Amendments to Karnataka Medical Bill Aimed At Bettering Healthcare

The Karnataka Private Medical Establishments (Amendment) Bill 2017 was tabled in the assembly on Tuesday, to amend certain provisions of the Karnataka Private Medical Establishments Act 2007 leaving government hospitals out of the ambit of legislation meant to ensure humane and timely treatment of patients and crack down on malpractices. 

The Karnataka government announced that a private hospital will be liable to pay a fine of up to Rs 5 lakh and its authorities will face a jail term of six months to three years in case of irregularities.

A government appointed committee headed by former chief justice of Karnataka high court Vikramajit Sen was appointed in July 2016 to regulate the healthcare system in Karnataka. It submitted its report in April 2017 and suggested sweeping reforms, including regulation for private and government hospitals. Justice Sen had emphasized that "the act should encompass government establishments as the standards of health care should be uniform for one and all, Since the patient is getting treated in both public and private hospitals, we think that despite their limitations, public hospitals should also be brought under this regime," said Justice Sen.

During committee meetings, Justice Sen is said to have made it clear to the government that its hospitals and doctors should also come under the ambit of the law. "Now to target only private players is shocking," a source close to the developments said.

"If the government has its own agenda, then why call experts to help them? The committee worked on the bill for a year. It is ridiculous now for the state to do what it wants," said the CEO of a private hospital. "The whole idea was to ensure patient safety and rights. But that must be applicable for government hospitals as well. The private sector is not against regulation, but there cannot be discrimination in punishment. How is the life of a patient in a government hospital less precious? Why are government doctors spared from regulations?"

However, public health voluntary groups like the Karnataka Janarogya Chaluvali maintained that the meetings were exclusionary and this Act would unfairly be pitting public hospitals against private one.

"There is absolutely no grievance redressal system. We were not given a chance to look at the features. It was stage-managed from the beginning and there has been no price capping on procedures. We wanted criminal action against hospitals if found guilty in patient rights redressal. There's nothing along those lines, as I gather," said Akhila Vasan, convener, Karnataka Janarogya Chaluvali.

The government has proposed to fix charges or fees that can be collected by private hospitals from patients for various medical procedures. The bill says that any private medical establishment or person found overcharging the patients or their kin will have to pay a penalty of Rs 25,000 to Rs 5 lakh and face imprisonment of six months to five years. On the other hand, a government hospital or doctor does not come under the penalty clause at all. "This is ridiculous. Irrespective of where he or she works, an offence is an offence," said the CEO of a prominent hospital.

Some important amendments emphasized in the KPMA 2017 are:

1. The bill envisages the setting up of an ex pert committee that would make recommendations on the cost of treatment for different categories of private medical establishments. "Every private medical establishment shall follow the rates as fixed by the government and this includes package rates for investigation, bed charges, operation theatre procedures, intensive care, ventilation, implants, consultation and any additional treatments," the bill says.

2. It prohibits private hospitals from imposing additional charges "unless explained to and consented to by the patient". However, the bill does not specify the expert committee's composition, powers and responsibilities and terms and conditions of service of the members.

3. Though the fate of the bill remains uncertain at this juncture, new clauses have been inserted to ensure private hospitals not to demand advance payment in case of emergency treatment. "Every private medical establishment shall handover in the event of the death, the body of the deceased immediately without insisting on the payment of the dues," the bill states, while adding that dues can be recovered from representatives of the deceased in due course.

4. The Sen committee had suggested that it's not advisable to have a private diagnostic lab within 100 metres of a government hospital but the final version of the bill has increased the radius to 200m because it will make it difficult for a patient in case of an emergency, given the state of diagnostic facilities in government hospitals as distance matters during an emergency.

5. The bill also suggests the setting up of a district of metropolitan grievance redressal committee for redressal of grievance of patients.