envisioning ima hospital board of...

Envisioning IMA

Hospital Board of India

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Issues Of Hospitals

• Different Groups (Nursing Homes Associations) In Different Cities And States

• To Bring Them All Under One Umbrella

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Issues Of Hospitals

• Right From ‘How to start?’• ‘N’ Number of Rules & Acts.• Medico-legal Issues…• How many Acts you know,

those are applicable to us?

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Law Related to Governing the Commissioning of Hospital

1. Society registration Act2. Companies Act3. Municipality to Local Authority4. Delhi Fire Prevention and Fire

Safety Act,

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5.Electricity rules6. Bombay Lifts Act,7. Bombay Nursing Homes Registration

(Amendment) Act,8.Radiation protection certificate for

radiology dept from BARC

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9.Atomic energy ( safe disposal of radioactive waste) rules

10.Indian telegraph Act11. Clinical Establishments Act 201012.BUILDING AND OTHER

CONSTRUCTION WORKERS (REGULATION OF EMPLOYMENT AND CONDITIONS OF SERVICE) ACT. 6


13.Red Cross Society (Allocation of Property) Act

14.St. John Ambulance Association (India) Transfer of Funds Act,

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Laws Governing the Qualifications / Practice and

Conduct of Professionals1. Indian medical council (professional

conduct, etiquette and ethics) regulations 2002,

2. Indian medical degrees Act,3. Registration of medical practitioners

with state medical councils,4. Indian nursing council Act

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Laws Governing the Qualifications / Practice and

Conduct of Professionals5. The ICN Code of ethics for nurses,6. The Apprenticeship Act,7. Rehabilitation Council of India

(Amendment) Act,,

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Law Governing Storage / Sale of Drugs and Safe Medication

1. The drug and cosmetics rules (Amendment 2005),

2. Pharmacy Act,3. License for possession and use of

Rectified / denatured spirit,4. Narcotics and psychotropic

substances Act,10

Law Governing Storage / Sale of Drugs and Safe Medication

5. The drug and cosmetics rules (Amendment 2005),

6. Central excise Act ( for permit to use and store sprit ),

7. Negligent conduct with regard to poisonous substances (IPC Sec 284),

8. Blood bank regulations under Drugs and cosmetic (2nd amendment) rules 11

Law Governing to Management of Patients

1. Drugs and magic remedies ( objectionable ) advertisements Act 1954,

2. Pre conception and prenatal diagnostic techniques ( prohibition of sex selection ) Rules,

3. MTP Act,4. Transplantation of human organ Act

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5. Rules for insurance cover for the sterilization cases,

6. Laws of contract section 13 (Consent),

7. Birth and death and marriage registration act,

8. Indian lunacy Act, 13


9. The epidemic disease Act,10. National guidelines for clinical

management of HIV / AIDS , NACO, Govt Of India,

11. The Mental Health Act,

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Law Governing Medico Legal Aspects

1. Law of privileged communications,2. Indian Evidence act (disclosure of

privileged / confidential patient related information before a court of law – under protest),

3. Law of torts,4. Consumer protection Act 1986

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6. Protection of human rights Act,

7. IPC section 52 (“Good faith”.—Nothing is said to be done or believed in “good faith” which is done or believed without due care and attention),

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8. IPC section 80 (Accident in doing a lawful act.—Nothing is an offence which is done by accident or misfortune, and without any criminal intention or knowledge in the doing of a lawful act in a lawful manner by lawful means and with proper care and caution),

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9. IPC section 89 – (Act done in good faith for benefit of child or insane person, by or by consent of guardian),

10. IPC section 92 – (Act done in good faith for benefit of a person without consent),

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11. IPC section 93 – (Communication made in good faith.)

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Law Governing The Safety of Patients, Public and Staff

Within the Hospital Premises and Environmental Protection

1. Biomedical medical waste management handling rules 2000,

2. The Water (Prevention and Control of Pollution) Cess (Amendment) Act,

3. The Noise Pollution (Regulation and Control) (Amendment) Rules,

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3. Rules regarding the safe discharge of effluents in the public sewers / drains,

4. Air ( prevention and control of pollution ) act,

5. Environment protection Act 1996,21



6. IPC section 269(negligent act likely to spread infection or disease dangerous to life , unlawfully or negligently).

7. IPC sec 278 ( making atmosphere noxious to health)

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8. Indian Boilers Act9. Petroleum Act + storage Rules 2002(e.g.- diesel storage)10. Gas cylinder Rules 2004,11. Rules for provision of safe drinking

water, 23



12. Rules for provision of uninterrupted power supply

13. AERB safety code no. AERB/SC/Med -2 ( REV -1),

14. Insecticide Act,15. Arms Act,

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16. IPC Sec 336 ( act endangering life and personal safety of others)

17. IPC Sec 337 (causing hurt by act endangering life and personal safety of others),

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16. IPC Sec 338 ( causing grievous hurt by act endangering the life and personal safety of others),

17. The Indian fatal accidents Act,18. Prohibition of smoking in public

places Rules26



19. Vaccination (Repeal) Act20. Disaster Management Act,

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Laws Governing the Employment of Manpower

1. Child Labour Act,2. Citizenship Act,3. Employees provident fund and misc

provision Act,4. TDS Act,5. Maternity Benefit (Amendment)

Act,28

Laws Governing the Employment of Manpower

6. Workmen's Compensation (Amendment) Act,

7. Information Technology (Amendment) Act

8. ? Shop Act – Equal remuneration, Minimum Wages, Bonus, Gratuity, PPF, etc.

