A group of senior members of the Indian Medical Association (IMA), the largest network of doctors in the country, met Union health minister Mansukh Mandaviya early this week.
Their main demand was an amendment to the Consumer Protection Act, 2020, to get healthcare services explicitly removed from the purview of the Act.
The government has remained non-committal so far but in case it accepts the demand, it may have far-reaching implications for the healthcare ecosystem, including doctors and patients,
What’s the background to healthcare being included in the Consumer Protection Act?
It was in 1995 that the medical profession was brought under the purview of the 1986 Act and patients paying for health services were defined as consumers following a landmark judgment by the Supreme Court.
What are the reservations the IMA has developed over healthcare’s inclusion in the Act?
IMA says the move completely changed the doctor-patient relationship dynamic and led to a massive trust deficit between the two. On ground, it has meant that in cases of medical negligence and malpractice, patients and aggrieved families could appeal against doctors at consumer protection forums for monetary compensation and in some cases, regulatory action against medical practitioners. IMA says that this has led to a raft of cases against doctors, making it tough for them to practice medicine.
Under the first version of the draft CPA (Amendment) bill introduced in 2018, healthcare stayed in the list of services under its purview but following protests by doctors, it was modified despite having passed by the Lok Sabha once. The 2019 version of the bill removed healthcare from the list of services covered.
So what’s the point of contention now?
The Act that was eventually notified in 2020 says “service" means service of any description made available to potential users and includes, but is not limited to, the provision of facilities in connection with banking, finance, insurance, transport, processing, supply of electrical or other energy, telecommunications, boarding or lodging or both, housing construction, entertainment, amusement or the purveying of news or other information, but does not include any service that is free of charge or provided under a contract of personal service.
This, in practice, means that despite healthcare not being mentioned in the “inclusion list,” it is also not excluded from the list of services covered by the Act and litigation against healthcare providers in consumer courts has continued.
Dr R V Asokan, a former general secretary of the IMA, says that unless the Act explicitly removes healthcare from the list services under its ambit, the doctors’ body will keep fighting for it. He also says that the Supreme Court, in the past, had turned down its appeals to remove healthcare from the purview of Act so the association wants a “parliamentary route to validate the point that we have been making.”
What does it mean for patient rights?
T Sundararaman, a former executive director of the National Health Systems Resource Centre, who is also associated with Jan Swasthya Abhiyan, insists that since the Clinical Establishment Act, 2010--a legislation to regulate private healthcare providers in the country--has not been implemented properly, patients will be at a loss if platforms for judicial appeal in cases of medical negligence and violation of ethical practices are taken away from them.
“I understand that doctors at certain level, too, feel vulnerable and there are a few malafide cases against them, but there has to be some grievance redressal mechanism where patients and their kin can fight for the protection of their rights. Otherwise, only cases of criminal negligence can reach the judiciary,” he said.Dr Asokan insisted that a different system for patients’ grievance redressal would be acceptable to the IMA provided a cap is put on the compensation awarded to patients.