NEW DELHI: Jan Swasthya Abhiyan, a network of civil society groups including several eminent doctors and public health professionals and activists, has written to the health minister protesting against the Indian Medical Association‘s (IMA) demand to exempt accredited hospitals from registration under the Clinical Establishments Act (CEA). Accreditation is a voluntary process and cannot be a substitute for licensing under CEA, pointed out JSA.

The IMA had withdrawn its proposed nation-wide ‘satyagraha’ on November 16 after health minister J P Nadda constituted an inter-ministerial committee to examine its demands, which included the issue of registration under CEA.

Stating that the unethical threat of a strike was euphemistically being called ‘satyagraha’, the JSA wrote that it was opposed to any exemption of doctors or hospitals from licensing under the CEA. “In the past the IMA and other similar organisations have shown scant interest in actively pursuing accreditation of private health facilities. It is only now when the CEA has been enacted by the central government and by some state governments and is being implemented, that the IMA is advocating the idea of accreditation as an alternative to CEA registration. This is a clear attempt to scuttle CEA,” stated the letter.

It argued that it was not enough to lay down minimum standards for quality of care but that there also ought to be a mechanism for monitoring the observance of these standards. JSA also demanded a grievance redressal mechanism for patients in case of violation of the standards and punishment for avoidable lapses. Since CEA 2010 also lays down that charges levied by hospitals be within a range decided by the government, it would not work if some hospitals are kept out of CEA licensing, it pointed out.

In its six demands submitted to the Health Ministry recently, IMA

​is said to have suggested amendments in CEA, such as accredited hospitals be exempted from licensing process, the medical profession and private hospitals should have the right to fix charges for private patients, the penalty rate determined in the Act should be scaled down, and the onus of safe transport and the cost involved in emergency case management should be borne by the government.

The JSA ​ letter alleged that the IMA was advocating the idea of accreditation as an alternative to CEA registration, which it said, was “a clear attempt to scuttle the CEA”.

“Accreditation is a voluntary process and cannot be a substitute for licensing under CEA. From the point of view of patients it is not enough to lay down minimum standards for maintenance of minimum quality of care for patients. There needs to be a mechanism to monitor the ongoing observance of these standards and an effective grievance redress mechanism for patients in case of perceived violations of these standards as well as punishment for avoidable lapses,” said the letter.

CEA-2010 rules lay down that charges to be levied by hospitals would be within the range decided by the government. “All this is not possible if some hospitals are kept out of CEA licensing,” it added.

The JSA letter stated that any decision on healthcare ought not to be taken only in consultation with a body that represents a section of the medical profession. “The reason for the very existence of a healthcare system relates to the needs of patients, and hence the views of civil society organisations which represent the interests of patients ought to be sought on issues which affect healthcare,” it said, demanding that any committee to examine IMA’s demands should include JSA. The JSA network includes All India Drug Action Network (AIDAN), Federation of Medical Representatives of India (FMRAI), Centre for Community Health and Social Medicine, JNU and All India People’s Science Network among several others.