November 10, 2010

Doctors up against Clinical Establishment Act

With the state government seriously considering regulation of private hospitals by making registrations mandatory, doctors associations in the state are gearing up to coax the health department into relaxing certain norms.

The Indian Medical Association on Saturday held a symposium, raising at least six objectionable points.

The Tamil Nadu Private Clinical Establishment Act came into force in April 1997, but the Act could not be enforced as the state did not frame rules. But after the Clinical Establishment Bill, 2010 was passed by Parliament on May 3 by vote of voice without discussion, the state health department is holding discussions on whether it should adopt the state Act or the Central Act.

Health minister MRK Panneerselvam said he would consider the recommendations by doctors associations, without compromising on accessibility and safety. Health secretary VK Subburaj prefered stringent regulations. The state Act is more powerful than the Central Act, he felt.

At present, private hospitals are not required to register with the government, and cases of medical negligence are dealt with by consumer courts. The legislation is to ensure all hospitals are registered with the state government, they have doctors and nurses to match the beds strength, carry out procedures based on its infrastructure and create registries for diseases and form committees to conduct infection and death audits.

Indian Medical Association honorary secretary Dr TN Ravishankar said the main objection to the new Act was regarding Section 10 (1) which says that the state government shall, by notification, set up an authority to be called the District Registration of Clinical Establishments, with the district collector as the chairperson and the health officer as convener. "In subjects related to medicine, competent authority should be none other than a doctor. We want representatives from our association in every such committee," he said. The Act, he added, also gives more scope for bureaucrats to misuse power. "There is no reason why fines should be as high as Rs 50,000 to Rs 5 lakh. When the state frames the rules to implement the Act, we want to ensure that they are not draconian," he said.

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