The draft rules of the controversial Karnataka Private Medical Establishments (Amendment) Act, that have been put up on the public domain, again have health activists up in arms. They argue that the rules are “highly watered down”, indicating that the State government is “a collaborator with the private medical establishments”, rather than a regulator.
Demanding that the rules be redrafted, the activists have submitted objections pointing out that although the initial amendments said the government would notify charges, the rules do not indicate that the government has any control on regulation.
Raising several concerns, a group of 20 like-minded organisations, led by Karnataka Janaarogya Chaluvali (KJC), Alternative Law Forum, and Manthan Law, who had stood against the private doctors’ opposition to the KPME (Amendments) Act, have pointed out that the draft rules show that the government has “invisibilised citizens/ patients’ interests, while leaning towards large private/corporate hospitals and other such entities.”
“The rules blatantly allow for inclusion of pro-corporate entities into various expert committees, which will skew both standards and costing in favour of large corporate hospitals. This will escalate costs that will only push citizens into pauperisation and destitution,” said Akhila Vasan of KJC.
The State government initiated amendments to the KPME Act, 2007, purportedly to “protect citizens’ well-being and patients’ interests”. The Act introduced certain measures to ensure transparency and accountability of private medical establishments, protection of patients’ rights, and mechanisms to ensure enforcements of the same. But the draft rules have taken the Act further away from these objectives, she said.
“The rules are ominously silent on enforcing the Patient Rights Charter or the Private Medical Establishments Charter. The rules do not clarify how each of the Rights in the Patient Rights Charter is to be interpreted, the procedure to be followed for filing complaints, leaving it open to confusion. There are no rules that prevent misuse of the various provisions by vested interests against patients and vulnerable citizens,” Ms. Akhila Vasan pointed out.
“Representatives of Indian Medical Association (IMA), National Accreditation Board for Hospitals and Healthcare Providers (NABH), and Public Health Foundation of India (PHFI) are referred to representatives of the State government. This is a gross misrepresentation. These three organisations have to be dealt with as private entities and therefore should not be referred to as representative of State government,” she added.
Quoting the rules, public health researcher Sylvia Karpagam said the expert committee for recommending uniform package rates for healthcare assurance schemes consists of the director of the Suvarna Arogya Suraksha Trust (SAST), the nodal agency that runs the existing health insurance schemes.
“Having the SAST director to decide uniform package rates may tilt costs in favour of the private sector rather than patients. There is no mention of what happens if these rules are not implemented,” she pointed out.
Moreover, having representatives of the PHFI in the State committee that will look into regulation of private hospitals is not called for. “The foundation recently lost its Foreign Contribution Regulation Act (FCRA) licence over allegations of lobbying with parliamentarians,” she said. However, private doctors, who are happy with the rules, say the government has addressed most of their concerns in the “larger interests of the community”.
“The rules show the importance of private health sector participation in providing affordable and quality healthcare services to the people,” said C. Jayanna, president (elect) of Private Hospitals and Nursing Homes Association (PHANA).
