In a landmark judgment that reinforces patient rights and healthcare transparency, the Kerala High Court has issued comprehensive directives to all clinical establishments across the state. The Division Bench comprising Justices Sushrut Arvind Dharmadhikari and Syam Kumar V M delivered this significant ruling while dismissing appeals challenging the Kerala Clinical Establishments (Registration and Regulation) Act, 2018 and its corresponding Rules.
Court Upholds Healthcare Regulations
The Kerala High Court firmly upheld the constitutional validity of the Kerala Clinical Establishments (Registration and Regulation) Act, 2018, which provides for the registration and regulation of clinical establishments throughout the state. The court dismissed appeals filed by the Kerala Private Hospitals Association and the Indian Medical Association that had challenged certain provisions of the legislation.
The appellants had argued that requirements to furnish exhaustive employee details and publish comprehensive fee lists were arbitrary, vague, and impractical. They contended that publishing sensitive staff information could lead to misuse by competing institutions for poaching activities. However, the state successfully argued that the single bench had correctly dismissed the original writ petition since the matter concerned public interest at large.
15 Key Directives for Hospitals
The court issued fifteen specific guidelines that hospitals must implement to ensure transparency and protect patient rights:
1. Bilingual Information Display: Every hospital must provide brochures or leaflets in both Malayalam and English containing detailed information about services offered, baseline and package rates, deposit requirements, and refund policies.
2. Prominent Rate Display: Clinical establishments must prominently display at reception areas and on their official websites the complete list of services, package rates for common procedures, bed categories, ICU/OT availability, imaging facilities, laboratory services, and ambulance contact details.
3. Emergency Care Protocol: Every establishment must screen and stabilize emergency patients within its capacity and ensure safe transfer to higher centers with proper documentation when necessary.
4. No Denial of Emergency Care: No hospital can deny initial life-saving aid based on non-payment of advance or lack of documents.
5. Complete Medical Records: At discharge, hospitals must provide patients with all investigation reports including ECG, X-ray, CT scan, and other test results along with the discharge summary.
6. Patient Rights Display: Hospitals must display a summary of patients' rights covering emergency care, informed consent, confidentiality, non-discrimination, access to medical records within 72 hours, itemized bills, and grievance redressal pathways.
7. Grievance Officer Details: The name, phone number, and email ID of the grievance officer, along with contact details of the district registering authority and DMO helpline must be clearly displayed.
8. Insurance and Billing Information: Hospitals must provide comprehensive information about insurance/TPA empanelment, claim procedures, estimate and billing policies, discharge procedures, ambulance charges, and 24x7 emergency care protocols.
9. Grievance Registration System: Every establishment must maintain a grievance desk/helpline and register every complaint with a unique reference number, issuing immediate acknowledgement through SMS, WhatsApp, or physical form.
10. Timely Complaint Resolution: All complaints must be resolved within seven working days, with unresolved or serious matters escalated to the district registering authority without delay.
11. Complaint Register Maintenance: Each establishment shall maintain a complaint register in physical or electronic form available for inspection, with grievance summaries forming part of monthly compliance reports.
12. Regular Information Updates: All displayed rate lists, brochures, and website information must be kept current, with revision dates clearly indicated for any changes.
13. Consumer Redressal Rights: Patients can pursue remedies for service deficiency before competent consumer disputes redressal commissions and lodge police complaints for cases involving alleged fraud or cheating.
14. Escalation Mechanisms: Patients can escalate grave grievances to the chief secretary and state police chief, and seek assistance from district or state legal services authorities.
15. Accessible Information: All mandatory displays, notices, and brochures must be provided in Malayalam and English, and placed in conspicuous locations within establishments and on official websites.
Consequences of Non-Compliance
The court has issued a stern warning that non-compliance with these guidelines will attract regulatory action under the Kerala Clinical Establishments Act, 2018. Penalties may include suspension or cancellation of registration and imposition of financial penalties, in addition to civil, criminal, or constitutional remedies available to affected patients.
In its concluding remarks, the court emphasized that this judgment serves not merely as a declaration of law but as a reaffirmation of the right to dignified, ethical, and equitable medical care. The ruling represents a significant step toward ensuring healthcare transparency and protecting patient rights across Kerala's medical landscape.
