Private Sector Regulation
India has one of the largest private medical sectors in the world – yet this gigantic entity has remained almost completely unaccountable and unregulated until now. Serious problems in this sector include frequent financial exploitation of patients, often accompanied by sub-standard and irrational care in private hospitals and nursing homes. Costs of private medical services have spiraled. It is estimated that Health care expenditures account for more than half of all Indian households falling into poverty, with nearly 4 crore Indian people being pushed into poverty every year due to such costs. While ordinary patients are suffering tremendously due to this situation, it should be kept in mind that due to growing corporatization and commercialization of the entire health care sector, it is also becoming extremely difficult for the dwindling numbers of rationally practicing doctors and genuinely non-profit health facilities to practice ethically.
Located within the broader context of need for strengthening public health services and rolling back privatization, comprehensive social regulation of the private medical sector is an outstanding need today.
Further we need to keep in mind the context of the National Clinical Establishment Act (CEA) which has been adopted in 2010, followed by related rules in 2012. The central government is now pushing state governments to adopt this act in existing form. Although the central CEA has some positive steps like mandatory minimum standards, standard treatment guidelines, regulation of charges and consumer representatives in national and state councils, it has several major lacunae like no provision for ‘patient’s rights’ in the entire act, no provision for grievance redressal mechanism for patients, and no scope for complaints by citizens regarding implementation of the act. Since this central act is being used as a kind of ‘framework legislation’ by various states, and some states are adopting it in existing form, it is essential to develop a national consensus among civil society organisations regarding this framework and to develop an effective national advocacy strategy regarding this framework.