Adopt the Patient Rights Charter, regulate rates in private hospitals NOW!

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Shri J.P. Nadda,

Union Minister for Health & Family Welfare, Government of India

Dear Shri Nadda,

Not a day passes when we do not read or hear about some horrific instance of medical malpractice or negligence in the media, with the numbers increasing by 110% every year. Cases like that of 7-year-old Adya Singh, who died of Dengue after being hospitalized for a fortnight in a corporate hospital in Gurgaon, Delhi in November 2017 made headlines when her parents were billed a whopping amount of Rs. 16 lakhs. Her tragic case highlighted the lack of transparency, rampant profiteering and unaccountability prevailing in many private hospitals across India.  Such shocking stories which we read about in the media are just the tip of the iceberg of a much larger problem.

Millions of vulnerable patients and their families across rural and urban India go through similar harrowing experiences at the hands of unscrupulous, commercialized private and corporate hospitals. Many grieving patients or their families who have suffered immense physical, emotional and financial hardship due to the irresponsible actions of private hospitals, have been fighting lonely and prolonged battles for justice in consumer courts and Medical Councils. These bodies are set up to supposedly resolve medical negligence and malpractice cases, yet proceedings drag on for years with no resolution in sight.

You as the Health minister can change this situation NOW, by taking a few long overdue steps regarding which most of the groundwork is already in place. We demand that the Ministry of Health and Family Welfare (MOHFW), Government of India (GoI) should:

1. Immediately adopt and implement the Charter for Patient Rights, without any dilution:

The National Human Rights Commission (NHRC) finalized this 17-point charter in mid-2018, including the following Rights:

  • Right to information, records and reports, transparency in rates, and care according to prescribed rates.
  • Right to emergency medical care, proper referral and transfer.
  • Right to informed consent, confidentiality, human dignity, privacy and non-discrimination. 
  • Right to safety and quality care according to standards.
  • Right to choose alternative treatment options and right to a second opinion.
  • Right to choose source for obtaining medicines or tests when admitted in hospital
  • Right to protection for patients involved in clinical trials and biomedical research
  • Right to take discharge of patient, or body of deceased, without being detained on  procedural grounds
  • Right to patient education, right to be heard and seek redressal

 This Charter is pending adoption by the MOHFW since October 2018. It is high time that this charter is now adopted and implemented across the country which would provide much needed protection to people seeking healthcare. We urge you to not succumb to any pressure in this regard by certain private medical lobbies, and to take a stand to protect the full range of rights of millions of patients, to whom you are accountable as Health minister of this country.

2. Ensure price control of services, making care in private hospitals affordable:

This is a long pending measure on which your ministry has been dragging its feet, despite outstanding evidence of massive over-charging by many private hospitals. The Clinical Establishment Rules-2012 clearly specifies that all hospitals must charge for procedures and services within the range of rates determined by the government.

Now to ensure such control of rates in practice, your ministry needs to take two long overdue steps – firstly re-start the stalled process of developing standard rates for various medical services, which had been initiated by your ministry in 2014 but was then stopped for reasons unknown to the public. Secondly, legally notify all standards for hospitals related to the national Clinical Establishments Act 2010, which would enable states which have adopted the act, to insist that hospitals fulfil these standards (including standard rates) as a condition for regular registration. Since all the proposed hospital standards are already displayed on your website, and basic work on standardization of rates has already been carried out, such price control of rates in private hospitals must now be done without further delay, which would bring relief to hundreds of millions of patients.

3. Create a patient friendly Grievance Redressal Mechanism such as an independent commission or tribunal which is accessible to the common person, and acts swiftly, objectively and effectively to deliver justice to victims of malpractices in the private healthcare sector. This demand is keeping in view the utter failure of Medical Councils – both State Medical Councils and Medical Council of India (MCI) – to ensure timely and unbiased action on numerous complaints by patients related to unethical care in private hospitals.

Honorable Minister, today, across India ordinary patients and their families are increasingly becoming aware of their rights, they are sharing their stories of negligence, extortion and discrimination in the private medical sector, while facing long and frustrating struggles for justice which is often denied to them. Although your ministry is eagerly rolling out the Pradhan Mantri Jan Arogya Yojana (PMJAY), requiring millions of patients to seek care in private hospitals at public expense, it seems that you have not given comparable priority to protect the rights of patients who obtain care in private hospitals and suffer innumerable violations. It is high time that these skewed priorities are changed, and that your ministry moves with utmost speed and effectiveness to take long-overdue steps mentioned above. This would be an appropriate response to the urgent need for dignity and protection, which is deserved by patients across the country today.

Yours sincerely,

SATHI team - On behalf of patient groups and health activists across India