Patna: IMA Bihar (Indian Medical Association, Bihar Branch) on Monday said it is not opposing the registration of health facilities under the Clinical Establishments Act (Registration and Regulation) but is opposing certain provision of the Act which will lead to closure of 90 percent of government and privately run health establishments manned by competent and qualified doctors.
IMA Bihar has already filed a writ petition in the Patna High Court challenging the validity of the Act and has been meeting policy makers and leaders of the state and central governments to apprise them about the unrealistic minimum standards prescribed under the Act, according to a statement.
The central government has constituted an inter-ministerial committee to discuss the provisions of the Act. “The central government is already looking into the matter and we also demanded from the state government to review certain provisions of this Act which will lead to closure of medium price and small health facilities,” IMA Bihar said in the statement.
In the meanwhile, IMA Bihar has called upon all the registered and duly qualified doctors not to get their nursing homes and clinics registered under the Act since the matter is sub-judice.
Speaking to India Medical Times, Dr Sachchidanand Kumar, president, IMA Bihar, said, “We have kept five main points to amend in the Clinical Establishments Act:
“1. We want that the civil doctor clinics, like the clinic where a doctor has kept one or two beds and is running his small clinic, that clinic should not come under this Act.
“2. They say that if a patient has come in emergency then the doctor should stabilise the patient before referring it to other hospital. We doctors are specialised in different fields; we have different clinics; they have not mentioned the specialist type. What if the patient was brought to a skin specialist and the patient had heart attack, he can’t be stabilised by the doctor if the patient’s condition was serious. We want this provision to be excluded from the Clinical Establishments Act.
“3. They say that the cost of stabilising the patient, who has come in emergency, should not be taken from the patient, then who will be paying the amount? Neither the government nor the patient will pay! Many a times emergency treatment is very costly, which a private clinic cannot afford to provide if they will not be paid anything.
“4. They should try implementing the Act stage by stage. First, they should try implementing and testing it in hospitals of officers and doctors of medical colleges, then in district level hospitals, big private hospitals and then in other low level hospitals.
“5. It must be implemented as per the socio-economic conditions of the state.”
When asked about the support from nursing homes and clinics on this matter, Dr Sachchidanand Kumar said, “We have got maximum support and approximately only one percent of big hospitals and nursing homes have registered under the Act till now, as the case is in court and hearings are going on.”
Dr Harihar Dikshit, secretary, IMA Bihar, told India Medical Times, “We are not against the Clinical Establishments Act but it should be as per our state’s economic standard, it must be affordable.”
He said, “The government must first raise the standards of its hospitals and get its hospitals registered under the Act. Then private hospitals will automatically increase their service standards.”
He further said, “We also want to give quality services. But we must see that we are living in a state which has low economic standard. We can’t implement the Act keeping the standards of high economic standard states. Even the national IMA is opposing the Act.”
Dr Ashok Kumar Tiwari, chief medical officer (Bihar Government Health Services), Bagaha, told IMT, “The Act says that every clinic should follow a standard which can not be implemented in every part as the service and proper manpower is not always available in all areas. Sometimes we do train and utilise the available manpower in clinics but not every clinic can afford experts because that will increase their costing. The government must focus on first raising the standards of public hospitals.”
by Pooja Pandey