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Three laws, multiple prescriptions; Clinical Establishments Act amendments

Thursday, 30 November 2017

The prolonged agitation by doctors in Karnataka earlier this month, protesting against amendments to the Karnataka Private Medical Establishments Act, 2007 regulating private hospitals is in sharp contrast to the response in West Bengal to Chief Minister Mamata Banerjee’s Town Hall-style meeting in February, wherein she announced that the state government would bring legislation to rein in private hospitals.

Hospitals in West Bengal hardly got time, however, to join forces and protest before the law, termed the West Bengal Clinical Establishment (Registration, Regulation and Transparency) Bill, 2017, was passed by the state Assembly on March 3. The contrast is significant because Karnataka is said to have been “inspired” by the Bengal Act into changing its existing Medical Establishments Act of 2007.

Significantly though, the Karnataka Act includes much more severe penal provisions, including imprisonment in case of lapses. Its model of a District or Metropolitan Grievance Redressal Committee as an inspection authority is also among its more contentious provisions

Both West Bengal and Karnataka’s Acts prescribe different regulatory structures from that envisaged in the Clinical Establishments (Registration and Regulation) Act 2010 (CEA), passed by Parliament for regulation of the private healthcare sector. This has been adopted by 16 states and Union Territories, which include Bihar, Jharkhand, Uttarakhand, Himachal Pradesh, Arunachal Pradesh, Sikkim, Rajasthan, Mizoram, Uttar Pradesh, Puducherry, Dadra and Nagar Haveli, Daman and Diu, Andaman and Nicobar, Chandigarh, Lakshadweep and Assam.

All three Acts require a mandatory registration of medical establishments, albeit with different authorities— but that is where the similarities end.

The Acts differ significantly in three main areas. The first deals with the regulatory authority supervising medical establishments. Under the West Bengal Clinical Establishments (Registration, Regulation and Transparency) Act, 2017, the West Bengal Clinical Establishment Regulatory Commission constituted by the state government is tasked with the “regulation and supervision of the functioning and activities of the clinical establishments”. The chairperson is a former High Court judge, a former chief secretary or additional chief secretary in the state government or a similarly ranked person in the government of India. The vice-chair is a “person of eminence” and members are selected from diverse fields, including medicine, law, public health, academics, social services and consumer interests. All members are appointed by the government.

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