CLINICAL ESTABLISHMENTS ACT

CLINICAL ESTABLISHMENTS ACT

• The Clinical Establishments (Registration and Regulation) Act, 2010 is a central legislation enacted by the Government of India.

• Aim: To provide a system of registration and regulation of all clinical establishments in the country with a view to prescribe minimum standards of facilities and services.

• It applies to both public and private clinical establishments, across all systems of medicine including Ayurveda, Siddha, Unani, Homoeopathy, Allopathy, etc.

DEFINITION OF CLINICAL ESTABLISHMENT

According to the Act:

• A Clinical Establishment includes:

  • Hospitals

  • Nursing homes

  • Clinics

  • Sanatoriums

  • Day care centres

  • Laboratories, diagnostic centres

  • AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) establishments

OBJECTIVES OF THE ACT

• Ensure registration of all clinical establishments.

• Standardize healthcare facilities across systems.

• Prescribe minimum standards for services and infrastructure.

• Promote transparency and accountability in healthcare.

• Provide accessible, affordable, and quality health services.

KEY FEATURES OF THE ACT

• Mandatory Registration:
  All clinical establishments must register with the district registering authority.

• Minimum Standards:
  Prescribes minimum infrastructure, human resources, equipment, and records for services.

• Digital Health Records:
  Maintenance of electronic records of every patient is mandated.

• Penalties:
  Penalty imposed for non-registration or non-compliance.

• National & State Council Formation:

  • National Council for Clinical Establishments

  • State Council for Clinical Establishments

• Exemption:
  Establishments run by the Armed Forces are exempt.

APPLICABILITY OF THE ACT

• Applicable to all clinical establishments in the states and union territories that have adopted this Act by passing a resolution under Article 252 of the Constitution.

• As of now, several states like Arunachal Pradesh, Himachal Pradesh, Mizoram, Sikkim, etc., have adopted the Act.

RELEVANCE TO AYURVEDA PRACTITIONERS

• Ayurvedic clinics, hospitals, and Panchakarma centres fall under the ambit of this Act.

• Mandatory for Ayurveda doctors to register their clinical establishment.

• Must comply with minimum standards set by the Central/State authorities.

• Ensures legal protection and credibility to qualified Vaidyas.

LEGAL AND ETHICAL ASPECTS (AGADATANTRA PERSPECTIVE)

• The act aids in preventing quackery and malpractice.

• Ensures professional ethics, hygiene, and patient care standards.

• Promotes Ayurvedic toxicology (Visha Chikitsa) by recognizing and regulating such centers.

RELEVANT SANSKRIT REFERENCES

From Charaka Samhita (Vimana Sthana 8/89):

"न चैकचिकित्सकः सर्वान् रोगान् साधयेत्।"
Na chaika chikitsakaḥ sarvān rogān sādhayet.
(One physician alone cannot treat all diseases – stresses the importance of specialization and systematic practice.)

From Sushruta Samhita (Sutrasthana 36/10):

"विशुद्धा चिकित्सा भवनानि सर्वविधायिनीः भवन्ति।"
Viśuddhā cikitsā bhavanāni sarvavidhāyinīḥ bhavanti.
(Proper clinical establishments contribute to comprehensive treatment.)

From Ashtanga Hridaya (Sutrasthana 1/7):

"स्थानं कालो दृव्यं यश्च युक्तिः चिकित्सितस्य च।"
Sthānaṁ kālo dravyaṁ yaśca yuktiḥ cikitsitasya ca.
(Success in treatment depends on place, time, medicine, and physician’s method – highlights importance of suitable clinical setting.)

MODERN FORENSIC AND TOXICOLOGICAL RELEVANCE

• Forensic Responsibility: Proper record maintenance as per CEA helps in medico-legal cases.

• Chain of Custody in Poisoning Cases: Registered establishments are responsible for documentation and sample preservation in poisoning cases.

• Medical Negligence: Adherence to prescribed standards reduces the chances of litigation under IPC Sections 304A, 337, 338.

• Consumer Protection Act: Ensures patient rights and facilitates grievance redressal.

• Disaster Management: Registered clinical establishments are coordinated in health emergencies like pandemics, poisoning outbreaks, etc.

BENEFITS OF THE CLINICAL ESTABLISHMENTS ACT

• Promotes uniformity in healthcare service delivery.

• Enhances public trust in Ayurvedic and other traditional medicine systems.

• Protects genuine practitioners from imposters and quacks.

• Encourages modernization and scientific validation of traditional practices.

• Useful in toxicological emergencies where timely referral, standard treatment, and documentation are crucial.

CHALLENGES AND LIMITATIONS

• Lack of awareness among rural practitioners.

• Resistance due to fear of regulatory burden.

• Infrastructure cost for small Ayurveda clinics.

• Incomplete implementation in non-adopting states.

SUGGESTIONS FOR BETTER IMPLEMENTATION

• Conduct awareness campaigns and training programs.

• Provide financial aid and tax exemptions for AYUSH clinics.

• Involve Ayurvedic councils in standard-setting.

• Encourage integration with modern toxicological protocols.