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Regulations Governing The Business Aspects of Hospital

1. Charitable and religious trust Act,2. Contract Act,3. Income Tax Act,4. Customs Act,5. Insurance Act,6. Rules for display of Red Cross

Insignia, 30


7. Sales of good Act,8. Vehicle registration certificate,9. Wireless operation certificate from

post and telegraphs,10. Cable television network ACT11. Gift Tax Act,

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12. Copyright Act,13. The Public Liability Insurance Act,

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Issues Of Hospitals

AND• Each Hospital Have Its

Own Plan.• So, Form A Guiding Cell

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Issues Of Hospitals

• Procurement Issues• E.g – If a large group ties

up with some instrument company, everybody will get the instrument at the lowest possible price.

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Issues Of Hospitals

• Financial Issues…..• Finance Chief Of the large

group to guide hospitals on financial matters.

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Issues Of Hospitals

• Insurance Issues…..• Indemnity &

Compensation together.

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Issues Of Hospitals

• Bad Mouthing Issue…..• 90% litigations are due to bad

mouthing and wrong method of giving second opinion….

• So, Needs Networking Plus Coordination...

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Issues Of Hospitals

• Ethical Issues…..• What was unethical in past

may be ethical today..• Who shall decide?..• Branding Of The Large

Group...38

Issues Of Hospitals

• Security Issue…..• City wise Alarm App of the

large group

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Issues Of Hospitals

• Similar Apps for material / instrument purchase, staff personnel,…

• NOC from the group before employing someone, etc

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Issues Of Hospitals

• Ideal GP Clinic –Guidelines…

• Bulletin of the group to keep the members updates….

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Point of no return ?Private Hospitals and hospital bed facilities in

Kerala1986,1995 and 2004

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Healthcare Institutionsin India

OAE (own account enterprises) : 10,77,347Establishments : 2,30,304

13,07,651

Source : 57th round NSS 2001-02

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Healthcare Institutionsin India

• Modern Medicine doctors : 721553• Nurses ,Physiotherapists : 163502• Ayurveda : 160166• Unani : 24941• Homeopathy : 145536• Others : 91953

13,07,651Source : 57th round NSS 2001-02

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Health :The Out of Pocket Nation

In Rural In Urban

Source :National Sample Survey 201545

The bottom Line

• The unpredictability of illness requiring substantial amounts of money at short notice are impoverishing an estimated 3.3% of India's population every year.

Source :Report of the National Commission on Macro Economics

and Health MOH, GOI 200546

Health Care Cost Thiruvananthapuram Medical

College and KSSP study• The average out-of-pocket expenditure

of a person in visiting OP (out-patient)clinics in the Government sector wasRs.4,034 in an year. In the privatesector, this OP expense was not verydifferent at Rs. 4,739.

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Thiruvananthapuram Medical College and KSSP study

• However, when it came to IP expenditure (in-patient),

the average annual out-of-pocket expenditure was

Rs.6,267 against the figure of Rs. 30,800 in the private

sector. Here again, this escalation in expenditure was

mostly due to tertiary care.

• When tertiary care is deducted the expenditure in

public and private sector are the same.

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The Silver Lining

• “This would mean that the IPexpenditure in Government andmedium-level private hospitals arequite comparable and that thesemiddle-level private hospitals areactually holding the price line down...”

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Small and Medium private hospitals are an asset and not

a liability

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IMA HBI

• With all these issues in mind IMA HQs. started a new wing “Hospital Board Of India”.

• It is a brainchild of our past National President Dr.Vinay Aggarwal

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Political objective

To maintain the benign influence of

the medical profession on the

healthcare industry.52

PREAMBLE

The healthcare delivery system in India is in transition.

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PREAMBLE

In a country where large percentage of healthcare expenditure is outside the Government system, it is important to have institutions to give direction to the growth and activity all players.

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PREAMBLEOver the sixty plus years of

independence, the leadership in healthcare delivery has been slowly and steadily passing into the hands of entrepreneurs of all backgrounds.

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PREAMBLE

It is important to moor the industry strongly on the ethics and dynamics of the medical profession.

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PREAMBLE

To achieve the political objective of maintaining the benign influence of the medical profession on the healthcare industry, IMA steps in with the initiative of Hospital Board of India.

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PREAMBLE

IMA will strive to improve quality of services and ensure better patient safety.

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AIMS & OBJECTIVES

1. To assist and equip all healthcare institutionsto provide quality healthcare to people byfacilitating accreditation.

2. To facilitate all healthcare institutions to playtheir effective role in public health.

3. To represent and safeguard the interest of allhealth care institutions and their personnelirrespective of their affiliation.

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Office Bearers of IMA HBI

• Dr. K. K. Aggarwal - National President• Dr. Ravi Wankhedkar- National

President Elect• Dr. R.N.Tandon - Hon Sec General HQ• Dr. V.K.Monga – Hon Finance Secretary

HQ• Dr. R V Asokan – Chairman IMA HBI• Dr. Jayesh Lele- National Secretary

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Office Bearers of IMA HBI

• Dr. Mangesh Pate – Hon Treasurer HBI• Dr. Dinesh Thakare - Hon. Joint

Secretary• Dr. Pankaj Mutneja- Hon. Joint

Secretary• Dr. M.E.Sugathan- Hon. Joint Secretary

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Board Members of IMA HBI

• Dr. B. Sridhar - Director• Dr. Prabhakara - Director• Dr. Vinod C. Shah - Director• Dr. R. S. Bedi – Director• Dr. D. D. Choudhury - Director• Dr. Rajeev Agrawal - Director

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