Will Kerala's new Bill put healthcare beyond common man's reach?
The state of Kerala is set to introduce a draft Clinical Establishments Bill, which could pave the way for future legislation on the regulation of hospitals and clinics across the country.
The Bill aims to provide for the registration and regulation of clinical establishments, with a view to prescribing minimum standards for facilities and services, which may be provided for the purpose of improvement in public health.
The legislation applies to "any hospital, maternity home, nursing home, dispensary, clinic or an institution, by whatever name called, that offers services, facilities requiring treatment, diagnosis or care for illness, injury, deformity in any recognised system of medicine established and administered or maintained by any person or body of persons".
The Bill proposes to establish a State Council for Clinical Establishments, which would conduct periodic reviews of clinical establishments for verifying the standards to be maintained. The council would broadly have the following tasks:
1. Classify the clinical establishments into different categories, in accordance with the minimum standards for each category, which will be decided by the council.
2. Cancel registration of such clinical establishments where there is an imminent danger to public health, and the health and safety of patients and staff.
3. Establish and maintain a grievance redressal mechanism, to receive and investigate complaints received about clinical establishments.
4. The council will need to compile, maintain and publish a register to be known as the State Register of Clinical Establishments, in such form and containing such particulars as may be prescribed.
5. The council shall follow a consultative and transparent process for the classification of clinical establishments.
6. The authority will have the power to grant, renew, suspend or cancel the registration of a clinical establishment, enforce compliance of the provisions of the Act, and investigate complaints of breach of the provisions of the Act.
7. A clinical establishment, if found to continue functioning without registration, is liable to a monetary penalty, which may range from fifty thousand rupees to five lakh rupees.
8. The council or the authority or any officer authorised by them shall have the right to cause an inspection of, or inquiry in respect of, any clinical establishment, its building, laboratories, diagnostic facilities and equipment, and also of the work conducted or done by the clinical establishment, to be made by such person or persons as they may direct and to cause an inquiry to be made in respect of any standards or conditions of the registration, after issuing notice to the clinical establishment and that establishment shall be entitled to be represented threat.
While many activists in the state have demanded a quick passage of the Bill, many among the medical community have also raised concerns on specific clauses in the Bill.
Heads of private hospitals in the state have raised the most concern. According to them, the state relies on a number of affordable private hospitals. Dr P.K Mohammed Rasheed of the Kerala Private Hospitals Association believes the Bill enforces appointment of qualified and trained professionals only, which would force them to increase the rates of services, as they will have to pay more to the staff.
Indian Medical Association (IMA) state general secretary Dr AV Jayakrishnan believes the Act, if passed, would heavily affect the health sector. According to him, it is fine if only super-speciality hospitals and large private hospitals come under the law, and not small ones. He states that there are one-man clinics that provide affordable service in rural areas, which may not meet the requisite criteria to get registration, and hence, many will have to commute miles for treatment.
The fear is that the Bill will eliminate clinics and small hospitals, and people will have to then rely on expensive corporate hospitals, which will lead to exponential increase in healthcare costs.
While the move to ensure quality healthcare should be lauded, it should not increase the already quite expensive healthcare options people rely on.
Edited by Shreyas Sharma