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JP Nadda questions govt for not implementing Clinical Establishment Act

Union Health Minister JP Nadda on Tuesday questioned the Delhi government for not implementing the Clinical Establishment Act that tightens the noose over the functioning of private hospitals, clinics and path labs.”Why Delhi government has so far not implemented the act? I have also written a letter to all the state CMs to enforce the act in their respective states. The states should adopt the act at the earliest. The model act is extremely important in dealing with the clinical establishment in the city,” said Nadda.The Clinical Establishments (Registration and Regulation) Act, 2010, has been enacted by the Centre to provide for registration and regulation of all clinical establishments in the country with a view to prescribe minimum standards of facilities and services provided by them.”We have also asked them to alter the act, if needed but should not leave the area unattended,” the minister added.The Delhi government is already considering to implement the act. A letter has been sent to Delhi Health Secretary with the suggestions regarding the act. However, the decision is yet to come out.”The plan has been sent to the health secretary. We will have a meeting with all the stakeholders to finalise it,” said Dr Kirti Bhushan, Director General of Health Services (DGHS), Delhi government.At present, the state government regulates the nursing homes and private hospitals under the Nursing Home Cell. The cell was established in the department to register private nursing homes and hospitals as per the Delhi Nursing Home. Inspections are carried out to see that the nursing homes maintain the standards and norms as per the rules in the said Act. Efforts are made to prevent the functioning of the nursing homes providing inferior quality service and suggesting appropriate action against the unregistered nursing homes.The act is already implemented in four states, including Arunachal Pradesh, Himachal Pradesh, Mizoram, Sikkim, and all Union Territories except the NCT of Delhi since March 1, 2012.The act is applicable to all types (both therapeutic and diagnostic types) of clinical establishments from the public and private sectors, belonging to all recognised systems of medicine, including single-doctor clinics. The only exception is clinical establishments run by the Armed Forces.

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Decision is an example to other hospitals, nursing homes: Dr Kirti Bhushan

As the Delhi government cancelled the license of Max Hospital in Shalimar Bagh, DNA speaks to the Director General of Health Services (DGHS), Dr Kirti Bhushan, who played an active role in preparing the enquiry committee report and suggesting ways to the government.This is the first time that any government has taken such a bold step against a major private hospital. How did this work out?A life has been lost in this case. The baby survived for five more days in another private hospital. The hospital had registered the child as a stillbirth. When the baby was handed over to the patients, his heart was beating. As a result, we could not ignore the hospital’s actions in this case. This is a case of error of judgement, where the hospital failed to understand the situation of the newborn.What about the other private hospitals?The decision will set an example to other hospitals and nursing homes. All these private institutes will now be more vigilant in dealing with sensitive cases. They will properly follow the Standard Operating Procedure (SOP) in all cases.The hospital’s licence has been cancelled. What will happen to the existing patients who are availing treatment there?We have asked them to treat the existing patients till the time they are completely cured. For the rest, all the OPD services have been suspended with immediate effect. They cannot admit any new patient in the hospital.Delhi still does not have the Clinical Establishment Act, so what is the government doing about this? (Recently, Union Health Minister JP Nadda also wrote to various CMs to enforce the act in their respective states)We have submitted a report to the Secretary (Health) to introduce the Clinical Establishment Act in the Capital. The matter is being discussed with the stakeholders. The act, if enforced in Delhi, will help us in getting hold of the large number of diagnostic centres and pathology labs that are operating without following any guideline.

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Clinical Establishment Act to soon come into force in Capital

The Delhi government is soon planning to soon bring in Clinical Establishment Act, 2010 in the Capital. The Act that applies to registration and regulation of all clinical establishments will help the government to tighten the noose over the diagnostic centres and pathology labs running in various parts of the city.The move comes after the capital reported cases of medical negligence in private hospitals and diagnostic centres. On Thursday, a diagnostic centre in Delhi’s New Friends Colony wrongly declared a patient as HIV positive. The Delhi Medical Council even wrote a letter to the Directorate of Health Services (DGHS) cancelling license of the centre.”We are chalking out a plan to bring in the act in the Capital as well. Till now, we do not have any control on these diagnostic centres and pathology labs. We are only limited to the hospitals and nursing cells,” said Dr Kirti Bhushan, Director General of Health Services, Delhi government.At present, the state government regulates the nursing homes and the private hospitals under the Nursing Home Cell. The cell was established in the department to register the private nursing homes and hospitals as per Delhi Nursing Home. Inspections are carried out to see that the nursing homes maintain the standards and norms as per the Rules in the said Act. Efforts are made to prevent the functioning of the nursing homes providing inferior quality and suggesting appropriate action against the unregistered nursing homes.Union Health Minister J P Nadda on Thursday directed all the Chief Ministers to adopt and implement the Clinical Establishments (Registration and Regulation) Act, 2010 so that malpractice in private hospitals can be curbed.In a letter to the Chief Ministers of all states and Union Territories, the Minister said that effective implementation of the Act would deter clinical establishments from indulging in unethical practices and ensuring that they discharge their duties responsibly towards the patients.WHAT THE ACT MEANSThe state government regulates the nursing homes and the private hospitals under the Nursing Home Cell. Inspections are carried out to ensure norms are followed. The Act has taken effect in Arunachal Pradesh, Himachal Pradesh, Mizoram, Sikkim, and all Union Territories except the NCT of Delhi
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After Fortis shocker, it’s Medanta now

