The Uttarakhand High Court has passed several directions to the state government and hospitals/clinical establishments in the state to strictly adhere to the Clinical Establishment (Registration and Regulation) Act, 2010.
The division bench of Acting Chief Justice Rajiv Sharma and Justice Manoj Tiwari passed several directions in a petition filed by one Ahmad Nabi who pointed out how many hospitals and clinical establishments were not complying with the said Act.
Case Background
The petitioner initially filed a complaint regarding two hospitals namely BD Hospital Doraha Bazpur and Public Hospital Sarkari Road Kela Khera, district Udham Singh Nagar. In the complaint, Nabi alleged that the two hospitals were being run by persons without having any medical degree and without any registration under the Clinical Establishments (Registration and Regulations) Act, 2010. Nabi stated that operations were being conducted by the persons having no medical degree in surgery.
Thereafter, the Chief Medical Officer issued two notices to the said hospitals in March 2016. An enquiry was conducted and a report was filed. It was found that 10 patients were admitted for surgery in BD Hospital, Doraha Bazpur, however, no doctor having an MBBS degree was found to be practicing in the hospital.
Thus, the two hospitals were sealed. The court noted that the State had given a provisional registration to these two hospitals on the basis of two doctors having a degree. While one had a degree in BHMS (Homeopathic Medicine) and BUMS (Unani Medicine).
The petitioner, therefore, contended that the State has not adhered to the Uttarakhand Clinical Establishments (Registration and Regulation) Rules, 2013 as well as the Operational Guidelines for Clinical Establishment Act and Clinical Establishment Act Standard for Hospital (Levels 1A & 1B).
The state government in its affidavit stated that necessary instructions have already been issued by the Chief Medical Officer to medical officers in respective territories. The state also sought to explain the non-compliance of Clinical Establishments (Registrations and Regulation).
The court was informed that the Indian Medical Association had requested to the authorities concerned to keep the provisions of clinical re-establishment in abeyance, as the expenditure of the patient would increase five times. Thus, the District Magistrate, Nainital, had requested the Secretary, Medical to the State of Uttarakhand, to keep the registration pending till the matter is reviewed.
Final Order
“Once the enactment has been made, it must be implemented/ carried out in letter and spirit,” the court said.
The court further recorded its surprise at the fact that surgeries were being performed by people with no degree.
“The surgery is very serious procedure and it can be performed only by duly qualified surgeon. In a hospital, in which, there was no surgeon, ten patients were found to be admitted for surgery.
It is better to have no law than not to enforce it. The State Government cannot be permitted to keep the enforcement of the Act at abeyance. The State Government has also adopted the Clinical Establishment Act Standard for Hospital (Level 1A & 1B), Standard No.CEA/Hospital 001.”
According to the said standard, every aspect of such clinical establishments has been looked into. The court reiterated those standards set in terms of medical infrastructure and other infrastructure that are mandatory.
Disposing of the petition, the court passed the following directions-
1)      The state of Uttarakhand is directed to seal all the clinical establishments which are not registered under the Clinical Establishments (Registration and Regulation) Act, 2010 forthwith.
2)      The state government is directed to ensure that all the clinical establishments registered under the said act follow the Operational Guidelines for Clinical Establishments Act as well as Clinical Establishment Act Standard for Hospital (Level 1A & 1B).
3)      All the clinical establishments throughout the state of Uttarakhand are directed that the patients are not unnecessarily put to diagnostic tests. Only necessary diagnostic tests are ordered to be undertaken to access the clinical condition of the patient.
4)      All the doctors throughout the state of Uttarakhand including government doctors and doctors serving in clinical establishments are ordered to prescribe only generic medicines which are readily available. No patient shall be forced to buy branded medicines.
5)      The state government is directed to prescribe the rates for various diagnostic tests or procedures or surgeries or treatments extended by clinical establishments, within one month from today.
6)      The outer wall of the Intensive Care Unit (one of its side) shall be fitted with transparent glass, closed with cloth curtains to enable the attendants of the patient to see the patient. The attendants of the patient shall be informed about the health/condition of the patient after every 12 hours and the same is ordered to be videographed.