May 30, 2024
📰 FEATURE STORY
Should healthcare come under the Consumer Protection Act?
A couple of weeks back, the Supreme Court ruled that advocates can’t be held liable for deficiency of service under the Consumer Protection Act (CPA). But what it said after is what’s really interesting. The court said its 1995 ruling, which held that doctors and other medical professionals can be held under the CPA should be revisited.
This is significant because it touches upon several aspects of the relationship between a doctor and their patients. It also poses some tricky questions. What constitutes a service? Is a patient a consumer? What legal mechanisms are available to hold healthcare professionals accountable if something goes wrong?
Context
The origin of the CPA dates back to 1986 when it was first inducted into the Constitution. The goal was to provide a legal framework to address consumer concerns and give them better protection. The definition of a consumer was anyone buying goods or availing of any service for payment. Services included banking, transport, housing, entertainment, etc. Notably, it didn’t mention doctors or medical services.
However, the text included a line that stated the definition wasn’t limited to listed services. That being said, patients weren’t seen as consumers in a strict reading of the definition.
That changed in 1995. In the Indian Medical Association v. V.P. Shantha case, the Supreme Court explicitly stated medical professionals would be included under the CPA. The exceptions were doctors and hospitals that provided free services to all patients. This judgment paved the way for the CPA and the Consumer Disputes Redressal Forums to become additional tools for litigation against medical professionals.
The Act, however, didn’t change concerning doctors despite amendments in 1991, 1993, and 2002. When an updated CPA was introduced in 2019, it didn’t mention medical services. However, just like the previous version, the 2019 one has the key phrase “but not limited to” before the list of services.
The new criminal code bills passed in the Lok Sabha in December lowered the punishment for doctors on medical negligence cases. When the Bills were being debated, Amit Shah stated that if there’s a death due to negligence, it’s treated as a murder or a criminal act. He brought in an official amendment to shield doctors from legal ramifications.
The original draft asked for seven years of imprisonment in case of death due to negligence. The IMA lobbied the parliamentary committee to differentiate medical death by a doctor from death due to negligence.
An overview of this issue shows some interesting trends. Consumer complaints are most often filed against individual doctors and the healthcare establishment. Criminal complaints tend to focus on the medical practitioner alone. Most cases involve private healthcare providers.
Given the legal complexities involved, should the apex court revisit its 1995 decision and explicitly state that doctors should be included under the CPA, or would that be a bridge too far?
VIEW: It’s a slippery slope
When the 2019 version of the CPA was being discussed, the medical profession didn’t take too kindly to it. In Andhra Pradesh, for example, IMA state members protested the Bill on several fronts. Among their concerns was that it would leave doctors susceptible to unnecessary harassment by patients and their kin. It allowed anyone associated with the patient to file complaints.
Since most cases involve private healthcare providers, many argue healthcare reform is what’s needed, and not legislation hanging over a doctor’s head. In fact, that could cloud the judgment of medical professionals and make them scared to make certain decisions at crucial moments. Even the Supreme Court has argued for protecting doctors from frivolous lawsuits.
Some of the provisions under the 2019 CPA are too broad. For example, the definition of unfair trade practice included not issuing proper cash memos or bills. In 85% of cases where it goes to the courts, doctors pay out of their own pockets to defend themselves. Ultimately, the relationship between a doctor and the patient isn’t that of a buyer and seller since it goes beyond that definition. It’s a relationship of trust since there’s confidential information about the person and illness.
COUNTERVIEW: The patient comes first
A 2022 study showed an alarming annual incidence rate of up to 5.2 million medical malpractice cases across various healthcare settings in India. Another study from the Indian Journal of Medical Ethics showed that only 40% of healthcare providers comply with ethical guidelines. Patients already face difficulties in filing cases since gaining access to medical records is cumbersome, and the resolution of cases is slow.
Patients must come first. They need an effective adjudicating body and legal mechanisms to get their grievances redressed. While the 1956 Indian Medical Council Act defines misconduct and officials can punish doctors based on this, that doesn’t help patients or their families. The National Medical Council doesn’t have the power to award compensation. While there’s recourse in civil law, it’s a long process filled with elaborate procedures, rules, and delays.
It’s why the CPA is important and necessary to have the medical profession under its ambit. The whole point is to protect consumers. While the medical profession isn’t a business per se, it’s a service rendered to a person, which is often associated with a cost. The 1995 judgment clearly and rightly stated that the relationship between a doctor and a patient is a contract of service. That shouldn’t change.
Reference Links:
- Consumer Protection Act: Patients Delight Doctors Dilemma – Legal Services India
- Consumer Protection Act and health, medicine and hospitals – The Sunday Guardian
- The criminal liability of doctors under new code – Deccan Herald
- CPA Bill damaging for doctors, patients: Indian Medical Association – Deccan Chronicle
- Holding Healthcare Providers Accountable: Consumer, Civil, and Criminal Mechanisms – Vidhi Centre for Legal Policy
- Over 5.2 mn medical malpractice cases filed in India annually, shows data – Business Standard
What is your opinion on this?
(Only subscribers can participate in polls)
a) Healthcare shouldn’t come under the Consumer Protection Act.
b) Healthcare should come under the Consumer Protection Act.
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