January 02, 2009

National Council in offing to check hospitals

A five-year-old Mumbai child, who recently fractured his wrist, waited overnight to get it attended to, at a private hospital. This instance highlights the urgency for accountability among hospitals. If all goes well, consumers could finally access quality medical service. A senior official in the ministry of health and family welfare hopes the Clinical Establishments (Registration and Regulation) Bill, 2007, will be cleared in a few months. As mentioned earlier in these columns, the proposed legislation provides for both registration and regulation of clinical establishments in the country, as also prescription of minimum standards for medical facilities and services.

For the purpose, the bill proposes a National Council, which will not just formulate standards for the segment and classify clinical establishments, but also compile, maintain and update their national register. The official says, “We have done lot of groundwork (on the council), with the expectation that the bill would be passed soon. We have started preliminary work on the body, which is currently purely technical in nature.’’ In another fortunate development, many states have responded positively to the bill.

“It will be applicable to those states, which request for it,’’ says the official, considering health is a state subject. Currently, each state has its own regulatory mechanism for hospitals. In Mahashtra, Mumbai’s corporation and private hospitals are monitored by the executive health officer; and those at the district and rural level by the director of public health. The new bill, if passed, will ensure a uniform country-wide body for regulation of hospitals in the form of the National Council.

As Dr Sujit Chatterjee, CEO at Mumbai’s L H Hiranandani Hospital, says, “Health may be a state subject, but healthcare is the responsibility of the state of India.’’ Hiranandani Hospital is one of the 23 hospitals to have secured accreditation from the National Accreditation Board for Hospitals & Healthcare Providers (NABH), a constituent board of the Quality Council of India. NABH was set up to establish and operate accreditation programme for healthcare organisations. The NABH website adds, “The board is structured to cater to much desired needs of consumers and set benchmarks for progress of health industry.’’

Till the new standards are in place, NABH accreditation appears to be the only national mark of assurance of a hospital’s quality. Other than hospitals, nursing homes and blood banks can also apply for voluntary accreditation. Dr B K Rana, deputy director at NABH, says currently applications of nine blood banks and about 55 more hospitals are in the pipeline. To popularise the initiative among medical establishments and consumers, the board holds awareness programmes in cities and in districts, through the year. “We try to amalgamate the process through media, websites and seminars. It (an NABH accreditation) is not an expensive process.’’

However, accreditation depends on a total of 530 criteria. Says Chatterjee, “It is an Indian standard. But fact of the matter is NABH is a member of ISQUA, which is the International Society for Quality in Health Care.’’ ISQUA is an international body that grants approval to accreditation bodies in healthcare. “It is the gold standard for healthcare in the world.’’ Besides, NABH accreditation is not a one-time process. It is reviewed every 1.5 years, he says.

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