Private Health Sector In India

CEHAT when started its work on Health Legislation, Ethics and Patients Right with the deep conviction that no system is without social control and regulation would work for people and respect right to health and healthcare. The strategies to bring people and patients at the centre of healthcare through policies, legislation, system of medical ethics etc. need to be evolved in the specific situation of each country and society.

This programme of CEHAT has helped in bringing the issue of Regulation of the private Health Sector. With regard to the private health sector CEHAT has undertaken a wide range of research studies documenting the size, nature and character of the private health sector, assessment of quality of care in private provision, documenting existing physical and clinical standards of private clinics and hospitals, formulating minimum standards for healthcare establishments to facilitate regulation, documenting medical malpractice, reviewing ethical norms for medical practice, developing a framework for accreditation for the healthcare system etc.. have been carried out.. CEHAT has proactively dialogued with the medical profession and their associations to advocate self-regulation and ethical practices, adoption of minimum standards and developing a system for accreditation, as also facilitated patients to secure their rights as consumers of healthcare. (Past studies done by CEHAT)

In 2000-2005 the larger focused has been on documentation, advocacy for changes in legislation. CEHAT was thus invited by the Government of Maharashtra to facilitate the process of formulating Rules for the Bombay Nursing Home Registration Act (Amendment) 2005.The draft rules to the BNHRA 2005 were drafted after having various consultations with medical associations, consumer groups, rural surgeon’s association and health rights organizations. Work on Bnhra)

CEHAT has been actively involved in initiating reforms in the private health sector. The current project activities are concentrated within the State of Maharashtra, in western region. Currently CEHAT has completed a study that looked at the existing standards of care in the private sector and developed minimum standards of care in the state of Maharashtra It also supported the implementation of the state legislation for nursing home regulation, promote self-regulation, accreditation and education for the same. Read more about the present Project

Accreditation initiative in Mumbai

While CEHAT was doing the study “Self Regulation of Private Hospitals and Nursing Homes in Mumbai City: Need for an Accreditation System?" in 1997 the study incorporated an approach where various constituents in the health care services to collaborate and participate in understanding and evolving an accreditation system so various hospital and nursing home owners, their associations, specialists associations, government, consumer organisations, insurance companies, financial institutions, among others were part of the study. The study findings clearly bring out the fact that all the stakeholders felt the need and expressed their willingness to participate in an accreditation body for hospitals.

CEHAT thus collaborated with a group of private medical practitioners (stake holders) who were interested in the issue of accreditation and regulation. A forum who collectively came together and discussed on developing standards and advocacy for accreditation system and improving the quality of health care. The group begin to have increased interaction and partnership with various bodies of medical professionals like forum for medical ethics society, IMA, NAOH, Association of hospitals. Issues of collaborative work included education in medical ethics, developing accreditation system and standards for quality care. The group discussed whether accreditation was needed and what its objectives should be. An Ad-hoc committee known as ‘Forum for HealthCare Standards’ (FHS)was formed along with other stakeholders, with CEHAT as its convener.

The council was to develop standards for up to 10 beds, 10-20 beds and 20-30 beds. After the completion of this phase of standard development, the forum planned to develop standards for different specialties and super-specialties. The council was also considering issues like grading,method, period of assessment and how to finance. The council was to be registered as a non profit body as Health Care Accreditation Council (HCAC) however the HCAC had to be dissolved in the summer of 2008 when it completely ran out of funds. The process has been re-initiated afresh with some outside agency acting as the audit body. This initiative is the first of its kind across India to involve the stakeholders. This initiative was undertaken to set an example that can be replicated in other states based on their individual needs.

Advocacy Education & Campaign

CEHAT continues its advocacy on strengthening overall regulation of medical practice and the profession is continued and as part of the above initiative this process too was accelerated, especially the implementation of the Maharashtra clinical Establishments Act, in whose formulation CEHAT was one of the active groups.

CEHAT continues its effort by regularly following up with the Public Health Department and the Office of the Director General of Health Services for the implementation of BNHRA rules. CEHAT has proactively dialogued with the medical profession and their associations to advocate self-regulation and ethical practices, adoption of minimum standards and developing a system for accreditation, as also facilitated patients to secure their rights as consumers of healthcare.

India has witnessed an increased number of Public Private Partnership initiatives in the health sector, each of them with their unique setting, approaches and issues.CEHAT organised a National Conference on Emerging Health Care Models: Engaging the Private Health Sector on 25th and 26th September 2009.The Conference was rolled out with the basic aim to create a forum for encouraging the display of debate and discourse in the field of PPP in health.Read More....

Training Workshop on the Regulation of the Private Health sector for Medical Practitioners

As part of the current study CEHAT along with The Association of Medical Consultants (AMC), Bombay Nursing Home Owners Association come together to offer awareness workshops on the regulation of the private sector. The main objective of the workshops is to develop an understanding amongst the participants about the minimum standards of care; to create awareness about the Bombay Nursing Home Regulation Act and the other legislation and to initiate a dialogue amongst the participants about the need for self regulation of the private health sector.The first training workshop was at Mumbai. About 19 participants attended the training workshop. In order ensure participation of doctors CEHAT collaborated with the Indian Medical Association(IMA). IMA organises most of its own workshops/meetings for various regions. CEHAT decided to follow the same pattern and conducted regional workshops in Mumbai, Nasik, Nagpur and Aurangabad. About 128 doctors participated in these workshops.

The broad areas covered in the training were laws governing the private health care, accreditation, issues of patient’s rights and others. read more...