Supreme Court Issues Nine Interim Directions to States on Road Accident Trauma Care
A Division Bench of Justices J.K. Maheshwari and Atul S. Chandurkar directed all States and UTs to integrate emergency helplines, operationalise PM RAHAT, and build trauma registries within fixed deadlines.
The Supreme Court on 26 May 2026 issued nine time-bound interim directions to all States and Union Territories requiring them to overhaul emergency response for road accident victims. The Division Bench of Justice J.K. Maheshwari and Justice Atul S. Chandurkar, hearing Writ Petition (Civil) No. 726 of 2024 filed by Savelife Foundation and its founder, found that while States had expressed willingness to implement Union-level schemes, actual implementation remained “fragmented and its status differs from one place to another.” The order covers helpline integration, Good Samaritan grievance systems, ambulance standards, GPS tracking, paramedic training, trauma registries, hospital grading, cashless treatment, and mass-media campaigns. Chief Secretaries of all States and UTs have been directed to receive a copy of the order and report compliance to the Court's Registry within the specified timelines. The matter is listed after four months for further directions.
How the Petition Reached This Stage
Savelife Foundation, described in the order as a social impact organisation, and its founder filed the writ petition under Article 32 of the Constitution of India seeking a series of mandamus directions to the Union and all States and UTs. The petition argued that the right to trauma care is an integral part of the right to life under Article 21, and that the absence of a uniform, swift emergency response system was causing preventable deaths.
The Court noted that the petitioners had placed reliance on reports and empirical data showing that a major cause of fatalities in road accidents is the lack of access to quick emergency and trauma care. The order observed that with a staggering increase in the number of accidents in recent years, the need for a robust trauma care system was “only becoming more pertinent by the day.”
The petition also drew on the Court's earlier judgment in Savelife Foundation v. Union of India, (2016) 7 SCC 194, in which the Court had recognised the need for Good Samaritan laws and given credence to Ministry of Road Transport and Highways guidelines protecting Good Samaritans. Those guidelines were subsequently incorporated as Section 134A of the Motor Vehicles Act, 1988 after its 2019 amendment.
Notice was issued on 6 November 2024. By order dated 1 August 2025, the Court requested the Attorney General of India to scrutinise the stands of different State Governments and UTs and submit a report on what steps could be taken. On 21 May 2026, the Court permitted the Attorney General to place his suggestions on record, after the Union contended that subjects such as public health, hospitals, ambulance services, police, and public order fall within the State List under the Seventh Schedule of the Constitution.
The Union's Position and the Compliance Affidavit
Attorney General R. Venkataramani submitted that the Union's role is to act as an enabler and lay down a national framework. He pointed to several existing policies and schemes — the PM RAHAT cashless treatment scheme, the Rah-Veer Scheme, the Good Samaritan Rules, the National Ambulance Code, the NELS Curriculum, ERSS-112, and Ministry of Health and Family Welfare trauma guidelines — as evidence that the Union had discharged its framework-setting function. He acknowledged, however, that implementation of these policies and advisories was “scanty and fragmented across different States / UTs.” He suggested the Court issue directions to States and UTs for effective implementation with time-bound compliance reporting.
The Court examined a Compliance Affidavit dated 12 May 2026 filed by the Union, which compiled responses from 34 State Governments and UTs on the various prayers in the writ petition. The responses showed willingness to progressively implement Union schemes, but confirmed that implementation remained uneven across jurisdictions.
The Nine Interim Directions
Having considered the petitioners' suggestions, the Union's submissions, and the affidavits of 34 States and UTs, the Court issued the following interim directions:
Helpline integration. All States and UTs must complete full technical and operational integration of all emergency and ambulance helplines — including 100, 101, 108, 102, 1033, and 1091 — into helpline 112 within three months, and undertake concurrent mass-media publicity of helpline 112.
Good Samaritan grievance systems. All States and UTs must establish functional physical and digital Good Samaritan Grievance Redressal Systems with designated nodal authorities at State and District level within three months. Monthly meetings must be organised and minutes uploaded on the concerned portals.
