
