Compliance Reduction initiative suggests allowing doctors to practise across states without fresh registration and simplifying hospital approvals
The Government of India has proposed two major healthcare sector reforms to the Government of Kerala under Phase II of the Compliance Reduction and Deregulation initiative, aimed at simplifying regulations and improving healthcare accessibility.
According to reports, the proposed reforms focus on allowing healthcare professionals to practise across states without fresh registration and introducing a single-window clearance system for hospital licences, which could significantly ease regulatory procedures in the health sector.
Proposal to Allow Doctors to Practise Across States
Currently, doctors registered in one state cannot directly practise in another without obtaining fresh registration. In Kerala, medical practice is governed by the Kerala State Medical Practitioners Act 2021, which authorises state medical councils for modern medicine, Indian Systems of Medicine, and homeopathy to grant registration.
As a result, doctors from other states must apply for fresh registration and often obtain a no-objection certificate (NOC) before working in the state.
Similarly, nurses are required to register under the Kerala Nurses and Midwives Act 1953 through the Kerala Nursing Council, while paramedical staff must register with the Kerala Paramedical Council.
However, the Centre has now suggested that healthcare professionals registered with any state medical council or listed in the National Medical Register under the National Medical Commission (NMC) should be allowed to practise in Kerala without undergoing the entire registration process again.
The proposal suggests a self-certification system, eliminating the need to obtain an NOC from the practitioner’s previous state. The reform aims to leverage the National Medical Register framework to enable seamless interstate mobility of healthcare professionals.
Reform Could Help Address Doctor Shortage
Reacting to the proposal, Kerala Government Medical Officers’ Association (KGMOA) General Secretary Jobin Joseph said the move could help tackle the shortage of doctors in rural and border regions.
According to him, districts such as Idukki, Palakkad, and Wayanad could particularly benefit, as the reform may attract doctors registered in neighbouring states to practise there.
Single-Window System for Hospital Licences
The second reform proposal focuses on reducing the complex regulatory process required to establish and operate healthcare facilities in Kerala.
Currently, hospitals must obtain approvals under several laws and regulatory frameworks, including the Kerala Clinical Establishments Act, Drugs and Cosmetics Act, Biomedical Waste Management Rules, Pre-Conception and Pre-Natal Diagnostic Techniques Act, Surrogacy Regulation Act 2021, and the Assisted Reproductive Technology Regulation Act 2021.
Healthcare establishments must also secure fire safety clearances, pollution control board consent, and trade licences from local self-government bodies, making the process time-consuming and complex.
Proposed Nodal Agency to Simplify Approvals
To streamline the process, the Centre has recommended establishing a single nodal agency within the Health and Family Welfare Department that would serve as the only point of contact for healthcare-related approvals.
This agency would coordinate with all relevant departments to obtain licences, registrations, and NOCs on behalf of healthcare establishments.
The proposal also allows for the appointment of a third-party private entity to manage coordination and regulatory processes for a fee paid by healthcare investors.
Implementation Requires Policy Changes
If implemented, the reforms would require policy decisions and possible amendments to existing state laws and regulations. Authorities would also need to revise procedures followed by various professional councils and regulatory bodies in Kerala.
The proposals are expected to be examined by the state government before any legislative or administrative changes are introduced.
