Clinical Establishment Act

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Repeal !Renegotiate !

IMA opposes the Clinical Establishments (Registration and Regulation)Act 2010 1. IMA supports registration and regulation of clinical establishments by an autonomous Hospital Authority of India which has democratic and representative character.

2. Government licensing out healthcare institutions will lead onto harassment, corruption and nepotism.

3. Government imposing uniform treatment protocol is unacceptable .This endangers patient safety.

4. Government fixing rates is unrealistic. Government should first define parameters to measure skill and proficiency of doctors.

5. Government have taken a layman’s approach to the subject as evidenced by the ‘stabilization clause’. First aid is the right of the patient and duty of the medical profession. Stabilisation is unachievable.

6. Single doctor establishments should be exempted from the act.

7. The proposed autonomous Hospitals Authority of India should provide single window clearance for all legislations regarding clinical establishments.

8. The clinical establishments act should include provisions for promotion of healthcare institutions. It should be The clinical establishments (Registration and Regulation and Promotion)Act 2010.

9. The licensing character of regulation should be replaced by a more friendly procedure.

10. Complaints cells are incompatible with administration and delivery of health care services. Alternative forums already exist.

The clinical establishment (Registration and Regulation) Act 2010 has become a fait accompli. Nevertheless the law in its present format is unacceptable to the medical profession of the country. It is admitted that registration of the clinical establishments is necessary for various reasons. However the regulation aspect of it has serious flaws. License raj imposed on healthcare institutions will lead onto disappearance of single doctor practitioners, corporatization of health care and promote corruption and nepotism.IMA is apprehensive of large scale harassment of private sector. A) General Objections:-

1. Who is affected:
The private sector consists mainly of single practitioners or small nursing homes having 1-20 beds. 90% of the facilities are manned by single practitioners. According to the survey in 2001-02 there were approximately 13 lakh enterprises providing health care services in the country. The majority of these enterprises are own account enterprises (OAEs), which accounted for over 80% of the total health facilities in the country. OAEs are typically run by an individual or are a house hold business providing health services without hiring a worker on a fairly regular basis. The number of health establishments in the country was roughly around 2.3 lakhs. Establishments are those that hire at least one worker on a regular basis. OAEs are dominant in rural areas. There are 92% OAEs and around 7% of establishments in rural areas . In the urban areas, establishments accounted for roughly 38% and the remaining 62% facilities were OAEs. If we consider all the 13 lakh private health providers, a little over half of them are modern medicine practising physicians and specialists. So it is clear against whom the Government is moving. If 90% of the healthcare institutions in this country are manned by single practitioners, it does not take much to understand that the target of these regulations are these single practitioners. By imposing standards unachievable by them these regulations are going to lead to closure of majority of these small institutions. India is well served by its army of family physicians and small hospitals. They provide low cost service at the doorsteps of the commonman 24x7.Any law resulting in diminution of the role of single practitioners will seriously hamper the accessibility and affordability of healthcare. Government will do well to recognise that these family doctor single person institutions are holding the lifeline...
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