The Kerala High Court, in a landmark ruling on November 26, 2025, upheld the Kerala Clinical Establishments (Registration and Regulation) Act, 2018, dismissing appeals from the Indian Medical Association (IMA) and Kerala Private Hospitals Association.
A Division Bench comprising Justices Sushrut Arvind Dharmadhikari and Syam Kumar V.M. issued comprehensive guidelines mandating hospitals to display services, baseline and package rates at reception and websites in Malayalam and English.
Establishments must also set up grievance desks, issue reference numbers, resolve complaints within seven days, escalate serious issues to District Medical Officers, and maintain monthly registers, with emergency care provided without payment barriers.
Mandates for Transparency and Care
Hospitals now face strict requirements: screen and stabilise emergencies within capacity, ensure safe transfers with documentation, and hand over reports at discharge. Every clinical setup must file a compliance undertaking within 30 days, audited within 60, facing suspension, penalties, or cancellation for violations.
The bench criticised private facilities for seven-year non-implementation, stating, “Let this judgment serve not merely as a declaration of law but as a reaffirmation of the right to dignified, ethical, and equitable medical care.” The Registrar must notify the Chief Secretary and Police Chief for enforcement, with statewide publicity in media for a month.
Background of Legal Challenges
The Act, enacted in 2018 and phased from 2019, regulates all clinical establishments to curb billing opacity and negligence amid rising complaints. IMA and hospitals challenged sections on registration, fee displays, and emergency aid as vague and burdensome, especially for smaller units lacking resources.
A single judge upheld it in June 2025, leading to these dismissed appeals; the court affirmed state competence under public health entries, aligning with Articles 21 and 47 of the Constitution and global standards.
Broader Implications for Patients
This framework operationalises constitutional duties through registration, transparency, and emergency minima, protecting rights without new burdens on ethical providers. It addresses exploitation concerns, fostering uniform standards across Kerala.
Non-compliance triggers civil, criminal remedies alongside regulatory action, ensuring accountability.
Kerala Clinical Establishments Act 2018
The Kerala Clinical Establishments (Registration and Regulation) Act, 2018, mandates registration of all clinical setups across recognised medicine systems like modern medicine, Ayurveda, and homoeopathy, in public and private sectors.
It requires displaying services, baseline and package rates at receptions and websites in Malayalam and English, alongside grievance mechanisms for swift resolutions. Enacted to curb exploitation through billing transparency and emergency care without payment barriers, the Act categorises facilities by size and services, ensuring safety standards and patient rights under constitutional provisions.
Non-compliance risks suspension or penalties, as upheld by the Kerala High Court in November 2025.
The Logical Indian’s Perspective
This verdict champions patient dignity, enforcing empathy-driven healthcare that builds trust and harmony between providers and citizens. By prioritising transparency and swift redressal, it drives positive change towards equitable access.
