At a time when there is regulatory confusion and well-founded concern over the cost and quality of health care, the Clinical Establishments (Registration and Regulation) Bill, 2010 passed by both houses of Parliament is an important step forward. Provided its objective is pursued sincerely, the legislation can go a long way in empowering patients who are now forced to deal with a medical establishment that is opaque, unaccountable, and often unethical in its working. Among other things, the Bill provides for compulsory registration of all clinical establishments in recognised systems of medicine (allopathy, yoga, naturopathy, ayurveda, homoeopathy, siddha, and unani); the publication, within two years of its commencement, of a national register of establishments; and the laying down of minimum standards, also within a period of two years. By prescribing penalties for violations by private as well as public institutions, it promises to raise standards of accountability. It can also eliminate quackery. The Bill protects the regulatory role of the State administration, as the district registering authority will have the district collector and the district health officer as members. Moreover, there will be a State Council involving senior officials and medical authorities.
A lot of work waits to be done to standardise protocols, define malpractice, and codify patient rights. The annual health expenditure in India is estimated by the Insurance Regulatory and Development Authority to be in the region of Rs.300,000 crore. Nearly a third of this goes towards hospital-related procedures and treatment, and the rest for outpatient and domiciliary treatment, medicines, investigations, and so on. Much of this is spent out-of-pocket. Given the impoverishing nature of costs and the poorly evolved state of health insurance, there is an urgent need for comprehensive regulation. It is notable that the new measure has come about as a result of resolutions passed by the legislatures of Arunachal Pradesh, Himachal Pradesh, Mizoram, and Sikkim, where it will automatically go into force along with the Union Territories. It is open for other States, including those that have similar laws, to adopt it. The IRDA, meanwhile, is expected to come out with draft norms for health insurance, including standard definitions of illnesses. Much time has been lost: a Bill with the same objectives introduced in Parliament three years ago lapsed. Regulation of quality and cost is doubly necessary considering that the State governments are now sending poor patients to for-profit private hospitals under subsidised health insurance schemes.
Keywords: healthcare, health issue, health insurance, hospitals, Clinical Establishments (Registration and Regulation) Bill, IRDA
I trust the government clinics too will come under the ambit of this bill. If so, I wonder how the government will ensure quality in the PHCs and Sub-Centers in remote areas like Arunachal Pradesh. If the government becomes really serious about quality assurance, most of the health centers in the rural areas have to be declared sub-standard and closed down. Does anybody have an alternative?
The bill passed by govt.should be followed effectively in all type of health centres, but if government really intended to empower the quality of health diffrent type of authorities should be appointed for proper and regular ispection of chemists generally those who are nearby to a health centre.
At the risk of sounding skeptical, I'm afraid I do have my doubts about the implementation of the practices needed to carry through the objectives of the bill. Unfortunately, there seems to be a huge scope for corruption. However good the ideas may be, implementation is the key. Nevertheless, this step certainly has to be welcomed with the hope that things will go right and ideas take shape into a series of health care reforms for our society.
This is an impressive initiative on part of the government to have decided to regulate the quality and costs of public healthcare. Today the medical treatment costs have touched sky. A reform in the health insurance would surely capacitate most of the people to have access to the quality medical procedures. One can say with conviction that this sector needs more spending from government in order to mitigate the grievances that many people face clearing off the medical costs.
Just like food security act , poor people in india are in very need of health security. As tropical country food & water borne diseases are prevailing all over india , low standards of living , unhigeinic conditions of work makes them vulnarable for disease. Ultimately leading to chronic diseases which are not in capacity of them . The parliament should pass health insurance bill for whole society but give more attention to below poverty level people , providing free of cost treatment with medicine for cancer related diseases.
Hope the other states adopt the bill. A commendable step by the Government.
Ensuring quality health, education and food would help decrease the crime rate too.
Health care has turned out to be a murderous absurdity for commoners. The measures to rein in the hospitals and the medical practioners unleash a breath of life for the folks, who suffer arbitrariness and cover-ups at the hands of the former.
Please Email the Editor