MUMBAI: After drawing flak from the Comptroller and Auditor General (CAG) and following the Bombay high court’s suo motu cognisance of the latter’s report, the Maharashtra government is set to unveil its first-ever health policy. The policy proposes major regulatory reforms aimed at improving transparency, quality and accountability in the healthcare sector by bringing hospitals, medical professionals, drugs and medical devices under stronger monitoring mechanisms to protect patients’ interests.
Based on the National Health Policy 2017 and the recommendations of the economic advisory council’s 2023 report, the public health department has drafted the policy with a spend of approximately ₹40,000 crore for 10 years. The policy recommends grading healthcare establishments and adopting standard treatment guidelines. Hospitals will be required to ensure patients’ rights, including access to medical records, informed consent, privacy and the right to seek a second opinion. An empowered medical tribunal has been proposed to speed up complaints related to medical negligence, treatment quality and unfair practices.
“The 2024 CAG report rapped the state government for not formulating a health policy and not adopting the Centre’s Clinical Establishments Act,” said a health department official. “At least 17 states have adopted the Act while several others have their own health legislation. Maharashtra, however, largely depends on the Maharashtra Nursing Homes Registration Act and the Maharashtra Public Trusts Act.”
The official said that the CAG report also lambasted the abysmal budgetary allocation to healthcare and the large number of vacant posts in hospitals, clinics and medical colleges. “Following the Bombay high court order to the government on the report, the Clinical Establishments Act Bill is expected to be tabled soon. The next step will be the health policy,” he said.
The official said the policy aimed to improve the quality of care in public hospitals on the one hand and monitor billing in private hospitals on the other. “It seeks to regulate unethical practices such as inflated billing and ‘cut practice’ in the private sector and fix accountability through heavy fines and criminal prosecution,” he said.
The monitoring mechanism is for all clinical establishments, professional and technical education, food safety, medical technologies and products, research, and the implementation of other health-related laws. Clinical trials will be brought under stronger monitoring with greater emphasis on ethics and participant protection.
Dr Avinash Bhondve, former president of the Indian Medical Association, said, “A health policy is a welcome step. However, it should not be unfair to the private sector, which is an integral part of the healthcare system. The government has proposed some burdensome provisions in the proposed Clinical Establishments Act while regulating the private sector. We are not against regulation, but it should not be arbitrary. The proposed health policy should also place strong emphasis on strengthening the public healthcare system, which continues to face a shortage of beds, hospitals and doctors.”
The policy also calls for expanding the mandate of the six medical councils governing modern medicine, Ayurveda, Unani, nursing, dentistry and other healthcare professions. With regard to drugs, it recommends strengthening the enforcement network under the Food Safety and Standards Act, 2006, regulating drug prices and availability through the pharmaceuticals department, and establishing a dedicated regulatory body for medical devices to promote entrepreneurship in medical device manufacturing.
The health policy aims to increase life expectancy at birth, reduce infant mortality, raise public health expenditure to 2.5% of GDP, and reduce catastrophic health expenditure by 25%, among other objectives.
Public health minister Prakash Abitkar said the government was determined to bring in the Clinical Establishments Act Bill during the monsoon session. “CM Devendra Fadnavis has given us the go-ahead and we have also sought opinions from other departments and stakeholders,” he said. “Once the consultation process is complete, the policy will be finalised and placed before the state cabinet.”
