March 2: The West Bengal Clinical Establishments (Registration, Regulation and Transparency) Bill, 2017, drawn up by the Mamata Banerjee government contains stringent norms for the functioning of hospitals and proposes hefty penalties for possible lapses.
Metro highlights the key provisions of the bill, copies of which were distributed to the MLAs on the eve of its tabling in the Assembly.
Clinical establishments must…
♦ Treat accident, acid attack and rape victims even if they cannot pay for treatment immediately. The hospital would have the right to recover the cost of treatment “in due course”.
♦ Release the body of a patient even if the bill for treatment has not been paid.
♦ Maintain grievance cells for patients and their kin to accept complaints about treatment, billing and staff behaviour.
♦ Set up a help desk each to ensure proper communication with patients.
♦ Implement the e-prescription system, maintain medical records electronically and provide a copy each of all medical records and treatment details at the time of a patient’s discharge.
♦ Follow “fixed rates and charges, including the package rates for investigation, bed charges, operating theatre procedures, intensive care, ventilation, implants, consultation and similar tests and procedures”. Any additional treatment or procedure shall not attract additional charges “over and above the fixed rates and charges, including the package rates”.
♦ Provide proper estimate of cost of treatment “not covered in fixed rates and charges, including the package rates”. The final bill cannot exceed the estimate by more than a percentage fixed by the government.
♦ “Endeavour” to set up fair-price medicine shops and diagnostic centres if it has more than 100 beds.
♦ Provide “completely free treatment” to 20 per cent of the patients in the outpatient departments and 10 per cent of admitted patients if the hospital has taken land or other help from the government.
If a hospital violates these norms…
♦ Penalty up to Rs 50,000 will be slapped if the violation results in “minor deficiencies” that do not pose imminent danger to people’s health and safety and can be rectified within a reasonable time.
♦ Penalty up to Rs 10 lakh if the violation results in “major deficiencies”.
♦ Penalty of Rs 50,000 for any other violation the first time and Rs 1 lakh for subsequent cases.
If lapse or negligence results in injury or death…
♦ he hospital must pay the victim or his legal representative a) up to Rs 3 lakh for simple injury; b) up to Rs 5 lakh for grievous injury and c) at least Rs 10 lakh for death. The compensation for an injury has to be paid within six months of the incident. In the event of death, interim relief must be paid to the next of kin within 30 days.
♦ The name, place of residence, offence and penalty could be published in newspapers at the guilty party’s own expense or publicised in some other manner.
♦ In the form of Clinical Establishment Regulatory Commission, a watchdog with enough teeth to ensure that hospitals follow norms
♦ Treatment will not be delayed or denied in an emergency because of money
♦ Clearer communication between hospitals and patients
♦ Forum for redress of complaints in every clinical establishment
♦ More accurate estimates of treatment cost and more transparent billing
♦ Stiff penalty for injury or death due to negligence will force hospitals to treat patients more attentively
♦ How the rates will be fixed
♦ Will the rates fixed by the government make it unviable for private hospitals to function
♦ Whether hospitals will charge paying patients more to make up for losses from those who don’t pay their bills
♦ If an accurate treatment cost estimate is possible at all in a complicated case
♦ A government watchdog will fail to keep pace with innovation in medical technology
♦ Hefty penalties will make doctors adopt safety-first policy at the cost of trying beneficial treatment that carry an element of risk
The bill’s journey
Speaker Biman Banerjee today said the bill, if passed through voting in the Assembly, would be forwarded to governor Keshari Nath Tripathi for his assent. “For this bill, given its contents and implications, presidential assent is not necessary,” he said.
According to the Speaker, the governor has the right to return the bill with suggestions for the government’s consideration. But after the bill is sent back to the governor – with or without changes – assent is a formality.
A gazette notification completes the process of turning the bill into a piece of legislation.