Checking for compliance of laws applicable to practicing doctors, clinics, nursing homes, dispensaries, consulting rooms, hospitals

Varsha Gupta, Sushila Baldwa, Mahesh Baldwa, Namita Padvi  

Introduction

Doctors in India in the twenty-first century are both a responsibility and a privileged. We know one out of six persons in the world is an Indian facing vast health care inequalities. Indian doctors have a shoulder huge responsibility but not allowed by few con doctors. The capitalists, politicians and vested interests who, see big money in healthcare in India are getting in the way of the good mannered, soft clinical doctors.  In the name of reform capitalists and politicians wish to milk healthcare bucks in the name of reforming the healthcare system to ensure affordable and quality care to the public. But today at such low cost only sham operations, surgeries and procedures can be performed to fill in log book of hospital. Putting house of medical facilities in the world of realism, we urgently need to establish an effective system of coordinating medical regulations to single window clearance to help clinical doctor with small capital to obey all laws, rules, regulation, which are described here. The current situation in India is lose–lose situation for both doctors and the public. Both are losing out capitalist forces perpetuating medical insurance and managed health care via corporate hospitals. The entire system as on date is built on corrupt practices. Sincere small time doctor is good clinical manners losing its battle the technology and also to ever increasing health regulatory system of which implementation is patchy and in-coordinate full of multiple bureaucratic windows requiring lot of time and a dedicated person to coordinate. Single doctor small nursing homes are vanishing because now large numbers of doctors are surprised to know plethora of laws which governed them but not implemented hence they didn’t know. Knowing laws, rules, regulations, bye laws and implementing them is need of hour. Even though various laws given below regulate medical practice in India they are only indicative but not exhaustive.

Compliance of Laws Governing the Commissioning of nursing home, clinic, day care centre or Hospital

These are the laws to ensure that the health care facilities are created after due process of registration, the facilities created are safe for the public using them, have at least the minimum essential infrastructure for the type and volume of workload anticipated, and are subject to periodic inspections to ensure compliance. These are listed in Table 1.

Table 1: Laws governing the commissioning of hospital/nursing homes

1. Nursing Home Registration Act – required for even day care centers admitting patients
2. The Clinical Establishment (Registration and Regulation) act,2010 is central act and each state has to make its own similar act since health is on concurrent list in constitution of India
3. Biomedical waste rules
4. Fire Prevention and Fire Safety Act 1986, and Fire Safety Rules
5. Shop and establishment act

Laws Governing to the Qualification/Practice and Conduct of Professionals

These are the regulations to ensure that staff employed in the health care facility for delivery of healthcare are qualified and authorized to perform certain specified technical jobs within specified limits of competence and in accordance with standard codes of conduct and ethics, their credential are verifiable from the registering councils and in case of any professional misconduct the councils can take appropriate action against them. These laws are listed in Table 2.

Table 2: Laws governing to the qualification/practice and
conduct of professionals

1. The Indian Medical Council Act 1956   apart from MBBS, Titles of seven courses of past are listed in schedule 3, part 1 of the Indian Medical Council (IMC) Act, 1956, are listed below:

i) DMMS — Diploma in Modern Medicine and Surgery (Orissa)

ii) DMS — Diploma in Medicine and Surgery (Madras, Indore)

iii) LCPS — Licentiate of College of Physicians and Surgeons (Bombay)

iv) LMF — Licentiate of Medical Faculty

v) LMP — Licentiate Medical Practitioner

vi) LMS — Licentiate of Medicine and Surgery

vii) LSMF — Licentiate of State Medical Faculty

• Central Council of Indian Medicine (CCIM) for ayurvedic, siddha and Tibb doctors
• State notification allowing for ayurvedic, siddha and Tibb doctors to prescribe allopathic medicines
• Central Council of Homoeopathy
• State Medical Practitioners Act, or similar act applicable in city
• State Medical council Act, 1965 , or similar act applicable in city
• Indian Medical degree Act 1916

Laws Governing Management of Patients

                   These are the laws for setting standards and norms for conduct of medical professional practice, regulating/ prohibiting performance of certain procedure, prevention of unfair practices and control of public health problems/ epidemic disease. They deals with the management of emergencies, medico-legal cases and all aspects related thereto including dying declaration, and conduct of autopsy and the types of professional negligence. These laws are listed in Table 3

 Table 3: Laws governing management of patients

1. Birth and Deaths Registration Act 1886-also done online

2. Registration of place for The Medical Termination of Pregnancy – also reporting online

3. Registration of place for PCPNDT Preconception and Prenatal Diagnostic Technology (prohibition of sex selection) act & PNDT Rules -– also reporting online

4. reporting number of TL done

5. Reporting number of IUCD put in

6. reporting notifiable diseases to municipality

Licences/Certifications Required for Hospitals

A hospital administrator should be aware about the licences that are essentially required and to renew them as and when required. These are as listed in Table 4.

 Table 4: Licences/certifications required for hospitals

  Sr. no.  Licences/certifications                                                                                                              Frequency

1. Registration under nursing Home Act                       Yearly
2. NOC from fire services                                 Before implementation
3. Registration for operation of X-ray                           Every 2 years
4. Drug Licence in case of  medical store                        Every 5 years
5. Licence to operate blood bank                                  Every 5 years
6. Registration of USG place PNDT Act 1994             Every 5 years
7. Registration of place MTP Act 1971                         One time
8. Authorization for BMW by PCB                                                 yearly/3 years
9. Medical council registration of degree                      Every 5 years

Conclusion

The local municipal staff and police are Checking regularly for compliance of laws applicable to practicing doctors, clinics, nursing homes, dispensaries, consulting rooms, hospitals hence please cooperative with them to avoid litigation