Public health activists have opposed the Indian Medical Association’s (IMA) demand that accredited hospitals be exempted from licensing process under the Clinical Establishment Act and have urged the government to include civil society organisations representing patients in the proposed committee to look into the issue.
In a letter to Health Minister J P Nadda, the Jan Swasthya Abhiyan (JSA), an umbrella of public health organisations and individuals, said “any policy decision about health care should not be taken only in consultation with a body that represents only a section of the medical profession,” urging him to include representatives of civil society organisations that represent interests of patients.
The JSA said it was writing the letter after media reports said that the Health Ministry was withdrawing or diluting several provisions of the proposed Act after a “Satyagraha” threat by the IMA.
“We understand a delegation of the IMA met you with charter of its six demands, which included exemption to accredited hospitals from registration under the Clinical Establishment Act. Media reports suggest that the Ministry of Health has since constituted an inter-ministerial committee to examine the demands placed by the IMA and the said committee has representation from the IMA,” said the letter signed by three doctors -- Anant Phadke, Arun Gadre and Joe Varghese.
In its six demands submitted to the Health Ministry recently, IMA
is said to have suggested amendments in CEA, such as accredited hospitals be exempted from licensing process, the medical profession and private hospitals should have the right to fix charges for private patients, the penalty rate determined in the Act should be scaled down, and the onus of safe transport and the cost involved in emergency case management should be borne by the government.
The JSA letter alleged that the IMA was advocating the idea of accreditation as an alternative to CEA registration, which it said, was “a clear attempt to scuttle the CEA”.
“Accreditation is a voluntary process and cannot be a substitute for licensing under CEA. From the point of view of patients it is not enough to lay down minimum standards for maintenance of minimum quality of care for patients. There needs to be a mechanism to monitor the ongoing observance of these standards and an effective grievance redress mechanism for patients in case of perceived violations of these standards as well as punishment for avoidable lapses,” said the letter.
CEA-2010 rules lay down that charges to be levied by hospitals would be within the range decided by the government. “All this is not possible if some hospitals are kept out of CEA licensing,” it added.