ABSTRACT
This article examines the constitutional recognition of periodic medical check-ups as an important component of prisoners’ right to life under Article 21 of the Constitution of India. Analysing the recent ruling of the Madras High Court, it argues that custodial healthcare is a constitutional obligation, not an administrative choice. It places prison health within broader human-rights law, and that highlights the duty of care by the State and the need for the structural reforms which prevent violations of constitutionally guaranteed rights within prisons.
KEYWORDS: Article 21, Prison healthcare, Custodial Rights, Periodic Medical Checkups, Fundamental Rights
INTRODUCTION
The Constitution of India provides the right to Life under Article 21. This has been interpreted for a long time to include the right to health and medical care as well. Importantly, this right extends to those in custody as well, since imprisonment may curtail liberty, but cannot curtail human rights. The Courts have, over the years, increasingly recognised the right to basic healthcare in prisons. Recently, the Madras High Court held that every prisoner has a right to periodic medical checkups as a part of Article 21. This judgment shows that courts are enforcing humane prison conditions and dignified treatment for inmates. The issue requires urgent attention, considering India’s prison population and the chronic overcrowding in this sector, as in such conditions, serious health vulnerabilities are more likely to be hidden. Recognising prison healthcare as a constitutional concern highlights that prisoners remain persons who are entitled to care, and the state undertakes action to maintain this duty of care.
PERIODIC CHECK-UPS: PART OF THE RIGHT TO LIFE
Periodic medical check-up in prisons means the scheduled, preventive health screening at proper intervals, conducted either annually or biennially, and not just occasional emergency treatment. This allows early diagnosis of diseases such as diabetes, hypertension, TB, mental illness, etc., and ongoing management of chronic conditions, timely interventions before the ailments worsen. Earlier, they were subjected to only purely reactive care, where treatment was only provided after serious illness or injury had already taken place. In the case of Parmanand Katara v. Union of India, the Supreme Court held that the right to health and medical treatment is “part and parcel” of the right to life. In a practical scenario, when an inmate has no freedom of movement, the State must proactively provide healthcare. The Madras High Court emphasised that a prisoner is also a person under Article 21, so prison authorities must assume a duty of care, which shall be especially for inmates with disabilities or chronic illness. Periodic checkups are now a constitutional obligation, not charity or optional policy. They enforce the State’s duty to preserve inmates’ bodily integrity and human dignity even while serving a sentence.
NECESSITY OF THE PROTECTION
Prisons have been recognised as exceptionally vulnerable in terms of health. Hence, special protections are justified. Prisoners rely entirely on the prison for food, shelter, and medical care. They cannot seek outside doctors or purchase medicines. Their health rights cannot be abandoned merely on the grounds of incarceration. Moreover, studies show that these inmates have high rates of chronic and communicable diseases. For instance, TB incidence in Indian jails is nearly five times the national rate, and mental illness is much higher than in the general community. With the rise in diabetes and hypertension in India, the prisons are not immune to the same.
Without proper and timely screenings, such conditions may go undetected. Many Indian prisoners also suffer overcrowding and a lack of basic facilities. Overcrowding, poor ventilation, and inadequate nutrition worsen health outcomes. Such prisons may operate as potential hotspots for diseases. Due to the absence of a screening process, many diseases that are preventable but catastrophic, and lead to serious outcomes has become common in prisons. Beyond efficiency, healthcare is tied to human dignity. Treating prisoners as persons means safeguarding their health needs. Denying them routine care amounts to awarding them punishment with suffering.
HEALTH CONDITIONS IN INDIAN PRISONS
Indian Prisons face serious health challenges. India has about 1276 prisons with the sanctioned capacity of approximately 2,77,304 inmates. However, the actual occupancy is nearly 4,00,000, running at a 120-130% capacity. Overcrowding increases disease transmission and strains medical services. As per a Central Prison Study, the inmates suffered from a range of ailments such as TB, skin diseases, psychiatric disorders, etc., due to prolonged confinement and poor facilities provided. Globally, an estimated 6 to 7% of prisoners have diabetes, which mirrors community rates, but they often have worse management in custody. Mental health conditions are reported to be 2-3 times higher among prisoners.
