If states were to adopt the Clinical Establishment Act 2010 in its present form, it would amount to just that
Allegations of irregularity in treatment of a seven-year-old girl who died of dengue in Gurugram after a stint at a private hospital in the city and of over-charging—the girl’s parents were handed a bill of nearly Rs 18 lakh—have stirred a debate over regulation of the healthcare industry. The Haryana government has launched an investigation into the matter, and if the allegations are found to be true, there must be strict and exemplary action. This will not only likely deter unscrupulous hospitals, it will also go a long way in restoring faith in the accessibility of the healthcare system in India. However, the Centre writing to states to adopt the Clinical Establisments Act 2010 to prevent such instances of malpractice by healthcare establishments is akin to chopping off the limb to get rid of a wart.
To be sure, the Act—adopted by 10 states so far, including Haryana—lays down watertight provisions mandating acceptable standards of service, facility and personnel as also registration of healthcare establishments. It speaks of ensuring the closure of unregistered establishments. These provisions are enabling, in the sense that hospitals and clinics would know what template to follow for service and facility standards and there will also be a mechanism to punish violations. However, the Act also speaks of inspections and checks—creating the possibility of harassment under an inspector raj. What’s worse, sub-section 1 of section 12 of the Act says the clinical establishment will be required to fulfil “such other conditions as may be prescribed” to get and keep registration. Such ambiguity can prove to be a gateway to regulation that can throttle the industry. For instance, if a state government were to bring in pricing controls—Karnataka’s attempt to do so saw doctors launch a strike that severely debilitated healthcare in the state—establishments will not be able to afford, among other things, technology upgrades that could benefit patients as they will not have the pocket for it. The cure the government is suggesting may prove toxic. It would be better if the government were to amend the law to retain the parts that provide meaningful regulation and lose the bits that could result in heavy-handed control.