<!– /11440465/Dna_Article_Middle_300x250_BTF –>Inflated medical bills have come back to haunt Delhiites again. After parents at Fortis were in for a shock after the hospital charged them Rs 16 lakh for the treatment of their daughter,who died of dengue in the ICU, parents who admitted their seven year-old child Saurya Pratap to Medanta underwent a similar experience.After 22 days of treatment wit no hope of improvement, the family had enough and against medical advice withdrew their child from the hospital and transferred him, barely breathing, to RML Hospital on November 20, where he died two days later on Wednesday.The parents of the child claim that going to Medanta was not even their choice. On October 30, the child was brought via ambulance from Gwalior to Gurugram and here the father Gopendra Singh, an insurance agent, claims that they took them to Medanta despite their protests.”I wanted to admit my child to Sir Gangaram Hospital but the ambulance man insisted on taking my child to Medanta, as they said the treatment would be better there. Having no choice, we agreed,” Singh said.After this the child was admitted on October 30 into the ICU there. And though the family claimed that the doctor gave them and their child a lot of attention, they said that they were unclear about the line of treatment that was being followed.”The doctors continued to do tests and talk to us in English which we were unable to follow. We were constantly assured by them that our child would get better but after three weeks when we saw no improvement, we decided to shift him,” Singh added.There was another reason for the shift. The family, which had mortgaged their house and borrowed money from relatives, felt that after a bill of Rs 10 lakh they could not afford the hospital’s care. So they took the child, who had trouble breathing — doctors at Medanta claim that he was on the verge of death — to RML where he died.The family claim that the hospital kept them there with false promises, saying that they would reduce the amount of the final bill. But in the final bill there was only a discount of Rs 20,000.In a tweet, the hospital stated. “Our bills are absolutely transparent, anyone can come and check them.” However, doctors at the hospital have refused to comment on the matter.Medical experts say that the problem is not in legalisation but in political will. In 2010, the Clinical Establishments Act was set up and measures were put in place to rationalise hospital bills but so far little has happened with only seven states and six union territories having implemented it so far.

Fortis case fall-out: Health ministry asks states to warn hospitals against malpractices

<!– /11440465/Dna_Article_Middle_300x250_BTF –>The Health Ministry today asked all states to issue strict warnings and take action against hospitals, including private ones, which indulge in malpractices such as overcharging and don’t follow standard treatment protocols.The move comes in the wake of allegations that Gurgaon- based Fortis Hospital billed the family of a dengue patient Rs 16 lakh.In a letter to the chief secretaries, Union Health Secretary Preeti Sudan said that alleged malpractices by clinical establishments not only compromise patient safety but also raise concerns about accountability in healthcare costs. She asked the states to ensure implementation of the Clinical Establishment (Registration and Regulation) Act, 2010 under which all hospitals can be regulated. “It is time to learn lessons from such incidents and I advise that a meeting with all important healthcare establishments, including private hospitals, of your state be taken and they be clearly sounded not to indulge in such practices, failing which strict action will be taken. “I request you to kindly get the clinical establishment act adopted/implemented by your state also,” Sudan said in the letter.Referring to the recent incident in which a 7-year-old girl died of dengue at Fortis hospital, Sudan said it was alleged that the patient was grossly overcharged and standard treatment protocols were not followed.She also drew attention to the alleged malpractices by various clinical establishments in the recent past. These include exorbitant charges, deficiency in services, not following the standard treatment protocols, etc, resulting not only in compromised patient safety but also concerns about transparency and accountability in healthcare costs, she said.”Such incidents have an extremely deleterious impact on the faith of the general public in the healthcare system of the country. “It is our duty to ensure that such incidents don’t recur, quality care and treatment is provided to those in need and that it is provided at a fair and an affordable price,” she said. She said effective action can be taken against such healthcare establishments indulging in fraudulent and unethical practices under the act.Moreover, there are provisions under other acts, rules and regulations under which action can be contemplated against such activities. The clinical establishments act was been enacted by the Centre to provide for registration and regulation of all clinical establishments in the country with a view to prescribe the minimum standards of facilities and services provided by them.The act is applicable to all types (both therapeutic and diagnostic types) of clinical establishments in the public and private sectors. Till now, five states including Arunachal Pradesh, Rajasthan, Jharkhand and Assam and all Union Territories except the NCT of Delhi have adopted and implemented the act. States like Sikkim, Mizoram, Bihar, UP and Uttarakhand have adopted the act but are yet to implement it. Under the act, standard treatment guidelines are specified for 227 diseases, including dengue, chikungunya and malaria. The hospitals are supposed to abide by minimum standards in terms of infrastructure, services, staff, equipment and lighting arrangements among others.A technical committee is to be set up to decide on charges for treatment of diseases and procedures at clinical establishments, including private hospitals. Health facilities are supposed to display the charges for each procedure and facility to keep the patient informed in advance. Failure to adhere to these guidelines would result in imposition of penalty.

