Pune: The Maharashtra Indian Medical Association (IMA) has intensified its opposition to the state govt’s push for mandatory emergency care, calling proposed amendments to the Clinical Establishment Act (CEA) “coercive and impractical.” The doctors’ body is demanding clarity on hospital compensation and has raised concerns over harsh penalties, including fines up to Rs5 lakh and six months’ imprisonment for non-compliance.Under the proposed CEA amendments, all private hospitals and clinics would be mandated to provide emergency treatment and stabilise patients before referring them to higher centres, regardless of the patient’s ability to pay.State IMA president Dr Santosh Kulkarni argued that the mandate ignores the reality of small healthcare setups. “Clear guidelines are needed on which categories of hospitals fall under this mandate. Small, single-owner clinics or day-care centres often lack the specialised manpower or infrastructure to handle critical emergencies,” he said.Dr Kulkarni also criticised the “unjust” punitive measures. “Hospitals are being burdened with penalties ranging from Rs50,000 to Rs5 lakh, along with potential jail time. These are extreme measures for medical professionals who are already struggling with lack of resources,” he added.The IMA highlighted failures in the existing Balasaheb Thackeray Accidental Insurance Scheme, launched in 2020. While the scheme promises free treatment up to Rs30,000 for accident victims across 74 procedures, doctors claim it is dysfunctional at the grassroots level.“Compensation under this scheme is rarely implemented because guidelines are unclear at the district and taluka levels, leaving claims unfulfilled,” Dr Kulkarni said. “If private doctors provide free treatment, who will reimburse the medical bills?”Dr H.K. Sale, president, Association of Hospitals in Pune, echoed these concerns, pointing out the logistical hurdles in the referral process. “Ethically, we never refuse emergency care. However, if we stabilise a patient and refer them to a government hospital that lacks a ventilator or specific facilities, we cannot simply abandon the patient. In such cases, the question of who bears the treatment expenses remain unanswered,” Dr Sale said.Responding to the allegations, Annasaheb Chavan, CEO, State Health Assurance Society, claimed the govt has not received formal complaints regarding the accident insurance scheme. “The scheme remains active. While there may be some administrative delays, it is functional. If hospitals are facing specific implementation issues, they should bring them to our attention,” Chavan said.The IMA intends to raise these concerns directly with the state health minister in an upcoming meeting.
