Fortis case fall-out: Health ministry asks states to warn hospitals against malpractices

The Health Ministry today asked all states to issue strict warnings and take action against hospitals, including private ones, which indulge in malpractices such as overcharging and don't follow standard treatment protocols.
The move comes in the wake of allegations that Gurgaon- based Fortis Hospital billed the family of a dengue patient Rs 16 lakh.

In a letter to the chief secretaries, Union Health Secretary Preeti Sudan said that alleged malpractices by clinical establishments not only compromise patient safety but also raise concerns about accountability in healthcare costs. She asked the states to ensure implementation of the Clinical Establishment (Registration and Regulation) Act, 2010 under which all hospitals can be regulated. "It is time to learn lessons from such incidents and I advise that a meeting with all important healthcare establishments, including private hospitals, of your state be taken and they be clearly sounded not to indulge in such practices, failing which strict action will be taken. "I request you to kindly get the clinical establishment act adopted/implemented by your state also," Sudan said in the letter.

Referring to the recent incident in which a 7-year-old girl died of dengue at Fortis hospital, Sudan said it was alleged that the patient was grossly overcharged and standard treatment protocols were not followed.
She also drew attention to the alleged malpractices by various clinical establishments in the recent past. These include exorbitant charges, deficiency in services, not following the standard treatment protocols, etc, resulting not only in compromised patient safety but also concerns about transparency and accountability in healthcare costs, she said.

"Such incidents have an extremely deleterious impact on the faith of the general public in the healthcare system of the country. "It is our duty to ensure that such incidents don't recur, quality care and treatment is provided to those in need and that it is provided at a fair and an affordable price," she said. She said effective action can be taken against such healthcare establishments indulging in fraudulent and unethical practices under the act.
Moreover, there are provisions under other acts, rules and regulations under which action can be contemplated against such activities. The clinical establishments act was been enacted by the Centre to provide for registration and regulation of all clinical establishments in the country with a view to prescribe the minimum standards of facilities and services provided by them.

The act is applicable to all types (both therapeutic and diagnostic types) of clinical establishments in the public and private sectors. Till now, five states including Arunachal Pradesh, Rajasthan, Jharkhand and Assam and all Union Territories except the NCT of Delhi have adopted and implemented the act. States like Sikkim, Mizoram, Bihar, UP and Uttarakhand have adopted the act but are yet to implement it. Under the act, standard treatment guidelines are specified for 227 diseases, including dengue, chikungunya and malaria. The hospitals are supposed to abide by minimum standards in terms of infrastructure, services, staff, equipment and lighting arrangements among others.

A technical committee is to be set up to decide on charges for treatment of diseases and procedures at clinical establishments, including private hospitals. Health facilities are supposed to display the charges for each procedure and facility to keep the patient informed in advance. Failure to adhere to these guidelines would result in imposition of penalty.