Medical rescue protocol. The Union of India, through the Ministry of Health and Family Welfare and the Ministry of Road Transport and Highways, is permitted to issue a medical rescue protocol for trauma cases within three months. All States and UTs must operationalise the protocol at State and UT level within three months of its issue.
Ambulance standards and GPS. All States and UTs must ensure full Automotive Industry Standard-125 (AIS-125) compliance across all registered ambulances, both public and private. GPS and Vehicle Location Tracking Device fitment with real-time integration into helpline 112 is mandated. Periodic structured audits covering response times, quality of care, equipment, and outcomes must be conducted, with compliance reporting to a designated Union-level authority, within three months.
EMT curriculum. Since the curriculum has already been notified by the National Commission for Allied and Healthcare Professionals (NCAHP), all States and UTs must adopt and implement the NCAHP-notified Emergency Medical Technician curriculum and align their training institutions and certified personnel within three months.
Trauma registries. The Ministry of Health and Family Welfare must issue guidelines prescribing the requisite data format for a Trauma Registry within eight weeks. All States and UTs must then establish State Trauma Registries covering all medical facilities and link them to a Coordinated Trauma Registry within four months.
Hospital grading. All States and UTs must undertake grading and designation of all medical facilities, public and private, in accordance with Ministry of Health and Family Welfare guidelines. The geographic scope is extended beyond National Highways to State Highways, Major District Roads, and Urban and Peri-Urban areas, within three months.
PM RAHAT cashless scheme. Since the Union has already framed the PM RAHAT scheme in response to Prayer I, all States and UTs must take steps to fully operationalise it within eight weeks. This includes designation of hospitals, on-boarding of State Health Agencies on the Transaction Management System, district-police deployment on the electronic Detailed Accident Report system, and opening of DC sub-agency accounts within three months. The Court clarified that non-implementation would amount to a violation of the Motor Vehicles Act.
Mass-media campaigns. The Union and all States and UTs must undertake sustained, structured, multi-lingual mass-media campaigns covering helpline 112, Good Samaritan protections under Section 134A of the Motor Vehicles Act, 1988, the grievance redressal system, and the PM RAHAT cashless treatment scheme, with defined obligations and compliance reporting within one month.
Why the Court Framed the Issue as It Did
The order's reasoning rests on the Court's characterisation of trauma care as a right, not a welfare benefit. The judgment observed that when a person suffers an accident requiring urgent care, every minute spent without medical intervention “significantly narrows the scope for survival.” It identified three stages of care — initial response and first aid, transportation, and post-hospitalisation immediate care — and said a robust mechanism must take a bottom-up approach accounting for all stakeholders.
The Court also addressed the psychological and legal barriers that prevent bystanders from acting as Good Samaritans: fear of being summoned to a police station as a witness, and the psychological weight of witnessing injury. It said systemic intervention, a uniform framework, public awareness, standardised first aid skills, and proper Good Samaritan laws are required because the right to trauma care is an integral part of the right to life under Article 21.
On the federalism question raised by the Union — that health, hospitals, and ambulance services are State subjects — the Court's approach was to direct States and UTs to implement Union-framed schemes rather than to require the Union to legislate or act beyond its competence. The Attorney General's own suggestion that the Court issue directions to States for time-bound compliance was adopted as the operative framework.
Outcome
The Court directed that a copy of the order be sent to the Chief Secretaries of all States and UTs to issue general directions within their respective jurisdictions. Action taken reports, along with ground realities indicating inaction or good practices, must be submitted to the Registry of the Court within the specified timelines. The matter is listed after four months for issuance of further directions. The Court also requested the Attorney General to present structured suggestions on efficient and effective implementation of trauma care upon receiving the compliance reports.
The Court acknowledged the assistance of Attorney General R. Venkataramani, Senior Advocate Sidharth Luthra, and Advocate Malvika Kapila for appearing in what it described as a pro bono cause with massive public interest implications.