Amity University organises TEDx event

<!– /11440465/Dna_Article_Middle_300x250_BTF –>Amity University organised a TEDx event themed as “Waves of Changes.”The independently produced event aimed at providing a unique platform for speakers to transfer their energy and experience, to listeners to inspire change.The “change makers” from across the country gathered at Amity University to share their ideas and stories while motivating a multitude of listeners.”The entire world is in flux and all the certainties are being re-shaped. She stressed that the changes are happening at various levels across the world which not only hold promise of better future but also a risk of catastrophe,” said Meera Shankar, former Indian Ambassador to the US and Non-Executive Director, ITC Limited, who was one of the speakers.Dwelling on the next level of change, Shankar cautioned that the looming crisis of global warming threatens the existence of human beings on the planet and shared that with growing awareness about the same globally, there has been a decline in fossil fuel economy and renewables have been coming up as viable options for the future.She remarked that the changes are occurring at a time when technology is crossing borders and stressed that the growth of new technology would lead to scraping of baseline jobs in IT, which requires less skills. She averred that in future the focus will be on education, skilling and re-training which will become a lifelong process.Other speakers for the event included Jagdish Chaturvedi, Director, Clinical Innovations, Nidhi Goyal, Disability Right and India’s first female disabled stand-up comedian, Parshwanath Upadhye, Indian classical dancer and ‘Natya Mayura’ Awardee, Jhankar Gadkari, Founder of Metahumin Consultancy among others.

30 new labs soon for WHO-recommended MDR-TB detection test

<!– /11440465/Dna_Article_Middle_300x250_BTF –>To improve detection rate of Multiple Drug Resistant Tuberculosis (MDR-TB), the government is planning to open 40 additional TB containment laboratories across India to ensure more patients have access to liquid culture testing method. To be set up by the Ministry of Health of Family Welfare under its Revised National Tuberculosis Programme (RNTCP), these new laboratories will come up at various government medical colleges.Liquid culture testing is considered as a gold standard by World Health Organisation (WHO) for TB detection. In case of suspicion of MDR-TB, experts recommend samples be subjected to second line drug susceptibility testing (DST) via liquid culture.Besides confirming MDR-TB, the test also helps determine drugs that can treat patients. WHO strongly recommends it be offered to patients co-infected with TB and HIV, paediatric TB, extra pulmonary TB, and smear negative TB cases.“There is a need to improve the sensitivity of existing tools to improve the detection rate, especially in high burden laboratories where more number of TB and MDR-TB cases are detected,” said Dr Sarman Singh, Professor and Head, Division of Clinical Microbiology and Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences.“Inaccurate and incomplete diagnosis of MDR-TB continues to be a challenge in public and private sectors. This often leads to delayed or inappropriate treatment; perpetuating the spread of TB infection, especially the drug resistant variety,” said Varun Khanna, Managing Director, Becton Dickinson India associated with RNTCP for TB culture and DST in laboratories.Currently, about 34 laboratories are certified by RNTCP for liquid culture tests, which are free. These are National Referral Laboratories in Bangalore, Chennai, Agra and New Delhi, and 17 Intermediate Reference laboratories across metros in India. Laboratories at six medical colleges in Jaipur, Jamnagar, Mumbai, AIIMS New Delhi, PGI Chandigarh and BHU Varanasi are also certified to conduct liquid culture tests.Five private laboratories such as Metropolis, SRL Mumbai, SRL–Kolkata, Shankar Nethralaya Chennai and Infexn, Thane, along with one NGO laboratory, PD Hinduja in Mumbai, and one government laboratory at GTB Sewree, Mumbai are also certified to conduct the test.DEMYSTIFYING DIAGNOSTIC TERMSWhat is drug-susceptibility testing?The test helps identify if a person has drug-resistant TB or not. It finds out what drugs the TB bacteria in their body is sensitive to. It’s done by culturing bacteria.Conventional TB drug-testingThe conventional TB drug-testing cultures are solid-culture systems, where TB bacteria are grown on a solid surface in a laboratory (in a petri dish) over more than 30 days.Liquid-culture systemsLiquid-culture systems are currently the standard for drug-susceptibility testing (DST) in industrialised countries. WHO recommends liquid-culture systems for low- and middle-income countries as well. The advantage of liquid-culture systems is that results come in less than two weeks

