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LATEST NEWS UPDATES | Activists fight IMA on hospital charges

Activists fight IMA on hospital charges

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published Published on Nov 22, 2015   modified Modified on Nov 22, 2015
-The Telegraph

New Delhi: Public health activists have asked the Union health ministry to reject a demand from an association of Indian doctors to exempt hospitals and clinics with accreditation from proposed rules to regulate the costs of services charged to patients.

The Jan Swasthya Abhiyan (JSA, or People's Health Movement) has opposed a demand from the Indian Medical Association to the health ministry seeking exemption for accredited hospitals from the Clinical Establishment Act (CEA) that seeks to regulate healthcare services in the country.

The IMA is trying to "scuttle the CEA," representatives of the Jan Swasthya Abhiyan have said in a letter sent to the health minister J.P. Nadda. "Accreditation is a voluntary process and cannot be a substitute for licensing under the CEA," they said.

The activists say proposed rules under the CEA will effectively impose caps on the costs of diagnostic and healthcare services levied by hospitals and clinics on patients. The health ministry has asked a panel to draw up a range of charges for various services.

The JSA has pointed out that accreditation primarily deals with the quality of healthcare services available in a hospital or clinic and ensures certain levels of quality. The accreditation process does not provide any effective mechanism to monitor observance of standards or grievance redress mechanisms for patients.

"Accreditation is between the healthcare institution and the accreditation agency - it is quality minus patients' rights," said Anant Phadke, a physician and director of Saathi-Cehat, a non-government public health research agency in Pune and member of the JSA.

An IMA office bearer said the association is not opposed to the regulation of the healthcare sector, but has questioned the need for a new regulatory layer.

"We already have the Medical Council of India to regulate medical practice in the country, and we have the National Accreditation Board for Hospitals to accredit healthcare institutions - so why do you need a new licensing system under the CEA?" said Krishan Kumar Aggarwal, a senior cardiologist in New Delhi and IMA secretary general.

"A new regulatory system will just bring another inspector raj," Aggarwal said.

The IMA had three years ago expressed its opposition to government moves to introduce rules under the CEA that would impose minimum standards for infrastructure, space, equipment and qualified staff in clinics, nursing homes and hospitals.

Health officials as well as public health activists say the opposition to the CEA from within the medical community appears intense. "We've been urging states to take this up," a senior health ministry official had told The Telegraph earlier this year.

Although it is over three years since the Union health ministry notified the CEA, only some states - Arunachal Pradesh, Bihar, Himachal Pradesh, Mizoram, Rajasthan, Sikkim, Uttar Pradesh, and Uttarakhand - have adopted it.

A senior Delhi-based physician-turned-administrator of hospitals said it would be "impractical" to use the CEA to set a range of costs of healthcare services to be charged by hospitals.

"How can the government fix charges - some hospitals may use second-hand diagnostic equipment, others might have something far more expensive, we have a range of healthcare institutions across the country and charges will differ from place to place," said Vinay Aggarwal, former president of the IMA.

But a Delhi-based physician and member of the JSA said there is need to rationalise costs charged by healthcare institutions.

"We're hoping the rules under the CEA will be used to set a range of charges - thus providing upper limits to prevent gross overcharging," said Amit Sengupta, JSA convener.

Sengupta and other JSA representatives concede that the task of calculating charges for various diagnostic and medical procedures would be challenging and difficult, given the diversity of hospitals, nursing homes and clinics across the country.

"But just because something is difficult, doesn't mean it should be abandoned," Sengupta said.

The Telegraph, 22 November, 2015, http://www.telegraphindia.com/1151122/jsp/nation/story_54431.jsp#.VlFDutIrLDc


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