New framework may come into effect in six months

In six months, the State may put in place a regulatory mechanism to streamline all healthcare institutions. The framework for a new set of rules to replace the Clinical Establishment (Registration and Regulation) Act, 2010, (CEA) is almost complete, say professional medical bodies.

The CEA was notified by the Union government earlier this year, and had already been adopted by a few states.

Tamil Nadu however, was one of many states opposing it, as its doctors claimed that it had excessively stringent clauses.

However, State doctors have now agreed in principle to the new set of rules, which they say are fairer to them.

One of the rules of the CEA that the Tamil Nadu Medical Council (TNMC) objected to was the monitoring of hospitals and clinics by non-medical professionals.

K. Prakasam, president, TNMC, who participated in meetings with the government, said: “We have made several suggestions to the State government. For instance, the CEA wanted us to declare the price for every procedure. We have told the State government that we will tell the patient the cost he or she would incur.”

While the CEA had proposed that only local authorities would be empowered to supervise and punish violators under the Act, doctors in the State have suggested that a competent authority should decide on penalties for violations.

For example, the director of public health would be the State authority and the joint director of health would be the appropriate authority at the district level, the Indian Medical Association (IMA) has said.

The monitoring committee will be represented by one member each from the IMA, nursing board, Indian medical systems, dental, nursing and medical councils.

Only doctors registered under the TNMC would be allowed to run single-doctor clinics or nursing homes, thus ensuring that all practising doctors are registered. Any violation by a medical professional will attract a fine, but the punishment for a non-medical person should be imprisonment of not less than five years, the doctors have said.

The doctors have also suggested online registration of clinics and hospitals. “We are insisting that nurses qualified in other states and registered with the nursing councils there should be recognised and allowed to practise in our State. A hospital with 30 beds should be supervised by a doctor who is available round-the-clock. Clinics for physiotherapy, pain relief and oxygen therapy should also be under the supervision of a doctor. The inspection committee, which usually has government officials, should be represented by a member from IMA or a private doctor,” Dr. Prakasam said.

It will, however, be a while before the rules are in place as the IMA has yet to ensure that all doctors are members. Of the 90,000 doctors in the State, currently 50,000 are not members of the IMA.

“We need six months to sensitise the doctors on the importance of getting registered. We have agreed to the government’s condition to declaring an institution either a hospital or a clinic. We have also told the government that we will give the rate list to the patient and attendant but putting up the price list on the notice board will only commercialise the medical service,” Dr. Prakasam said.

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