1 Consumer Protection Act & The Medical Services National Workshop on “ Accessibility & Affordability of Quality Health Services in India” Trivandrum, September 2004 By Bejon Misra, Chairman Consumer Coordination Council (CCC) Delhi, India.

2 About CCC Established as a Registered Society in 1993Established as a Registered Society in 1993 Issue based National Coalition of 55 leading consumer Organizations from all over IndiaIssue based National Coalition of 55 leading consumer Organizations from all over India Member of Consumers InternationalMember of Consumers International Recognized by Government of IndiaRecognized by Government of India Member in various advisory and technical committees at the National & International level on Health & Food Safety related issuesMember in various advisory and technical committees at the National & International level on Health & Food Safety related issues

3 Objectives 1.To make the existing consumer protection laws user- friendly to increase accessibility to the poor & accountability to the patients 2.To build a relationship between the patients & the medical practitioners based on trust, transparency & respect for each other 3.To insulate health care services from industry influence & increase involvement of the consumer organisations to benchmark quality of service in the health care delivery system

4 Consumer Protection Act Enacted in the year 1986 & acclaimed as the most modern piece of legislation on consumer protection globally It gave legal rights to the consumers to claim compensation on deliberate act of negligence, substandard products & unfair trade practice which caused loss or damage to the consumer

5 Rights of the Consumer 1. The right to be protected against marketing of goods which are hazardous to life and property 2. The right to be informed about the quality, quantity, potency, purity, standard and price of goods to protect the consumer against unfair trade practices 3. The right to be assured, wherever possible, access to an authority of goods at competitive prices Contd…

6 Rights of the Consumer 4. The right to be heard and to be assured that consumers interest will receive due consideration at appropriate forums 5. The right to seek redressal against unfair trade practices or unscrupulous exploitation of consumers and 6. Right to consumer education.

7 Consumer Protection Act & Medical Services The significant judgment by the State Commission of Orissa in Smt. Sukanti Behera vs Dr. Sashi Bhusan Rath (1993), upholding the rights of patient to challenge the quality of health care services, was a landmark decree in the history of consumer redress within India The judgment by the Supreme Court of India in the Indian Medical Association Vs V.P. Shantha (1995), settled the matter by explicitly including medical services under the protective sheath of the Consumer Protection Act 1986

8 CONSUMER REDRESS AT THE SAMPLED CONSUMER FORUMS

9 PROFILE OF CONSUMERS USING CONSUMERCOURTS

10 CASES OF MEDICAL NEGLIGENCE: NATURE OF CLAIMS Wrongful death – Patient dying on account of wrong treatment Physical loss of function – Patient losing physical function such as eye sight, ability to walk etc. on the account of wrong diagnosis Other kinds of damage – Suffering due to operative or other treatment procedures without loss of physical function or death

11 CONSUMERS SATISFIED WITH CONSUMER REDRESSAL MECHANISM Bejon misra:

12 CONSUMERS SATISFIED WITH CONSUMER REDRESSAL MECHANISM

13 COST INCURRED BY CONSUMERS

14 COMPENSATION AWARDED IN 42% CASES

15 PROVIDER’S VIEWS (PENDING) 97% of providers said that consumers had not approached them 54% claimed to have special facilities for handling consumer complaints 25% said CPA was one - sided biased in favour of consumers 24% blamed heavy filing in consumer courts as the main bottleneck

16 PROVIDER’S EXPERIENCES (POST) Dismissed 35% Had to pay Compensation 40% Received Compensation for Malafide Complaints 25%.

17 TIME TAKEN FOR THE FINAL JUDGEMENT

18 LAWYER’S RECOMMENDATIONS FOR IMPROVING THE EFFICIENCY OF CONSUMER FORUMS

19 VIEW POINT OF MEMBERS OF CONSUMER FORUMS 79% agreed that medical negligence cases were not disposed of within the stipulated period 84% were of the opinion that the present system had provided an opportunity to the poor to voice there problems.

20 Health Financing: How does India finance health compared to other countries? Moderate levels of overall spending on health (4.5% GDP) (middle 20% of countries) Low public expenditures on health (0.9% GDP; 3.9% of gov’t spending) (bottom 10% of countries) High proportion of private health expenditure (82% private) (highest 10% of countries)

21 Who Pays for Health in India?

22 State Level Per Capita Public Spending on Health

23 State Level Per Capita Private Spending on Health

24 How to make services affordable? Third party interventions: Health financing is a means to mobilizing a volume of resources sufficient to meet the health goals of a country Provider interventions: Transforming India into a regional healthcare hub.

25 The Roles of Government – Beyond Service Provision Contract with the private sector for services Information collection and analysis Information dissemination / communication Coordination of health sector actors Regulation and accreditation Resource mobilization (“tax and spend”)

26RECOMMENDATIONS a.Mandatory Citizen’s Charter for all hospitals b.Institutionalize complaint procedures User friendly complaint manuals Fixed time frame for redress c.Improve infrastructure of Consumer Forums. Standard assessment of Consumer Forum every 2-3 years Increase number of Consumer Forums Panel of medical experts be made available d.Amend Consumer Protection Act Bring free health care in the perview of CPA

27 CONCLUSION a.Benchmark quality of service in health care sector b.Build awareness and generate demand for quality service thru well defined legislation c.Induce competition with good regulatory mechanisms Promote accountability and transparency in health care services THANK YOU I AM NOW OPEN TO QUESTIONS