THIRUVANANTHAPURAM: The implementation of the Kerala Clinical Establishments (Registration and Regulation) Act, 2018, remains sluggish despite the removal of initial administrative hurdles. RTI data obtained by TNIE reveals that only about 3,000 healthcare facilities across the state have secured permanent registration so far.
A major backlog persists, with numerous prominent government and private hospitals either operating without permanent status or having their applications returned for corrections. In contrast, a staggering 13,633 health institutions are functioning under provisional registration. The crisis is highly visible even in the state capital, where a mere 125 institutions have managed to secure permanent registration.
This slow progress is particularly evident in the public sector, where many government institutions are struggling to register despite repeated directives from the health department. “The data available is revealing. Many government clinical establishments, including district hospitals, general hospitals, taluk hospitals, and public health labs are yet to be registered under CEA,” Dr Babu K V, central working committee member of IMA and RTI Activist, stated.
Pointing out that the applications of hundreds of small private hospitals and clinics are still pending, he emphasised that these detrimental clauses should be an eye opener for the new government, while enforcing CEA 2018.
The medical fraternity warns that without immediate reform, smaller healthcare providers face potential collapse under the weight of new standards. Former state president of IMA, Dr Samuel Koshy, warned that the closure of smaller hospitals, which played a key role in the state healthcare model, would lead to an increase in treatment costs.
Commenting on the widening gap between facilities, he stated, “The state is witnessing corporatisation of hospitals. While the large hospitals are able to comply with the norms, the smaller hospitals struggle.”
The Act itself is highly comprehensive, covering all clinical establishments across both public and private sectors. It encompasses all recognised systems of medicine, including Modern Medicine, Dental, Ayurveda, Yoga & Naturopathy, Homeopathy, Siddha, and Unani, and applies to clinics, polyclinics, daycare centres, nursing homes, laboratories, and diagnostic centres, exempting only Armed Forces establishments and facilities offering consultation services exclusively.
While provisional registration for modern medicine and labs began on January 1, 2019, before expanding to other streams, the IMA is now intensifying its lobbying efforts with the new government to exempt smaller clinics, citing similar leniency granted in other states.
However, the health department maintains a strict stance. A January directive from the department clarified that no establishment can operate without registration without facing legal penalties, and all certificates must be displayed prominently for the public to see.