The Supreme Court on Monday took up the matter concerning formulation of guidelines for Intensive Care Units (ICUs) across the country and held an extensive in-court consultation with leading medical experts, government representatives, and counsel to chart a roadmap for standardisation of critical care infrastructure.

During the hearing, the Court expressed dissatisfaction with bureaucratic delays and emphasised that healthcare reforms particularly in critical care cannot be left to administrative inertia. It highlighted that the objective was to create a uniform, implementable framework for ICU facilities across India, ensuring minimum standards irrespective of geography or economic disparity.

Senior doctors and experts addressed the Court on key challenges, including lack of standardised ICU classification, shortage of trained personnel, and infrastructural gaps. The expert panel proposed a three-tier classification of ICUs (Level 1, Level 2, Level 3) with clearly defined eligibility criteria, admission standards, and resource requirements, aimed at rationalising costs and ensuring appropriate allocation of patients.

The Court highlighted the importance of protocol-based healthcare delivery, noting that effective ICU care depends not only on infrastructure but also on trained manpower, documentation, audit systems, and coordinated emergency services. Concerns were also raised regarding hospitals mislabelling facilities as ICUs without meeting minimum standards.

Taking the process forward, the Court directed that the guidelines prepared by the expert committee be circulated to all States and Union Territories, and that a coordinated implementation strategy be evolved. It ordered that:

1. A joint meeting of State Health Secretaries, Central Government representatives, and expert members be convened within one week;

2. States must prepare a concrete action plan for implementation and monitoring of ICU guidelines;

3. Initially, the focus would be on five core priority areas forming the minimum mandatory standards;

4. A common, agreed draft implementation framework be finalised and circulated within three weeks.

The Court also stressed the need for training and augmentation of human resources, directing that bodies such as the Nursing Council and paramedical authorities be involved in enhancing specialised training for ICU care.

Recognising the role of technology, the Court noted the potential for systems such as real-time hospital mapping and remote monitoring, while cautioning that technology must act as an enabler rather than replace human decision-making.

The matter has been listed for further hearing on May 18, where the Court will review the progress made and consider the implementation roadmap.

Appearances:

Amicus Curiae: Karan Bharihoke

For Union of India: ASG Aishwarya Bhati alongwith Advocates Shivika Mehra; Anirudh Singh