Is IMA for Nursing Homes ?
Dear Dr Pillai
I have gone through minutes of the meeting of the interministerial committee setup under the chairmanship of Additional Secretary Heath held on 8-12-2015. I feel let down by the IMA members of this committee who have suggested only "Single doctor Establishments" to be exempted from the purview of CEA. Sir, what is the definition of a single doctor establishment ? Is it an OPD of a doctor ? No single doctor can on his own run a nursing home / hospital. I think members of the committee have themselves misunderstood the intent and implications of CEA and hence made this blunder. Please understand that;
1) Aim of CEA is to promote Corporate hospital culture
2) OPD Clinics are not the intended targets under CEA for harassment.
3) Actual target of CEA is Small and Medium Healthcare establishments like the nursing homes and small hospitals. Even WHO data shows that 80 % of hospital beds in India are in hospitals less than 30 beds. It is these hospitals and nursing homes mostly run by husband , wife doctor team with some doctors who come on visiting basis, where most of the surgeries, deliveries, and procedures are done in our country.
4) Any such surgery or procedure done in these SMHCE are loss to the corporate hospitals who consider it their turf and hence a loss. It is imperative for corporate world to close down these upstarts using the CEA.
5) The corporate hospitals wish for OPD clinics to function and refer all procedures / surgeries to them.
6) Unfortunately the IMA members of this committee have also fallen for this trap. They have asked for "Single doctor establishments" (which means OPD) to be exempted when actually they should have asked for Small and Medium Healthcare Establishments to be exempted. Definition of SMHCE is one with less than 20 beds.
7) If one closely looks at the minimum standards for "Clinic" under CEA it will be seen that the draconian legal / statutary requirements which are mentioned for level 1 & 2 hospitals have been dropped nearly totally for clinics
If the Members of this Committee who represent IMA are themselves not demanding SMHCE or hospitals less than 20 beds to be exempted from CEA, it is unrealistic to expect Government to help these nursing homes and hospitals. The result is going to be exactly what was planned and aimed for when CEA was sponsored by the corporate giants through the pliable hands of previous Government. OPD Clinics will be allowed , all small nursing homes and hospitals dotting the country run by couples / families will close down.
I request members of this Inter ministerial Committee who are representing IMA to kindly review their stand urgently failing which there will be a major catastrophe. Government does not have jobs for doctors and it is making medical entrepreneurship impossible with able assistance of IMA. I hope sense will prevail.
Dr Neeraj Nagpal
Convenor,Medicos Legal Action Group, Managing Director MLAG Indemnity,
Ex President IMA Chandigarh
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