Where civil actors do not trust
remedies within health systems, they may pursue redress for health
related grievances outside the health systems.
In India, the Supreme Court in
1995 decided in favour of a citizens' action to use the Consumer
Protection Act to defend their rights as patients against medical
malpractice, when the state did not adequately address patient
& Hodne Steen, 1995).
Such legal remedies are generally
more accessible to affluent groups, leaving poorer ones inadequately
protected or served. Hence broader civil society watchdog roles
have wider benefit, particularly where they are institutionalized
in national health boards or councils or linked with a state
facility such as an ombudsman.