Calling it a "turbulent period" in the healthcare system, Union health minister J P Nadda today urged the states to implement the Clinical Establishment Act for regulation of private healthcare institutions, in the backdrop of cases of alleged medical negligence and overcharging by private hospitals.
 

The Clinical Establishments Act was been enacted by the Centre to provide 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. The minister said that the government is committed to bringing about proactive policy changes in the healthcare sector to make it more responsive to the needs of the common man and to create a network where the government and the private sector can work together for ensuring universal healthcare at affordable cost."In this turbulent period of the healthcare system, stakeholders must sit together to sort out the differences to evolve a policy framework that should address how to provide affordable universal healthcare to the citizens.

"The private healthcare sector cannot remain unregulated and that is why we have been asking states to implement the Clinical Establishment Act," Nadda said inaugurating the 14th India Health Summit organised by the Confederation of Indian Industry (CII) here today. The minister pointed out that the medical profession is lacking communication skills, and the challenges as well as the impediments should be communicated to the general public. "You cannot afford to live in silos. The challenges, impediments and advantages India possesses in the medical system should be communicated to the general public. "At the same time, medical community should be aware of the imponderables being faced by those who are seeking medical help, particularly from the point of view of cost. Such meaningful interfaces can take the medical profession to its pristine glory," he added.

Nadda also highlighted the achievements of his government in the healthcare sector, such as increase in the health expenditure as a proportion to the GDP. Prior to 2014, there was a cut in the health expenditure. As against this, the expenditure is increasing every successive year since 2014. For the year 2017-18, the budgeted expenditure is 27.5 per cent higher than the previous year. Of that, more than 70 per cent has already been expended, he said. Pitching for greater cooperation between public and private hospitals to ensure universal healthcare, the minister said that a beginning has been made in this direction also. More than 4,000 gynaecologists from private hospitals have enrolled themselves for voluntary services to the poor living in rural and tribal belts.

Dr Naresh Trehan, Chairman, CII Healthcare Council and CMD, Medanta-The Medicity stressed the need for ensuring "some order" in the healthcare sector. The turbulent conditions should be addressed, he said, and offered that the stakeholders would sit together with the minister after the winter session of Parliament. AIIMS director Dr Randeep Guleria referred to the need for maintaining quality in medical education, while creating more manpower. The change from clinical approach to investigative medicine, he said, has increased the cost of treatment and has led to mistrust between the doctor and the patient. "What we need is a mix of both to ensure affordable treatment to the patients," he added. The Clinical Establishments Act is applicable to all types (both therapeutic and diagnostic types) of clinical establishments in the public and private sectors.

Till now, five states including Arunachal Pradesh, Rajasthan, Jharkhand and Assam and all Union territories except the NCT of Delhi have adopted and implemented the Act. States like Sikkim, Mizoram, Bihar, UP and Uttarakhand have adopted the Act but are yet to implement it. Under the Act, standard treatment guidelines are specified for 227 diseases, including dengue, chikungunya and malaria. The hospitals are supposed to abide by minimum standards in terms of infrastructure, services, staff, equipment and lighting arrangements among others. A technical committee is to be set up to decide on charges for treatment of diseases and procedures at clinical establishments, including private hospitals. Health facilities are supposed to display the charges for each procedure and facility to keep the patient informed in advance. Failure to adhere to these guidelines would result in imposition of penalty.