The Indian Medial Association (IMA) has demanded amendment in the Clinical Establishment Act (CEA) as many of the rules and clauses in CEA will only result in closure of small and medium level hospitals in the country, which are the backbone of India’s healthcare delivery system.

IMA strongly consider that CEA will affect the continued viability of small and medium healthcare institutions, which are accessible and affordable to people. While the association fully subscribes to the view that the standards of healthcare have to be improved, but it fears that the provisions of this Act will be counterproductive.

The association has suggested some amendment in the provision of the CEA like accredited hospitals should be exempted from licensing process; the medical profession and the private hospitals should have a right to fix their charges for their private patient; the penalty rate determined in the act should be scaled down and the onus of safe transport and the cost involved in emergency case management should be borne by the government.

Dr Jayesh Lele, president-elect of IMA Maharashtra says, “The clause and provision in the Act will only increase the cost burden and lead to the closure of small and medium hospitals in the country. We only want the Act to be patient and doctor friendly. At present Uttar Pradesh, Uttarakhand, Rajasthan, Bihar and Jharkhand have adopted the Act under clause (1) of article 252 of the Constitution and even Maharashtra has also applied for the adoption of CEA enacted by the central government.”

The present Act does not admit the accreditation process and has a licensing character. The association suggests that registration and upkeep of standards in healthcare delivery will be better maintained through the accreditation process. IMA and NABH have already started a unique scheme to assist even small and medium hospitals to gain entry level accreditation.

For promotion of healthcare institution, IMA has also urged to include the provision and act should be called as 'The Clinical Establishments (Registration and Regulation and Promotion) Act 2010'.

The Clinical Establishments (Registration and Regulation) Act, 2010 has been enacted by the central government to provide for registration and regulation of all clinical establishments in the country with a view to prescribing the minimum standards of facilities and services provided by them. The Act has taken effect in the four states namely, Arunachal Pradesh, Himachal Pradesh, Mizoram, Sikkim, and all Union Territories except the NCT of Delhi since March 01, 2012.