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Amidst news reports of violence against healthcare workers during the spread of the COVID-19 pandemic, the Epidemic Diseases (Amendment) Ordinance, 2020 was promulgated on April 22, 2020.  The Ordinance amends the Epidemic Diseases Act, 1897.  The Act provides for the prevention of the spread of dangerous epidemic diseases.  The Ordinance amends the Act to include protections for healthcare personnel combatting epidemic diseases and expands the powers of the central government to prevent the spread of such diseases.

Who is considered a healthcare service personnel under the Ordinance?

The Ordinance defines healthcare service personnel as a person who is at risk of contracting the epidemic disease while carrying out duties related to the epidemic such as caring for patients.  They include: (i) public and clinical healthcare providers such as doctors and nurses, (ii) any person empowered under the Act to take measures to prevent the outbreak of the disease, and (iii) other persons designated as such by the respective state government.

What is considered an ‘act of violence’ under the Ordinance?

An ‘act of violence’ includes any of the following acts committed against a healthcare service personnel: (i) harassment impacting living or working conditions, (ii) harm, injury, hurt, or danger to life, (iii) obstruction in discharge of his duties, and (iv) loss or damage to the property or documents of the healthcare service personnel.  Property is defined to include a: (i) clinical establishment, (ii) quarantine facility, (iii) mobile medical unit, and (iv) other property in which a healthcare service personnel has direct interest, in relation to the epidemic. 

What are the offences and penalties outlined under the Ordinance?

The Ordinance specifies that no person can: (i) participate in or commit an act of violence against a healthcare service personnel, or (ii) participate in or cause damage or loss to any property during an epidemic.  A person committing these two offences is punishable with imprisonment between three months and five years, and a fine between Rs 50,000 and two lakh rupees.  However, for such offences, charges may by dropped by the victim with the permission of the Court.  If an act of violence against a healthcare service personnel causes grievous harm, the person committing the offence will be punishable with imprisonment between six months and seven years, and a fine between one lakh rupees and five lakh rupees.   All offences under the Ordinance are cognizable (i.e., a police officer can arrest without a warrant) and non-bailable.

Do healthcare service personnel that face violence get compensation?

Persons convicted of offences under the Ordinance will be liable to pay a compensation to the healthcare service personnel whom they have hurt.  Such compensation will be determined by the Court.  In the case of damage or loss of property, the compensation payable to the victim will be twice the amount of the fair market value of the damaged or lost property, as determined by the Court.  

What protections did healthcare service personnel have prior to the promulgation of this Ordinance?

Currently, the Indian Penal Code, 1860 provides for penalties for any harm caused to an individual or any damage caused to property.  The Code also prescribes penalties for causing grievous hurt i.e., permanent damage to another individual. 

The Ministry of Health and Family Welfare had released a draft Bill to address incidences of violence against healthcare professionals and damage to the property of clinical establishments in September 2019.  The draft Bill prohibits any acts of violence committed against healthcare service personnel including doctors, nurses, para medical workers, medical students, and ambulance drivers, among others.  It also prohibits any damage caused to hospitals, clinics, and ambulances.   

Table 1 compares the offences and penalties under the Ordinance, the draft Bill, and Indian Penal Code, 1860.

Table 1:  Offences and penalties with regard to violence against healthcare service personnel 

Offences and Penalties

Epidemic Diseases (Amendment) Ordinance, 2020

Healthcare Service Personnel and Clinical Establishments (Prohibition of violence and damage to property) Bill, 2019

Indian Penal Code, 1860

Violence

 

  • Violence against a healthcare service personnel is punishable with imprisonment between three months and five years, and a fine between Rs 50,000 and two lakh rupees.     (Act of violence includes harassment, hurt/harm, and damage to property)
  • Violence against a healthcare service personnel, is punishable with imprisonment between six months and five years, and a fine of up to five lakh rupees.     (Act of violence includes harassment, hurt/harm, and damage to property)
  • Causing voluntary hurt is punishable with imprisonment up to one year, or with fine up to Rs 1,000, or both.

Violence causing grievous harm

  • Violence against a healthcare service personnel causing grievous harm is punishable with imprisonment between six months and seven years, and a fine between one lakh rupees and five lakh rupees.
  • Violence against a healthcare service personnel causing grievous harm is punishable with imprisonment between three years and ten years, and a fine between two lakh rupees and ten lakh rupees.
  • Voluntarily causing grievous hurt is punishable with imprisonment up to seven years, and a fine.

