Mumbai, Sept. 7 -- A 21-member Joint Select Committee (JSC) comprising legislators from across party lines is examining nearly 6,000 suggestions and objections to the draft Maharashtra Clinical Establishments Act, which was introduced during the monsoon session of the state legislature. The committee has already held one meeting with organisations representing doctors, medical clinics, hospitals and pathology laboratories and it will hold 5-6 more meetings with various stakeholders before submitting its report, which is likely to be tabled during the winter session of the legislature starting in the first week of December, a member of JSC told Hindustan Times. The Mahayuti government had tabled the draft Maharashtra Clinical Establishments Act in the first week of July, saying the age-old Bombay Nursing Homes Registration Act, 1949, was not sufficient to monitor clinical establishments. The proposed legislation aims to establish a comprehensive framework for the registration, regulation, inspection and standardisation of healthcare facilities across the state. It makes registration of all clinical establishments with the state authorities mandatory and provides for penalties of up to Rs.5 lakh for non-compliance. "After the bill was tabled, the JSC invited suggestions and objections from all stakeholders, and the response was massive, as nearly 6,000 suggestions and objections were received within the August 20 cutoff date," the JSC member said, requesting anonymity. The representations are being divided into categories for easier discussion and the JSC would submit its report after taking all the 52 clauses in the bill into consideration, the member said. On August 5, the JSC held its first meeting with stakeholders in the medical industry. The meeting was chaired by Public Health Minister Prakash Abitkar, and most participants expressed strong reservations about requirements and norms relating to registration of establishments. "Since many clinics and maternity homes in Mumbai and other space-constrained cities operate from premises smaller than the space prescribed for registration, stakeholders from these sectors sought clarity and urged that exemptions be provided," said an official from the public health department who did not wish to be identified. Concerns were also raised about clauses mandating the display of treatment rates, names of doctors and their remuneration, and many stakeholders feared that stricter penal provisions could lead to an 'inspector raj' and harassment of establishments, the official said. Sandeep Yadav, president of the Maharashtra Association of Practising Pathologists and Microbiologists (MAPPM), said the association had demanded that the definition of a medical practitioner be clearly incorporated in the bill. "Until this is clarified, how can other mandates be imposed on doctors and their establishments? We have also sought mandatory registration of medical laboratories and appointment of medical practitioners to operate such labs, as mandated in a 2017 Supreme Court order," Yadav said. The MAPPM is opposed to the exemption of government hospitals from the purview of the law and has demanded that they too comply with minimum prescribed standards. Santosh Kulkarni, President, Indian Medical Association (IMA), said the bill in its present form could impose serious administrative, financial and legal burdens on small, rural, charitable and specialised healthcare establishments, potentially affecting the availability of healthcare services. "The government should adopt risk-based and proportionate regulation, provide a separate framework for establishments with up to 50 beds, protect medical autonomy, ensure reimbursement for mandatory emergency care, and provide due process and legal protection to doctors acting in good faith," Kulkarni said....