FAQ (Frequently Asked Questions)

The National Council shall:

•  Compile and publish a National Register of clinical establishments within two years from the date of the commencement of this Act;
•  Classify the clinical establishments into different categories;
•  Develop the minimum standards and their periodic review;
•  Determine within a period of two years from its establishment, the first set of standards for ensuring proper healthcare by the clinical establishments;  
•  Collect the statistics in respect of clinical establishments;  Perform any other function determined by the Central Government from time to time. 

The detail composition of National Council for Clinical Establishments may be seen in the Act. National Council is a 20 member body under ex officio chairman DGHS, MOHFW, Government of India. Officer of rank of Joint Secretary of Ministry of Health and Family Welfare dealing with the subject of Clinical Establishments Act shall be ex-officio secretary of National Council. The National Council has elected members from regulatory councils for allopathic Doctors (MCI, DCI), Pharmacy, Nursing, Indian systems of Medicine (Ayurveda, Soddha, Unani), Homoeopathy, Indian Medical Association (IMA) and nominated representatives of Bureau of Indian Standards (BIS), Zonal council, North Eastern Council other paramedical systems, consumer groups and association of Indian System of Medicine. 

In case of provisional registration, the District Health Officer or Chief Medical Officer shall:

•  Accept for purpose of provisional registration, application in the prescribed proforma as adopted by the State Government along with the requisite fee as determined by the State Government.
•  Accept applications for provisional registration - either filed in person, or by post or online
•  After receipt of application, grant within a period of ten days from date of receipt, a certificate of provisional registration in such form and particulars as determined by the State Government  
•  Within a period of forty five days from grant of provisional registration, publish all particulars of the clinical establishment, in a manner as may be determined by the State Government.   
•  Renewal of Registration and issue of duplicate certificate as per the provisions of Act and Rules.

The district registering authority will comprise of District Collector as chairperson, District Health Officer / Chief Medical Officer as convener and 6  three other members nominated by the District Collector/District Magistrate. 

 The three nominated members shall include,

a) A senior level officer of the local self-Government at the district level,

 b) One representative from a professional medical association or body having presence, preferably within the district or within the State like IMA or AYUSH.  

c) City Police Commissioner or Senior Superintendent of Police (or his nominee), whose help is required if the particular Clinical Establishment does not cooperate with the district registering authority and refuses to give permission to the teams visiting his or her clinical establishment’s premises. 

A multi member authority at district level known as the District Registering Authority is the registering authority for clinical establishments located in that district

The owner of the clinical establishment is responsible for registering the   clinical establishments under this Act. 

The purpose of Clinical Establishment Act is to make available a database of Clinical Establishments which are authorized to function. Therefore the overall objective is improvement in public health quality by eliminating quacks.

Other objectives are:

•  To prescribe basic minimum standards for different categories of clinical establishments for ensuring provision of proper healthcare by the clinical establishments.
•  To collect the required statistics from clinical establishments for policy formulations, planning, implementation, response and evaluation. 

It is true Health is a state subject and in the same so the Act is not enforced   on any state. State has to adopt the Act by passing a resolution in the legislature assembly of state. The Bill was passed by Parliament after 4 states agreed to enforce the Act after notification. 4  As per the provisions of the Act, 

The Central Government is responsible for:

•  Notification of the Act (Completed)  
•  Notification of the National Council and Rules for the functioning (Completed)
•  Classification & Categorization of the Clinical Establishments by Central Government based on the recommendations of the National Council. (Completed)  
•  Establish Minimum Standards for the different categories of Clinical Establishments based on the recommendations of the National Council.
•  Develop and prescribe the form and manner in which the registry (National, State & District level) is to be maintained.  
•  Provide oversight and assistance to the States and UT’s for the implementation of the CEA 2010 including capacity building.
•  Assistance for the drafting of Rules under Section 54 of the Act. Draft of Model Rules circulated to all implementing States/UTs.
•  Assist States & UT’s in adoption of the proposed web based registration system and offline registration systems.  Assistance to the State & UT’s Councils for any other matter that may be required. 

The State Governments would be responsible for:

•  Notification of State Rules under Section 54 of the Act
•  Constitute & notify the State / Union Territory Council of Clinical Establishments
•  Constitute & notify District Registration Authorities in all districts
•  Begin the process of provisional registration
•  Identification and notification of Registrars of Clinical Establishment at State Level (Director of Health Services) and District level (District Health Officer)  
• Disseminate information about the Act and Rules at various levels and among stakeholders 

(i) The Act: (a) Assists in generation of reliable and comprehensive database (or registry) for all types of clinical establishments in the country at district, state and national level. (b) Helps classify various types of clinical establishments into categories & determine category wise basic minimum standards. (c) Defines basic minimum standards for operation, using participatory and consultative approach to ensure uniformity across all establishments. The minimum standards indicate basic standards which are mandatory and certain standards which are desirable.  (d) Assists Government in obtaining information and data required from clinical establishments for public health interventions including outbreak and disaster management  3  (ii) It establishes the multi-stakeholder bodies namely National Council for Clinical Establishments at National level, State Council for clinical establishments at State level & District Registration Authority at each district. Implementation of the Act is by respective state through State council and District Registration Authority. (iii) The Act allows for two-step process of registration – provisional and permanent registration. Provisional registration is done through a process of self-declaration, without any inquiry or inspection. Permanent registration would be undertaken after categorization, classification and notification of category wise minimum standards.  (iv) The Act places the entire process of registration and the data of clinical establishments in the public domain which ensures transparency. (v) Details of charges, facilities available would be prominently displayed at a conspicuous place at each establishment  (vi) Registry of clinical establishments would aid in policy formulation and resource allocation. (vii) Cancellation of registration would occur at any time, if conditions for registration are not complied with. (viii) Clinical Establishment to provide emergency medical treatment within staff and facilities available. (ix) The Act may control or act as deterrent against quackery by introducing registration which is applicable only to clinical establishments of recognized systems of medicine and no one can run a clinical establishment without registration.  (x) It lays down provisions for healthcare providers to maintain records and reporting as prescribed and provide information and statistics that may be asked for by the authority. 

No. This Act has come into force in the States of Arunachal Pradesh, Sikkim, Mizoram, Himachal Pradesh and all Union Territories (namely Andaman & Nicobar Islands, Chandigarh, Dadra & Nagar Haveli, Daman & Diu, Lakshadweep and Puducherry) except Delhi from 01 March 2012.  The States of Uttar Pradesh, Bihar, Rajasthan, Jharkhand and Uttarakhand have adopted the Act by passing resolution in their respective State assemblies. All clinical establishments in above mentioned States and Union Territories will need to register under this Act.  Other states may adopt the law by passing a resolution in their state assemblies under clause (I) of Article 252 of the Constitution.