Work in the private health sector in Karnataka has been affected for the past few weeks over fears that the State government will pass the proposed KPME (Amendment) Bill 2017. The amendments, which are directed at private sector medical establishments, have been met with fierce criticism from the private doctors' associations even as activists welcomed it.

So what exactly is the KPME Act and why has it stirred up this storm?

What is the KPME Act?

The Karnataka Private Medical Establishments Act was passed in 2007 to "to bring a comprehensive legislation in place of the Karnataka Private Nursing Home (Regulation) Act, 1976" that will be the legal control over private medical establishments (PMEs) in the State. Among other things, the Bill made the registration of PMEs mandatory and laid down guidelines to ensure their quality.

The Karnataka Private Medical Establishments (Amendment) Bill 2017, proposed by the current Health Minister K.R. Ramesh Kumar, is an amendment to the existing KPME Bill that intends to bring the PMEs under the purview of the government.

Why does it need to be amended?

According to the government, this latest amendment will pave way for the Karnataka government fixing the rates for each class of treatment, and will provide grievance redressal systems. It also aims to put a stop to the practice of demanding advance payment in case of emergency treatment, and not releasing dead bodies to relatives till all dues have been settled.

What are the main amendments?

The main amendments to the Act include increasing the fines and maximum imprisonment periods in the Act. For instance, the fine for running a non-registered private medical establishment has been increased from Rs. 10,000 to Rs. 5,00,000. Similarly, the fine and term of imprisonment for non-adherence to the rules regarding maintenance of clinical records, and payments has been increased from 6 months and Rs. 2,000 to three years and Rs.1,00,000.

The amendment also makes it mandatory to provide life saving or stabilising emergency measures without insisting on advance payment. Additionally, it adds that every PME should display prominently the Patient's Charter and Private Medical Establishment's Charter and that in the event of death, the body of the deceased should be released immediately without insisting on payment of dues.

So why are the private doctors protesting?

The Indian Medical Association State-unit president Dr. H.N. Ravindra has termed the amendments as "draconian". "We will go ahead with our protest till our demands for dropping the contentious provisions, including that of price capping of various procedures, imprisonment of doctors and setting up of a grievance redressal cell, are met. Otherwise, let the government accept the Vikramjit Sen committee’s report in toto," he said.

Among other points, the Vikramjit Sen report had suggested that the Act be made applicable to the government hospitals as well. However, this has not been taken up as of now.

As protests gained strength, over 500 doctors including private healthcare industry leaders such as Devi Shetty, the founder of Narayana Health, Bhujang Shetty the Chairman of Narayana Netralaya and S.C. Nagendra Swamy, the President of Federation of Private Association Karnataka had assembled in front of Indian Medical Association in Chamrajpet opposing the KPME Act.

What is the Opposition's stand on the issue?

BJP State president B.S. Yeddyurappa has said that the proposed amendments are in “undue haste” and has asked the Congress government to withdraw the Bill immediately. He further claimed that if voted into power in the next election, his government "will scarp the amendments within 24 hours of the BJP coming to power, even if this government rides roughshod over imposing the amendments. "

Meanwhile, there have been differences within the ruling Congress party over the issue. It has been reported that quite a few legislators have opposed the amendments as they have been running medical colleges and hospitals. Senior party leader and former Minister A.B. Malakaraddy, who is also a doctor by profession, has openly opposed the Bill, saying it will not safeguard the interests of medical personnel as well the public. JD(S) leader and former Chief Minister H.D. Kumaraswamy too had openly expressed the party’s support to the doctors’ strike and opposed some of the clauses in the Bill.

Resources:

The 2012 Amended version of the 2007 Bill: http://dpal.kar.nic.in/pdf_files/21%20of%202007(E).pdf

Amendment Bill: https://kpmeyake.files.wordpress.com/2017/07/kpme_amendment_english0001.pdf