The IMA president said the governor’s office was trying

<!– /11440465/Dna_Article_Middle_300x250_BTF –>to facilitate their meeting with the state health ministry and the Chief Minister’s Office. Aggarwal said they had apprised the governor of some provisions which were neither community-friendly nor doctor- friendly. The governor said that he would send our recommendations to the Mamata Banerjee government for consideration of amendments to the Law. He said that the IMA was already a part of a five-member ministerial committee in the central government. “There we are coming out with an alternative Clinical Establishment Act, compensation for negligence, violence against doctors. These are totally different from it,” he said. Whether the IMA is mulling the option to move court against the Law, Aggarwal said, “At the moment we have our representation to the governor. He has said that he will put his recommendations to the health ministry… We will have to meet the ministry and wait for those amendments. “But if the ministry rejects our suggestions then our legal team will decide what to do,” he said.(This article has not been edited by DNA’s editorial team and is auto-generated from an agency feed.)

New Bill in WB Assembly tomorrow to prevent patient harassment

<!– /11440465/Dna_Article_Middle_300x250_BTF –>The West Bengal government is all set to move a new Bill in the state Assembly tomorrow aimed at preventing harassment of patients and their relatives during treatment at hospitals. “The West Bengal Clinical Establishments (Registration, Regulation and Transparency) Bill, 2017 is scheduled to be placed before the House tomorrow for introduction, discussion and passing,” Speaker Biman Banerjee told(This article has not been edited by DNA’s editorial team and is auto-generated from an agency feed.)

Apollo patient’s death: Hospital’s regional director steps down over medical negligence case

<!– /11440465/Dna_Article_Middle_300x250_BTF –>One week after the death of Sanjay Roy, a resident of Dankuni in Howrah district, allegedly owing to the medical negligence of Apollo Hospitals, the eastern region director of the hospital, Dr Rupali Basu has resigned.She was on a holiday in New Zealand when the incident took place and was keeping a tab on it from overseas. On February 24, a day after Roy’s death, TMC leader Madan Mitra lashed out at Apollo Hospitals authorities. Later, a case was initiated by Phoolbagan Police Station under sections 304A (causing death by negligence), 34 (Acts done by several persons in furtherance of common intention) and 384 (extortion), of the IPC, based on the complaint of Roy’s wife, Ruby Roy. Sources said that Dr Basu stepped down anticipating an arrest, following an investigation by the police and a parallel probe by the state health department officials. Dr Basu, however, did not answer calls or replied to messages. Dr N Satyabhama , director (southern region), has replaced Dr Basu, taking additional charge, and Rana Dasgupta has taken charge as CEO of Apollo Gleneagles Hospital, Kolkata.The six-member committee formed by the health department has already submitted a primary report and sources said that they have found the private hospital guilty of negligence, overcharging and carrying out unnecessary expensive tests on Roy.Roy had been admitted to Apollo on February 16 after he met with an accident. Looking at the escalating bill of the hospital, which had run up to Rs 7.23 lakh till February 23, his family members decided to shift him to to the state-run SSKM Hospital. Late night on February 23, he was shifted to SSKM, where he breathed his last.The investigating committee, comprising specialised doctors, have sought all the relevant reports from Apollo as well as SSKM to assess whether the claims made by Apollo regarding the health condition of Roy matched those of SSKM. The committee will submit a final report after the post-mortem report of Roy arrived. The police are scanning the CCTV footage to find out whether Roy’s family was forced to submit fixed deposit certificates when they expressed their inability to pay up the entire amount.Meanwhile, the state will present the Clinical Establishment Bill on Friday at the Assembly to rein in malpractice by private hospitals. Sources said that the bill would propose that a regulatory commission be set up to take care of complaints of patients within six months of their complaint and the decision of the commission would not be challengeable at a lower court to save time of the litigation. The penalty would range from Rs 3 to 5 lakh, depending on the damage caused to the patient, and Rs 10 lakh in case of death owing to negligence. If need be, property of the hospital can be attached to pay penalty. It might also be proposed that emergency patients be treated first, ahead of a police report, especially in cases of rape and acid attack victims and see that they are not refused under any circumstances. Not adhering to the rules can attract imprisonment of up to three years and the registration of the private hospital can also be cancelled.The bill would also propose that the hospital not charge anything extra over the package charges. In case of a patient’s death, the hospital cannot keep the body if family members of the patient are unable to pay hospital bill.

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