Health Regulations Need a Base to Top Approach

The tragic fire incident in a private neonatal care nursing home in New Delhi in May has highlighted the systemic failure of healthcare regulations in India. This incident has sparked a discussion on the need for a comprehensive approach to health regulations.

Issues with Health Regulations in India:

• Introduction to the Issue:The incident has brought to light the issues with health regulations in India. Despite having numerous health regulations, the private health sector is often seen as insufficiently regulated.
• Excessive and Unrealistic Regulations:Some states have over 50 approvals under multiple regulations that need to be complied with by every healthcare facility. Additionally, health-care quality standards set by the government are often unrealistic and difficult to implement.
• Inadequate Adoption of Regulations:The Clinical Establishments (Registration and Regulation) Act, 2010, enacted 14 years ago, has not been adopted by states due to its impractical provisions. Similarly, only 15% to 18% of government primary healthcare facilities meet the Indian Public Health Standards (IPHS).

Mixed Health-Care System in India:

• Public and Private Health Sectors:India has a mixed health-care system, with private healthcare facilities and providers delivering nearly 70% of outpatient and 50% of hospital-based services. People often choose private health facilities for their healthcare needs.
• Regulation Enforcement in the Private Sector:There is often an overzealous attempt to enforce regulations in the private sector. This can lead to a perception of unfairness and can discourage adherence to regulations.
• Delayed Approvals:The sluggish approval process for renewals is a major concern for facility owners. Applications submitted well in advance for renewal are often granted approval months later.

Need for Affordable Care:

• Variety in the Private Sector:The private sector is not a homogenous entity. It ranges from single doctor clinics and small nursing homes to large corporate hospitals. Single doctor clinics and small nursing homes often provide affordable care and are the first point of contact for many people.
• Role of Small Healthcare Facilities:Small healthcare facilities deliver a large share of health services at a fraction of the cost of big corporate hospitals. They are often the lifeline of health services, especially for middle-income and low-income populations.
• Addressing the Needs of the Population:The parents of the babies involved in the tragic incident opted for a private neonatal care nursing home, highlighting the need for affordable and accessible healthcare services.

UPSC Mains Questions:

Q. Evaluate the role of the private sector in India’s mixed health-care system. How can regulation enforcement be improved in this sector?