The central government has finally woken up to the need for prescribing quality standards for the entire gamut of healthcare services. All medical establishments, from tertiary hospitals to nursing homes, clinics and diagnostic centres are to have specific standards. The government will also put an effective monitoring mechanism in place. While some states have already passed similar legislation, this is the first time a central legislation is planned to ensure uniform standards in our healthcare system. The key- provision in the proposed Clinical Establishments (Regulation and Accreditation) Bill is known to be the establishment of an apex policy making "National Council" to regulate Indian healthcare establishments. The National Council is to develop different standards for different categories of clinical establishments and bring both private and government healthcare centres under the ambit of the new law. Every state government would be asked to set up a three-tier implementing mechanism. Even states like Delhi, MP, Assam etc will have to fine-tune their existing laws to ensure uniform compliance. If the Centre's plans materialize, the states will soon have Clinical Establishments Regulation Boards at the state and district levels to keep eye on the services offered by hospitals and nursing homes. The government move is a right step forward to ensure minimum standards in medical establishments.

The second major component of the proposed law is accreditation of healthcare firms. While minimum standards are going to be mandatory, accreditation is to be of voluntary nature. Due to the same reason, the regulation is to be purely a government job and accreditation system a private-public initiative. The Indian Healthcare Federation (IHF), a grouping of all major corporate hospitals has already expressed its willingness to partner with the health ministry for introducing a "healthcare accreditation system". Indian Confederation for Healthcare Accreditation (ICHA), an autonomous body formed by all stakeholders in healthcare sector, is another move which is volunteering for the cause of an accreditation system. Though the health ministry has supported both the initiatives it is yet to say the final word on the exact nature and structure of the healthcare accreditation system. The ministry needs to give equal importance to both regulation and accreditation for the sake of quality healthcare. It should consider the fast changing nature of quality benchmarks in healthcare sector and turn the accreditation system as dynamic as possible. The standards should be periodically revised and today's desirable standards should become tomorrow's minimum standards. That is the only way how there can be continous upgradation of healthcare standards in the country. The link between the "National Board" that decides the minimum standards in healthcare and the "Accreditation Board" which prescribes multilevel standards for the same establishments should have strong linkages. The working relationship between these two bodies can result in periodic revision of mandatory standards.  The ministry should realize that all kinds of "voluntary" quality upgradation options would remain only in Urban India and will have no impact on thousands of rural healthcare establishments. The voluntary accreditation may help boost "medical tourism", but for real progress in rural healthcare standards, India needs rules with in-built mechanism to ensure strict compliance.