Patient Care Is Not Med. Negligence: SC Clarifies the Reach of Clinical Estab.Com.

The Supreme Court’s decision in Kousik Pal's Case  (2025 INSC 1487) settles an important and recurring question in health-law regulation: where does “patient care deficiency” end and “medical negligence” begin, and who decides each?

In answering this, the Court restored the authority of statutory clinical establishment regulators and warned against judicial interpretations that hollow out welfare legislation meant to protect patients.

What's The Matter?

The case arose from the death of the appellant’s mother shortly after she was transferred from B.M. Birla Heart Research Centre to another hospital in May 2017.

Alleging delay in diagnosis, improper treatment, and misleading discharge records, the appellant approached the West Bengal Clinical Establishment Regulatory Commission under the West Bengal Clinical Establishments (Registration, Regulation and Transparency) Act, 2017 (WBCE Act).

After examining records and affidavits, the Commission returned specific findings.

It held that critical diagnostic procedures such as echocardiography were conducted and interpreted by persons whose qualifications were not recognised by the Medical Council or the State Medical Council.

It also noted that the patient was described as being in a “stable condition” at discharge, a description later admitted by the concerned doctor to be erroneous.

Treating these as serious deficiencies in patient care and unethical trade practice, the Commission awarded ₹20 lakh as compensation.

The hospital’s challenge initially failed before a Single Judge of the Calcutta High Court.

However, the Division Bench overturned the Commission’s order, holding that issues of qualification, diagnosis, and patient outcome were inseparable from medical negligence and therefore lay exclusively within the domain of the State Medical Council.

This effectively stripped the Commission of jurisdiction in cases where patient care lapses had medical overtones.

The Supreme Court decisively rejected this reasoning.

At the heart of the judgment is a careful statutory reading of the WBCE Act.

The Court emphasised that the Act is a public-interest legislation aimed at enforcing minimum standards, transparency, and accountability in clinical establishments.

The Commission’s powers are not ornamental.

Section 38 expressly authorises it to examine complaints relating to patient care services, unethical trade practices, and to ensure that only properly trained and qualified personnel are employed.

Crucially, the Court drew a clear conceptual distinction.

The Court noted that the Commission had consciously refrained from giving any finding on medical negligence. Its inquiry into qualifications was not disciplinary in nature, but regulatory aimed at determining whether the hospital complied with statutory obligations to employ qualified personnel.

Such scrutiny, the Court held, is not only permissible but central to the Commission’s mandate.

Equally significant is the Court’s rejection of the High Court’s narrow view of regulatory competence.

Accepting the Division Bench’s approach would mean that whenever patient care lapses involve medical facts, the Commission would be rendered powerless.

That, the Court warned, would defeat the legislative intent of the WBCE Act and leave patients without an effective remedy for institutional failures.

The judgment also reinforces the patient-centric orientation of modern health regulation. Compensation under the WBCE Act is not contingent on proving medical negligence in the strict tortious sense.

Where death or injury results from statutory violations and serious deficiencies in service, regulatory compensation can follow independently of disciplinary proceedings against individual doctors.

By restoring the Commission’s award with interest and affirming its jurisdiction, the Supreme Court has reaffirmed that health-care accountability is multi-layered. Professional misconduct may be judged by medical councils, but hospitals as institutions remain answerable to regulatory bodies for how they organise, staff, and deliver patient care.

In doing so, the Court has ensured that regulatory law is not reduced to a paper tiger and that patient protection remains at the centre of health-care governance.