The Kerala High Court has delivered a big thumbs-up to the Kerala Clinical Establishments (Registration and Regulations) Act 2018, marking a huge win for the State government. This law aims to bring clear rules and honesty to hospitals, but private health groups in Kerala have been fiercely fighting it. The Kerala Private Hospital Association (KPHA) and the Indian Medical Association (Kerala Chapter) (IMA) challenged the law again in court, but their appeals were dismissed on Wednesday. Despite this, these groups warn the Act could be the "last nail in the coffin" for small and medium hospitals, which are already leaving the healthcare sector. Hussain Koya Thangal, president of KPHA, said, "We are not against the Act. But our concerns about the practical issues that stand in the way of its implementation have not been addressed, even though we have had several rounds of discussions with the government. Small and medium hospitals, which provide affordable health care to people, will have to shut shop if the government insists on going ahead with the implementation of the Act." The Act requires every clinic and hospital to register and stick to minimum standards based on their type. It also orders hospitals to openly display their prices for various treatments to bring in more transparency. The KPHA and IMA argued that asking hospitals to publish "type of service" and "package rates" is unclear and hard to do. They also said this violates their rights under the Constitution and is too heavy a burden on private hospitals. "We have 1,362 members; only about 50 are super speciality hospitals. Around 300 are medium hospitals with 100-200 beds. The rest are small hospitals with fewer than 50 beds. These small hospitals run with just enough staff and will be overwhelmed if the Act is enforced strictly," said Mr. Thangal. "How can they handle big duties like stabilising accident victims?" But the court clarified small clinics are only expected to do what they can – screen patients, stabilize within their limits, and safely transfer patients if needed. N. Sulphi, from IMA’s central committee, worried about small hospitals being harassed and licenses canceled: "We have been asking to exempt hospitals with up to 50 beds from this Act, like other states have done. Now, every death is blamed on medical negligence before any inquiry. This Act could be used against small hospitals unfairly." Health officials said the Act includes ways for hospitals to raise complaints and fight unfair actions. They accused the private sector of resisting honest checks because they don't want scrutiny. "Complaints about unlicensed practices, overcharging, hidden costs, and doubtful staff qualifications are many. They fear that the law's enforcement will expose all this," said an official. The court said, "Hospitals don't have to guess prices for every situation, only show basic rates for clear services." It added, "Just because a law is hard to put into practice, it doesn’t mean it’s invalid if it serves the public good. The law supports constitutional duties by ensuring registration, transparency, and minimum emergency care standards." Both KPHA and IMA stressed they don’t want conflict with the government but want serious talks to sort out their worries. Published - November 28, 2025 04:41 pm IST