The Clinical Establishment (Registration and Regulation) Act, 2010, which was enacted by the Centre for regulating all clinical establishments in the country, has come into effect in only four states and all Union Territories, except NCT of Delhi.

The issue has come to light following the recent incident of alleged overcharging by Gurugram’s Fortis Hospital, Haryana. The Centre believes that such an incident could have been prevented had the Act been implemented in the state. The Act, which was passed by Parliament in 2012, provides for registration and regulation of all clinical establishments in the country with a view to prescribe the minimum standards of facilities and services provided by them. However, even after five years, it has become effective in only four states—Arunachal Pradesh, Himachal Pradesh, Mizoram and Sikkim. The Act is applicable to all types (both therapeutic and diagnostic types) of clinical establishments from the public and private sectors, belonging to all recognised systems of medicine, including single doctor clinics. The only exception is clinical establishments run by the Armed Forces.

The main features of the Act include transparency in the process of registration, which would lead to better regulation. All hospitals and clinics are supposed to keep all the data in public domain and prominently display details of charges and facilities, in local as well as English language. The Act also stipulates that these institutions maintain and provide electronic medical records of every patient as may be determined and issued by the Central or state government. The Act was enacted as the government felt that “healthcare in India suffers from under regulation subjecting the populace to poor quality of treatment, quackery menace and high costs”. “The private sector has a vast range of service providers from the highly competent to quacks. Patients’ safety is compromised and financing and service delivery are not transparent and accountable, making delivery of healthcare prejudiced against the poor. High cost of healthcare in private sector raises the issue of affordability and equity,” says the Act. Taking note of the issue after the Gurugram incident, the Union Ministry  of Health has directed all states and UTs to adopt and implement the Act. Union Health Secretary Preeti Sudan has written a letter to all chief secretaries, saying it is time to learn lessons from such incidents (like Gurugram’s).

“I advise that a meeting with all important healthcare establishments (including private hospitals) of your state be taken and they be clearly sounded not to indulge in such practices following which strict action will be taken. I request you to kindly get the Clinical Establishment Act adopted and implemented by your state also,” Sudan has written in her letter.

A seven-year-old girl died at Gurugram’s Fortis Hospital after undergoing treatment for dengue on 14 September. The parents alleged that the hospital allowed them to take the body after paying Rs 18 lakh, which according to them was “over-charge”. The Health Ministry has directed the Haryana Health Department to look into the case and go for exemplary punishment if the hospital was found overcharging. Sudan said: “It has been alleged that the patient was grossly overcharged and standard treatment protocols were not followed.” “Such incidents have an extremely deleterious impact on the faith of the general public in the health care system in the country,” she has said in the letter.

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