All the hurdles to bring a comprehensive act to regulate clinical establishments in the country have been overcome now and the Centre has decided to place the ‘Clinical Establishments (Registration and Regulation) Bill in the budget session of Parliament. The Union cabinet approved the proposal of the health ministry last week for adoption of the Bill which has been pending for years. The main objective of the new statute is to bring some uniformity in the healthcare delivery by making the registration of all clinical establishments mandatory and prescribing enhanced penalty for the defaulters. Once the Bill gets the approval of Parliament, the new Act will initially take effect in Arunachal Pradesh, Himachal Pradesh, Mizoram, Sikkim and all Union territories. Subsequently, the Act will be adopted in other states also. As per the Bill, the clinical establishments would include hospitals, maternity homes, nursing homes, dispensaries, clinics and similar facilities with beds that offer diagnosis, treatment or care for illness or injury or pregnancy in any recognised system of medicine such as Allopathy, Yoga, Naturopathy, Ayurveda, Homoeopathy, Siddha and Unani. It also includes any laboratory which offers pathological, bacteriological, genetic, radiological, chemical, biological and other diagnostic or investigative services. The establishments can be owned by the government or a department of the government, a Trust (public or private), a corporation (including a cooperative society), a local authority or a single doctor establishment.
Clinical establishments in the country are being run without any standards or ethics for several years in the absence of an effective law. Most of them follow no rules or good medical practices and often indulge in fraud and undesirable activities. Existing Central and state government rules are not specific to these establishments and thus provide several loopholes to indulge in malpractices. As public health is a state subject, the Central government has been abstaining from bringing any meaningful legislation covering the entire country. At the same time, most of the state governments have been rather lax in bringing a proper regulatory framework for the healthcare sector. Now, the proposal to set up a national registry of clinical establishments in the Bill is key to this new regulatory system for making registration compulsory for all clinical establishments in the country. The proposed bill will also enable the government to create a National Council of Standards prescribing minimum standards for the healthcare services. What is going to be critical after the passing of the Bill is the implementation of the Act. The cooperation of the state health department in monitoring the operations of clinical establishments in the country is going to be the key to the success of this major initiative.