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MUMBAI: Maharashtra’s failure to implement the Centre’s Clinical Establishments (Registration and Regulation) Act, 2010, resulted in a lack of regulations for hospitals, dispensaries, clinics, sanatoriums, and diagnostic centres, leading to substandard healthcare quality, according to a recent report by the Comptroller and Auditor General (CAG).
The CEA, which mandates registration, inspections, and hefty penalties for non-compliance, is implemented at the discretion of individual states. Maharashtra opted instead to rely on its own Maharashtra Nursing Homes Registration Act (MNHRA), which the CAG criticised for being “very limited as it covered the registration and inspection of nursing homes only.”
“In 2018, there were policy changes proposed to cover more health facilities, but it never moved forward,” an official from the public health department said.
Dr Abhay Shukla, Co-Convenor of Jan Swasthya Abhiyan (JSA), noted that even within its limitations, the MNHRA offers important protections for patients. “MNHRA rules mandate hospitals display indicative rates for patients and require a grievance redressal toll-free number, but these provisions are not enforced,” he said.
JSA filed a PIL in the Supreme Court seeking nationwide implementation of the CEA. “While it needs improvement, the CEA’s basic framework would ensure immediate transparency and standardisation,” he added.
In its recommendations, the report said, “Govt may explore the possibility of adopting the Clinical Establishment Act, 2010 so that all the clinical establishments in the state are registered and are adequately monitored to ensure that minimum standards of facilities and services are provided to the public. Govt may also ensure that an updated database of medical facilities is maintained.”
However, Dr Shivkumar Utture of the Indian Medical Association (IMA) argued that the Act imposes uniform regulations on small and large hospitals alike, creating challenges for smaller facilities. “In states where the CEA is implemented, hospitals with fewer than 50 beds are struggling. These regulations could force small hospitals to shut down one by one,” Dr Utture said.