Review Guj's doctor's prescription norm for testing: IMA to HC

The Indian Medical Association and Ahmedabad Medical Association on Friday told Gujarat High Court the state government's insistence for a prescription by an MD doctor for COVID-19 tests in private laboratories is not rational, and sought a review of this requirement in order to pave the way for higher number of tests. In their replies to the High Court hearing suo motu PIL on matters related to coronavirus pandemic and lockdown, the IMA said the number of tests in Gujarat in terms of its population should be at least five times the number being undertaken in Delhi which is 18,000 per day.

While this will bring the number of tests in Gujarat to 90,000 per day, the tests done daily in the state currently is between 7000-8000. This comes as the state government, in its response submitted to the division bench of Chief Justice Vikram Nath and Justice JB Pardiwala, said "it is duly empowered to impose reasonable restrictions, as it deems fit, in the larger public interest," when asked whether pathological testing or diagnosis is one of the facets of right to health as embodied in Article 21 of the Constitution.

The government said fundamental right under Article 21 is "not an absolute right and is subject to reasonable restrictions". The state government earlier scrapped the mandatory rule for patients to be hospitalised to be tested for COVID-19 by private laboratories.

Instead, it made it mandatory for any patient seeking testing from a private laboratory to have a prescription from a MD doctor. In its reply, the ICMR said laboratory tests should only be offered when prescribed by a "qualified doctor".

The IMA said, "It is imminent to increase the testing for the purpose of implementing the strategy of testing, tracing and quarantine which is the only means to contain the virus from spreading further. Insistence of prescription by an MD physician is not rational and does not support objective of tracing and testing of COVID-19 patients. It is equally important to use private laboratories and government laboratories." The AMA echoed this. The ICMR, which was added as a respondent to the PIL, said, "Laboratory tests should only be offered when prescribed by a qualified physician for COVID-19 tests. It has already been mentioned in the guidelines dated March 21, 2020. It is submitted that in fact it is for the treating doctor/ physician to ascertain the physical condition of every patient and the symptoms of every individual patient based on which the laboratory testing can be prescribed." The ICMR also said the guidelines issued by it "are recommendatory/advisory in nature." The government in its response indicated that the state is "duly empowered to impose reasonable restrictions, as it deems fit, in the larger public interest, even when it can never evolve a policy contrary to the fundamental rights of its citizens.

It further said "it is always desirable to have an uniform central policy like ICMR policy, specially during pandemic situations like the present one, to be followed consistently by all the states in the country". The government said it has conducted tests in the state at the rate 4615 tests/million people, with the rate in Ahmedabad city, a hotspot, being 13263.30 tests per million population till June 12.

The lawyer representing the High Court in the suo motu PIL, Brijesh Trivedi, raised serious objection to the point of "reasonable restriction" on part of the government, saying whether there is any "political emergency" here. He also said the government cannot restrain doctors by not granting permission to all "qualified doctors" to refer their patients for COVID-19 tests.