'Civic, state rules favour pvt hospitals'
More than 90% of the 1,500 nursing homes in Mumbai and Thane district have been running without licenses for the past five months.
In December last year, after the fire at AMRI Hospital, Kolkata, in which more than 80 people were killed, a new set of regulations were issued by the fire department for nursing homes. Nursing homes looking to renew licenses were required to first adhere to these norms, which include several structural requirements such as a three metre-wide staircases, 50,000 litre of water storage and sprinklers, along with regular mock drills.
"These rules can only be followed by standalone hospitals. It is impossible for a nursing home in a residential colony to comply with these," said Dr Sudhir Naik, vice president, Association of Medical Consultants (AMC). Most nursing homes in the city are built in residential colonies.
The AMC is in talks with the urban development department to tweak the norms for nursing homes in housing societies. Some draft rules with minimum requirements have been set up, but are yet to be issued by the government. "We also want fire norms to be established, but they have to take into consideration our limitations. Even if we want to store that much water, is the civic body going to provide it to us?" asked Dr Naik.
Harassment by civic officials is another problem, claim nursing home owners. In 2009 and 2010, the Brihanmumbai Municipal Corporation (BMC) told nursing homes housed in residential societies that they would have to list themselves as a commercial premise and would have to produce a 'change of user' certificate for it.
They would also have to provide separate entry and exit points at the nursing home, for renewal of license. After doctors petitioned the BMC in 2011, the then civic commissioner said that the nursing homes would be regularised if they paid a regularisation fee of 15% of the ready reckoner price of their land.
While most nursing home owners paid up, many in south Mumbai could not afford the fee owing to high property prices. Forty-eight nursing homes, along with the Bombay Nursing Homes Association and the Bombay Ophthalmic Association then moved the Bombay high court. In June 2011, the HC ordered the BMC to issue licenses to the hospitals and ordered the civic chief to give them a hearing. The commissioner stuck to his stance. This order was also challenged in the court and is still subjudice.
The state government said that these rules would fall into place with the enforcement of the Clinical Establishment Act. "Fire norms are unavoidable and important for public safety. We believe that nursing homes built from now on should have separate entry and exit passages, as the healthy should not mingle with the sick people," said TC Benjamin, additional chief secretary, public health.
However, doctors have complained about provisions of the Act, finding them difficult to adhere to. They feel the legislations favour corporate hospitals. "The various moves by the BMC too favour corporate hospitals or chains that have the know-how to run their establishments will these impossible rules," said Dr Niranjan Agarwal, 2011 president, AMC.