Chandigarh: Sixteen years after the Centre enacted the Clinical Establishments (Registration and Regulation) Act to regulate healthcare facilities and curb unethical medical practices, Punjab is yet to implement the law. Though Punjab notified its own Clinical Establishments (Registration and Regulation) Act in Oct 2020, the state govt has still not framed the rules needed to enforce it.The delay has left regulation of private hospitals and clinical establishments in limbo, with no effective mechanism to check alleged overcharging and profiteering by healthcare providers. The Act makes registration mandatory for all healthcare facilities and prescribes penalties for operating without registration. A first violation can attract a penalty of up to Rs 50,000, a second up to Rs 2 lakh and subsequent violations up to Rs 5 lakh. Under the law, civil surgeons are to register hospitals with 50-100 beds, while larger hospitals are to be registered by the director, health services. The legislation also provides for regulation of rates charged by hospitals for consultations, investigations, ICU care, surgeries, implants and other services. Hospitals are barred from charging above prescribed rates, while final bills are not supposed to exceed estimates given to patients. However, Punjab has admitted before the Punjab State Information Commission that implementation of the Act is not feasible without notification of the rules. The Centre has been regularly reviewing implementation of the law and asking states to ensure mandatory registration and standardised healthcare norms. Punjab informed the Centre that draft rules were under finalisation and registration had not yet begun. Public health advocacy group Jan Swasthya Abhiyan India has also demanded implementation of the Act and regulation of private hospital charges. Amulya Nidhi, national convenor of Jan Swasthya Abhiyan India, said the law was not being implemented because the rules had not been framed. He asserted that the Punjab govt should frame rules under the Clinical Establishments Act and implement Standard Treatment Guidelines (STGs), while regulating the rates charged by private hospitals. He said rates for consultations, ICU care, surgeries, diagnostics and medicines should be regulated under the Clinical Establishments Rules to prevent overcharging, adding that this would help protect patients from high out-of-pocket expenditure (OOPE).According to National Statistics Office data for 2025, average out-of-pocket expenditure per hospitalisation case in Punjab stood at Rs 35,703, higher than the national average of Rs 34,064. In private hospitals, the average expenditure was Rs 45,080. Principal secretary, health, Kumar Rahul said the draft rules were ready and would be notified after consultations with stakeholders.WHY ACT IS IMPORTANTThe Act mandates registration and regulation of healthcare facilities to ensure improved quality of care, standardised services, transparency in costs and better patient safety. It also seeks to benefit patients by ensuring accountability, reducing quackery through mandatory registration, and prescribing minimum standards for infrastructure and staffing. The Act mandates registration and regulation of healthcare facilities to ensure improved quality of care, standardised services, transparency in costs and better patient safety. It also seeks to benefit patients by ensuring accountability, reducing quackery through mandatory registration, and prescribing minimum standards for infrastructure and staffing. The Act has been adopted in 19 states/UTs, including Arunachal Pradesh, Assam, Bihar, Chandigarh, Haryana, Himachal Pradesh, Jharkhand, Puducherry, Rajasthan, Telangana, Uttar Pradesh, Uttarakhand, Andaman and Nicobar Islands, Mizoram and Sikkim.CALL FOR TIME-BOUND ENFORCEMENTThe Punjab State Information Commission, in its recent order, asked the state’s chief secretary and principal secretary, health and family welfare, to look into the matter in the larger public interest, stressing that the law must be enforced in a time-bound manner.