Damage to property

  • Damage or loss to any property during an epidemic, is punishable with imprisonment between three months and five years, and a fine between Rs 50,000 and two lakh rupees. 
  • Damage or loss to any property of a clinical establishment, is punishable with imprisonment between six months and five years, and a fine of up to five lakh rupees.     
  • Loss or damage to the property worth Rs 50 or more is punishable with imprisonment up to two years, or fine, or both.

Sources: Epidemic Diseases (Amendment) Ordinance, 2020, Healthcare Service Personnel and Clinical Establishments (Prohibition of violence and damage to property) Bill, 2019, and Indian Penal Code, 1860; PRS. 

Are there provisions for the safety of healthcare service personnel at the state level?

Several states have passed legislation to protect healthcare service personnel.  These states include: Andhra Pradesh, Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Delhi, Gujarat, Haryana, Karnataka, Kerala, Maharashtra, Manipur, Odisha, Punjab, Rajasthan, Tamil Nadu, Tripura, Uttarakhand and West Bengal.  

Most state Acts define healthcare service personnel to include registered doctors, nurses, medical and nursing students, and paramedical staff.   Further, they define violence as activities causing harm, injury, endangering life, intimidation, obstruction to the ability of a healthcare service person to discharge their duty, and loss or damage to property in a healthcare service institution.  

All state Acts prohibit: (i) any act of violence against healthcare service persons, or (ii) damage to property in healthcare service institutions.  In most of these states, sf a person partakes in these prohibited activities, he/she is punishable with imprisonment up to three years and a fine of up to fifty thousand rupees.  However, in certain states such as Tamil Nadu the maximum prison sentence may be up to ten years. 

For more information on the spread of COVID-19 and the central and state government response to the pandemic, please see here.

Mr. Vaghul, our first Chairperson, passed away on Saturday.  I write this note to express my deep gratitude to him, and to celebrate his life.  And what a life he lived!

Mr. Vaghul and I at his residence

 

 

 

 

 

 

 

Our past and present Chairpersons,
Mr. Vaghul and Mr. Ramadorai

Industry stalwarts have spoken about his contributions to the financial sector, his mentorship of people and institutions across finance, industry and non-profits.  I don’t want to repeat that (though I was a beneficiary as a young professional starting my career at ICICI Securities).  I want to note here some of the ways he helped shape PRS.

Mr Vaghul was our first chairman, from 2012 to 2018.  When he joined the board, we were in deep financial crisis.  Our FCRA application had been turned down (I still don’t know the reason), and we were trying to survive on monthly fund raise.  Mr Vaghul advised us to raise funds from domestic philanthropists.  “PRS works to make Indian democracy more effective.  We should not rely on foreigners to do this.”.  He was sure that Indian philanthropists would fund us.  “We’ll try our best.  But if it doesn’t work, we may shut down.  Are you okay with that?”  Of course, with him calling up people, we survived the crisis.

He also suggested that we should have an independent board without any representation from funders.  The output should be completely independent of funders’ interest given that we were working in the policy space.  We have stuck to this advice.

Even when he was 80, he could read faster than anyone and remember everything.  I once said something in a board meeting which had been written in the note sent earlier.  “We have all read the note.  Let us discuss the implications.”  And he could think three steps ahead of everyone else.

He had a light touch as a chairman.  When I asked for management advice, he would ask me to solve the problem on my own.  He saw his role as guiding the larger strategy, help raise funds and ensure that the organisation had a strong value system.  Indeed, he was the original Karmayogi – I have an email from him which says, “Continue with the good work.  We should neither be euphoric with appreciation or distracted by criticism.” And another, "Those who adhere to the truth need not be afraid of the consequences".

The best part about board meetings was the chat afterwards.  He would have us in splits with stories from his experience.  Some of these are in his memoirs, but we heard a few juicier ones too!

Even after he retired from our Board, he was always available to meet.  I just needed to message him whenever I was in Madras, and he would ask me to come home.  And Mrs. Vaghul was a welcoming host.  Filter coffee, great advice, juicy stories, what more could one ask for?

Goodbye Mr. Vaghul.  Your life lives on through the institutions you nurtured.  And hope that we live up to your standards.

Madhavan