Chandigarh: Nearly six years after it was enacted, the Punjab Clinical Establishments Act, 2020, remains without rules, leaving the state with no statutory mechanism to regulate private hospital charges.The delay has stalled the implementation of a law meant to regulate private hospitals and clinical establishments across Punjab. While the act has been notified, the absence of rules has prevented its enforcement, including provisions relating to registration of private hospitals, prescription of minimum standards and regulation of charges.The issue assumes significance as private healthcare providers account for a substantial share of healthcare services in Punjab and a large proportion of out-of-pocket health expenditure.According to the National Statistics Office’s Survey on Household Social Consumption: Health (Jan-Dec 2025), the average medical expenditure per hospitalisation in Punjab is Rs 50,356 in private hospitals, compared with Rs 12,795 in govt hospitals. The overall average expenditure per hospitalisation in the state stands at Rs 39,793.Replying to a question by Barnalas MLA Kuldeep Singh Dhillon in the assembly, health minister Dr Balbir Singh said the govt had not fixed treatment rates for private hospitals such as Fortis, Apollo, DMC and CMC, nor had it examined their rate lists or constituted a high-level committee to review treatment costs.“The Punjab Clinical Establishments Act, 2020 has been notified by the govt of Punjab for the registration and regulation of private hospitals in Punjab. The rules under this act are under consideration of the govt,” the minister said in a written reply.He said private hospitals would be registered under the act once the rules are finalised. He also said the govt would make efforts to bring all private hospitals under the Mukh Mantri Sehat Yojana (MMSY) to provide free treatment to patients in Punjab.On the issue of regulating treatment costs, the minister said the govt proposed to prescribe minimum standards for hospitals and constitute the necessary committees after the rules under the act are notified.The delay in operationalising the legislation had also come under the scanner of the Punjab State Information Commission. In May this year, the commission expressed concern over the non-implementation of the law after the state govt stated it was not feasible to enforce the law without notifying the rules. It directed the chief secretary and the principal secretary, health, to ensure the time-bound implementation of the act in larger public interest.The act makes registration mandatory for all clinical establishments and prescribes penalties for operating without registration.A first violation can attract a fine of up to Rs 50,000, a second violation up to Rs 2 lakh, and every subsequent violation up to Rs 5 lakh. Civil surgeons are designated as the registering authority for hospitals with 50 to 100 beds, while hospitals with more than 100 beds are to be registered by the director, health services.The legislation also envisages regulation of charges for consultations, diagnostic investigations, ICU care, surgeries, implants and other healthcare services. It provides that hospitals should not charge beyond the rates prescribed under the act and that the final bill should ordinarily not exceed the estimate provided to the patient, subject to the conditions prescribed under the law.
