Bhat R
Indian Institute of Management, Ahmedabad, India.
Health Policy Plan. 1996 Sep;11(3):265-79. doi: 10.1093/heapol/11.3.265.
Private medical provision is an important constituent of health care delivery services in India. The quality of care provided by this sector is a critical issue. Professional organizations such as the Medical Council of India and local medical associations have remained ineffective in influencing the behaviour of private providers. The recent decision to bring private medical practice under the Consumer Protection Act (COPRA) 1986 is considered an important step towards regulating the private medical sector. This study surveyed the views of private providers on this legislation. They believe the COPRA will be effective in minimizing malpractice and negligent behaviour, but it does have adverse consequences such as an increase in fees charged by doctors, an increase in the prescription of medicines and diagnostics, an adverse impact on emergency care, etc. The medical associations have also argued that the introduction of COPRA is a step towards expensive, daunting and needless litigation. A number of other concerns have been raised by consumer forums which focus on the lack of standards for private practice, the uncertainty and risks of medicines, the effectiveness of the judiciary system, and the responsibility of proving negligence. How relevant are these concerns? Is the enactment of COPRA really appropriate to the medical sector? The paper argues that while this development is a welcome step, we need to comprehensively look into the various quality concerns. The effective implementation of COPRA presumes certain conditions, the most important being the availability of standards. Besides this, greater involvement of professional organizations is needed to ensure appropriate quality in private practice, since health and medical cases are very different from other goods and services. The paper discusses the results of a mailed survey and interview responses of 130 providers from the city of Ahmedabad, India. The questionnaire study was designed to assess the opinion of providers on various implications of the COPRA. We also analyze the data on cases filed with the Consumer Disputes and Redressal Commission in Gujarat since 1991. Four selected cases filed with the National Commission on Consumers Redressal are discussed in detail to illustrate various issues affecting the implementation of this Act.
私立医疗服务是印度医疗保健服务的一个重要组成部分。该部门提供的医疗质量是一个关键问题。诸如印度医学委员会和地方医学协会等专业组织在影响私立医疗服务提供者的行为方面一直没有成效。最近将私立医疗执业纳入1986年《消费者保护法》（COPRA）的决定被视为朝着规范私立医疗部门迈出的重要一步。本研究调查了私立医疗服务提供者对该立法的看法。他们认为《消费者保护法》将有效地减少医疗事故和疏忽行为，但它确实有一些不利后果，如医生收费增加、药品和诊断检查处方增多、对急诊护理产生不利影响等。医学协会也认为引入《消费者保护法》是朝着昂贵、令人生畏且不必要的诉讼迈出的一步。消费者论坛还提出了许多其他问题，这些问题集中在私立医疗执业缺乏标准、药品的不确定性和风险、司法系统的有效性以及证明疏忽的责任等方面。这些问题有多相关？《消费者保护法》的颁布对医疗部门真的合适吗？本文认为，虽然这一发展是值得欢迎的一步，但我们需要全面审视各种质量问题。《消费者保护法》的有效实施假定了某些条件，其中最重要的是标准的可用性。除此之外，由于健康和医疗案例与其他商品和服务有很大不同，需要专业组织更多地参与以确保私立医疗执业有适当的质量。本文讨论了对印度艾哈迈达巴德市130名医疗服务提供者进行的邮寄调查和访谈回复的结果。问卷调查旨在评估医疗服务提供者对《消费者保护法》各种影响因素的看法。我们还分析了自1991年以来向古吉拉特邦消费者纠纷和申诉委员会提交的案件数据。详细讨论了向国家消费者申诉委员会提交的四个选定案例，以说明影响该法案实施的各种问题。
