The Kerala High Court has dismissed a batch of petitions filed by various private medical associations challenging the constitutional validity of the Kerala Clinical Establishments (Registration and Regulation) Act, 2018.

The petitions were filed by stakeholders, including the Kerala Private Hospitals Association, Indian Medical Association, Indian Dental Association, and others.

Justice Harisankar V Menon, delivering the judgment, underscored that the right to health is a fundamental human right enshrined under Article 21 of the Constitution, and reinforced by Article 47, a Directive Principle obligating the State to improve public health.

The Court examined whether the Kerala legislature was competent to enact the 2018 Act in light of the Central Clinical Establishments Act, 2010. It noted that the Central law was enacted following resolutions by some States under Article 252(1) of the Constitution.

Since Kerala was not among those States, it was not bound to adopt the Central law and retained full legislative competence under Article 246(3) read with Entry 6 of List II (State List), which covers public health and sanitation.

“The Constitution nowhere provides that States not party to a resolution under Article 252(1) are bound to adopt Central legislation or are barred from making independent laws on the subject,” the Court observed.

Petitioners had primarily contested provisions mandating compulsory registration of clinical establishments and public display of fees and package rates (Sections 16(2), 39(2), and 39(3)). They argued that terms like "fee rate" and "package rate" were vague and that the law conferred excessive and unchecked powers to regulatory authorities. They also raised privacy concerns over data collection and inspection provisions.

Additionally, objection was taken to the inclusion of dentists under the Act—despite being governed by the Dentists Act, 1948—and to the composition of the State Council and Executive Committee, which included non-medical members such as representatives of patient welfare organisations.

Public Interest and Procedural Safeguards

Rejecting the challenges, the Court held that transparency requirements—such as displaying treatment fees—serve the public interest and enhance accountability in healthcare. It referred to an earlier ruling in Sabu P Joseph v State of Kerala, where similar provisions were upheld, noting that some of the present petitioners were parties to that litigation and could not re-agitate the same issue.

On the issue of cancellation of registration, the Court clarified that Section 25 mandates a notice and a hearing before action is taken, and immediate suspension is permissible only in exceptional situations posing imminent danger to public health, with reasons recorded in writing. The availability of appellate and revisional remedies under Sections 34 and 35 was also highlighted as evidence of procedural safeguards.

“There is no uncanalised or arbitrary power conferred on the authority. Adequate care has been taken to ensure fairness,” the Court noted.

The Court also rejected objections to including patient welfare representatives in regulatory bodies, stating that participatory governance is consistent with the purpose of the legislation. Further, it upheld the inclusion of dentistry under the Act, reasoning that dentistry, being a medical science, falls within the scope of the legislation aimed at regulating clinical establishments.

Finding no merit in any of the constitutional or procedural challenges, the Court upheld the validity of the 2018 Act and dismissed the petitions.

The petitioners were represented by Senior Advocates Kurian George Kannanthanam, George Poonthottam, KI Mayankutty Mather, and others. State Attorney N Manoj Kumar appeared for the State.