Private practitioners across the country have called for a bandh on June 25 to protest against the implementation of the Clinical Establishment Act, 2010. The act makes it mandatory for every doctor to set up a clinic on an area not less than 400 square feet, which they say is not possible in a space-starved city. The doctors are also against Union health ministry’s proposal to bring in NCHRH Bill, 2011, which they claim will dilute the powers of Medical Council of India. Speak Up delves deeper into the issues.
MCI is defending the interest of doctors
By making it compulsory for private practitioners to have a clinic not less than 400 square feet is not practically possible. Whether the compulsion is wrong or right, I don’t know. The aim of the move is to upgrade the clinics to a tertiary-care level. Meanwhile, doctors are against the government’s proposal to bring in the National Commission for Human Resources for Health (NCHRH) Bill, 2011. The question is by doing so will the national commission dilute the powers of the Medical Council of India (MCI)?
The MCI is a council for doctors only and it is defending their interest. The healthcare needs of the country are not only looked after by private practitioners but also nurses, community health workers, pathologists, radio technicians and others. The number of workers involved in the healthcare industry in the country is ten times more than all the practicing doctors. If the ministry wants to bring all the fields of healthcare under one commission, I don’t see any conflict in it.
Dr Abhay Bang, director, Society for Education, Action and Research in Community Health
Docs will be forced to hike their fees
The government has given an ideal proposal on how a clinic should be along with the required infrastructure. It will be in the interest of patients who need immediate tertiary care. Services like ECG, intravenous administration, oxygen and other such facilities must be available in all private clinics.
The compulsion of having 400 square feet and above area for clinics will be a bit too much for many practising doctors to afford. With the steep realty rates in the city, it would be impossible for many to buy a big space. If the government implements the new rule, doctors will be forced to hike the fees they charge from patients.
On the other hand, there is nothing wrong in having a national commission but it is important to know how will the governing body be formed. Will it involve equal participation of experts from various healthcare fields?
Vinod Shah, chairman, Janaseva Foundation
Clinic area mentioned is as per the central act
I have read the Clinical Establishment Act, 2010, and it is not mentioned anywhere that private practitioners must have a clinic not less than 400 square feet, unless the new rule is added to the existing act which I am not aware of. From what I know, healthcare is a state subject as per the Bombay Nursing Home Registration Act, 1949, which was passed by Maharashtra’s legislative assembly. The clinic area mentioned is as per the central act.
To implement it, the state will have to cancel the Bombay Nursing Home Registration Act. Rather than saying whether the new rule, is right or wrong, I would say it is not necessary. Also, will the new rule apply to the existing clinics or to the new ones henceforth? As for the NCHRH Bill, 2011, its proposition is right. The initiative to bring all the healthcare councils under national commission does not mean diluting the council. Anyway, the MCI has members in its governing body who are government representatives and private doctors. The question is by making the bureaucracy bigger, will it disturb the harmonisation and turn to be unhealthy for the healthcare field?
Dr Anant Phadke, co-convenor, Jan Arogya Abhiyan
400 sq ft clause is not possible to implement
All the city doctors who are members of Indian Medical Association (IMA) will be going on a one-day strike on June 25. We will also ask other doctors who are not part of IMA to participate in the protest. In the initial days, the government had laid down special criteria on setting up new nursing homes, which nobody could afford so some rules were relaxed.
The 400 square feet clause suggested by government is not possible to implement because it is a luxury which very few private practitioners can afford. If it is made compulsory, many doctors will have to close down their existing clinics. The other option left for them would be to form groups and start a corporate clinic. The government’s proposal to bring in the national commission bill is with an aim to dissolve the MCI and all other councils in the healthcare field in order to bring them all under one umbrella. It can make things complicated.
The MCI was formed by Parliament and it is for the doctors and by the doctors. The council governs everything related to the fraternity. However, the government’s intention is to give the authority in the hands of bureaucrats who have no knowledge of the vast medical field and its challenges.
Dr Ambrish Shahade, former president, IMA
The cost of setting up a clinic will be expensive
I practice from a 150 square feet clinic and if the new rule is implemented by the government, I will have no option but to close it down. The other option will be to make a group with other doctors and be part of a bigger clinic, which will be on a sharing basis. The new proposal is not practically possible. The cost of a 400 square feet clinic, be it on rent or owning one, together with the expense of setting up a tertiary care infrastructure and working staff, will be unaffordable to many private practising doctors.
Dr Rahul Mandare, general physician