The High Court of Kerala has reaffirmed key provisions of the Clinical Establishments Act by dismissing challenges brought by medical associations against mandatory requirements for hospitals under the law. The Court rejected the arguments advanced by petitioners who had sought to strike down statutory obligations such as publicly displaying treatment rates and package fees, and maintaining obligations to provide emergency medical care even if a patient cannot immediately pay. According to the Court, these requirements uphold transparency, protect patient rights, and conform with constitutional obligations to safeguard health and life.
Under the statute, all clinical establishments are required to prominently display—in both the regional language and English—their registration certificate, a list of services offered, baseline fees for common procedures, package rates where applicable, and other facility details including availability of intensive care units, operating theatres, bed categories, ambulance services, and more. Hospitals cannot charge more than the rates so displayed, but they may charge extra for unforeseen complications, extended stays, or additional services, provided that these are clearly itemised in bills. The Court clarified that the requirement for price disclosure does not amount to government-imposed price fixation. Rather, it mandates transparency so that patients are fully informed upfront. As such, hospitals retain autonomy to set their own rates; they only need to ensure that patients have access to that information before consenting to services.
Petitioners had also challenged provisions requiring disclosure of staff details and mandatory duty to treat emergency patients without demanding advance payment or documentation. The Court rejected these objections. It held that the statutory aim is not to intrude on staff privacy, but to ensure that the regulatory authorities have information to verify staff availability and competence. Confidentiality safeguards are available; public disclosure of personal data is not mandated. With respect to emergency care, the Court underscored that no hospital can deny lifesaving treatment on grounds of lack of advance payment or documentation. At minimum, a hospital must screen and stabilize an emergency patient within its capacity, or arrange safe transfer to a higher-level centre if required. Patients must receive all investigation reports and discharge summaries upon discharge. Denial of critical care under the pretext of payment or paperwork is impermissible under the law.
To ensure ground-level compliance, the Court directed that hospitals must display details at the reception and on their websites, and provide patients with a brochure—available in both the regional language and English—that lists all services, baseline rates, package fees, deposit and refund norms, billing and discharge procedures, insurance or third-party administrator procedures, 24×7 emergency protocols, and grievance-redressal mechanisms. Hospitals must maintain grievance desks or helplines, issue reference numbers for complaints, and provide time-bound responses. Serious complaints must be escalated appropriately. Additionally, the Court directed periodic audits by regulatory authorities to monitor compliance, and instructed the State to publicise the judgment’s key directives so that citizens become aware of their rights under the statute.
The Court also clarified the scope for additional charges by hospitals. While baseline or package rates must be displayed and respected, charges for unforeseen complications or extra services may be levied, so long as they are transparently itemised. This reconciles the need for fairness to patients with the practicalities of medical treatment, where unpredictability is common.
By upholding the Act, the Court reaffirmed the State’s legislative competence to regulate clinical establishments and affirmed that such regulation is in harmony with constitutional mandates — particularly the right to life, dignity, and equitable access to healthcare. The ruling makes it clear that transparency, patient rights, and regulation of private medical establishments are essential components of public health governance, and hospitals must comply with statutory obligations of disclosure, emergency care, and accountability.
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