May 20, 2019

The Golden Hour – 4. The Government Schemes and Effort

continued from:


  1. It is not that the Government has not been concerned. Steps are being taken, though implementation is tardy. Fifteen years after the Supreme Court directives in Parmanand Katara’s case in February 2004, the Ministry issued circular letters to Transport Secretaries and Commissioners of all States to take the required steps, and to help build confidence in the public for helping road accident victims. Till date (2014), however, public confidence remains low.
  1. Then, there is the 201st Report (Aug 2006) of the Law Commission of India on Emergency Medical Care to Victims of Accidents:

Though the life and liberty of a person is very much protected under Part III of the Constitution (under Art. 21), and though there is a Supreme Court direction that in all accident cases irrespective of the police complaint, it is the fundamental duty on the part of the hospitals (where the injured were taken) to attend on the patients, unfortunately nothing is done in the matter. As a result, many people have been dying without any care or attention.

After a deep analysis, necessary and welcome proposals for legislation and schemes have been included.

  1. The National Road Safety Policy states:

The Government will strive to achieve its target that all persons involved in road accidents benefit from speedy and effective trauma care and health management. The essential functions of such a service would include the provision of rescue operation and administration of first aid at the site of an accident, the transport of the victim from accident site to an appropriate nearby hospital.

Continuing the effort, the Ministry of Transport and Highways appointed a Working Group, which gave a 22-page report7 in 2012. Some of their proposals and suggestions are good. They need to be implemented.

  1. In so far as post-accident medical response is concerned, the Ministry of Health and Family Welfare (MoHFW) has established trauma centres in State Government hospitals to the extent possible and during the 11th Plan, the MoHFW had identified 140 government hospitals in 16 States along the golden quadrilateral highway for establishing trauma care facilities. The scheme is proposed to be extended to another 85 government hospitals during the 12th Plan and such facilities will be located near or on the national highways.
  1. In order to achieve an efficient and cost effective Inclusive Trauma System, the National / State Trauma Plan must specify how the various components will operate and interact to achieve specific goals.
  1. EMS in India is at crossroads and much needs to be done to achieve global standards and provide timely optimal care to victims. As recommended by the National Human Rights Commission (NHRC Annual Report 2004-05), emergency healthcare facilities should be present at every 50 kms along the National and State highways.
  1. As per the guidelines of the National Highway Authority of India, it is mandatory to set up trauma centres every 100 The government’s move to establish a trauma centre at every 100 kilometres alongside the highway system, and parking ambulances 50 kilometres apart, is welcome.
  • There is also, by the Ministry, an 80-page ‘Synthesis Report’ (in December 2011) of four Working Groups on Education, Enforcement, Engineering and Emergency Care constituted under the National Road Safety Coucil.
  1. It also needs a T to T centre (see sub-topic 10 infra) at every 10-20 kilometres. An ambulance can be parked next to a TtoT, which will also operate as an information counter for trauma and related services. A standardised ‘advance’ signboard (as on the previous page) could be useful.


  1. While the Government has come up with the Report by a Working Group (2011-12) and other schemes, particularly the September 2014 Bill, two issues remain: (1) their implementation; and (2) further continuing innovation. In short, the Government has a lot to do.

Next Topic: Trauma Centre