Many prisons lack even basic medical infrastructure. Only about two-thirds of jails conduct any TB screening, under 20% have diagnostic facilities, and only half have proper treatment centres. Very few prisons have resident doctors or specialists. Ambulance transfers in such cases can be delayed and have worsened health outcomes. A growing fraction of prisoners have lifestyle diseases, and the diets or meals offered in prisons often ignore the medical needs. Without regular check-ups and diet adjustments, simple conditions may spiral into emergencies.
IMPLEMENTING PRISON HEALTHCARE REFORM
Putting the right to periodic medical care into practice requires concrete measures. Prison healthcare reforms, thus, should include the following:
- Each prison should organise a comprehensive health camp for all inmates every year/ every two years. This can involve external medical teams from local hospitals..
- By implementing targeted screening such as annual blood sugar tests, hypertension checks, TB symptom questionnaires, etc. Such routine medical examinations have also been recommended by the NHRC, especially upon entry in prisons.
- For inmates whose conditions have been diagnosed, the jail must provide an appropriate diet and timely medication to them.
- To ensure that proper assistive devices and facilities are available for the disabled prisoners, including ramps, support rails, and accessible toilets. This supports the Rights of Persons with Disabilities Act, 2016, which mandates a reasonable accommodation in custody.
- Even providing them with the basic infrastructure through small changes may help. The availability of separate sick wards, clean bedding, adequate ventilation, and hygiene facilities can provide better living conditions. The Court’s direction of housing senior or disabled prisoners near toilets and a mess hall for ease adds to the reform measures.
- Periodic and regular mental health counselling and physical therapy for injured and chronically ill inmates, along with rehabilitation activities for the amputee prisoners, bring in a reform towards counselling and rehabilitation facilities in prisons.
- Lastly, maintenance to up to date medical records of each inmate allows for an analysis and tracking of every prisoner’s health and disability status. These can be monitored by regular review committees to introduce appropriate prison health programs.
STATE’S DUTY TO PROVIDE PRISON HEALTHCARE
The duty to care for prisoners’ health is mentioned in the statute and the Constitution. The right to life with dignity includes the right to medical care. In L. Muruganantham v. State of Tamil Nadu, the Court stated that Article 21 includes persons in custody. In Re: Deaths in Punjab and Haryana Prisoners, it was held that inadequate staffing and delayed treatment in prisons violate Article 21. In Re: Inhuman Conditions in 1382 Prisons, the Court declared that minimum medical standards and the combination of prison healthcare with public systems are essential under Article 21. Moreover, the Rights of Persons with Disabilities Act, 2016, directs reasonable accommodation, even in the prison. Statutes such as the Prisons Act of 1894 and the model prison manuals impose duties on state governments to maintain jail hospitals. The Model Prison Manual, 2016, states routine health screening, isolation wards, and resident medical officers. State prison rules also promote these reforms and require medical officer visits and sick quarters. A key doctrine is that custody raises the State’s responsibility. Thus, any lapse in prison healthcare results in constitutional accountability and not mere administrative oversight.
CONSEQUENCES OF NEGLECTING PRISON HEALTHCARE
Ignoring prison healthcare has grave consequences at multiple levels. the lack of regular screening leads to illness that go undetected and later become fatal. Such cases violate the right to life. Physical illness often co-exists with mental stress from imprisonment. Without counselling or psychiatric support, untreated mental illness can worsen, leading to higher suicide rates. Prisons can also become breeding ground of diseases that are communicable. Without routine checkups, controlling such diseases in prison is not possible. Further, neglect results in distrust towards the justice system, especially among marginalised inmates who disproportionately live in the jails. Constitutionally guaranteed rights thus become hollow if not enforced, and widespread neglect can trigger large-scale litigation and public outcry. Thus, inadequate prison healthcare becomes a second punishment beyond imprisonment.
CONCLUSION
Conclusively, the Madras High Court’s judgment is a landmark in affirming that inmates do not lose their fundamental right to health at the prison door. Periodic medical check-ups are an essential element of the right to life and dignity under Article 21, and the State must bring them into action. A civilized legal system is always judged by how it treats the vulnerable, and those behind bars are among the most vulnerable. This decision reflects India’s developing rights, which recognize prison healthcare as a core element of justice. Periodic health screenings are not mere protocol anymore; they are part of ensuring that those our society has sentenced to jail are not simultaneously sentenced to negligence or death.
“PRIME LEGAL is a National Award-winning law firm with over two decades of experience across diverse legal sectors. We are dedicated to setting the standard for legal excellence in civil, criminal, and family law.”
WRITTEN BY: STUTI ANVI
