Kerala High Court dismisses petitions against Kerala Clinical Establishments Act
A single bench of the Kerala High Court on Monday (June 23, 2025) dismissed six petitions filed by the Kerala Private Hospitals' Association, Indian Medical Association, and others against various provisions of the Kerala Clinical Establishments (Registration and Regulations) Act 2018, which they claimed were arbitrary and a violation of the Constitution.
In dismissing the petitions, the court ruled that nothing in the Act seemed arbitrary or a violation of the Constitution, as the Act clearly gives opportunities for the clinical establishments for a hearing before the authorities can take dire steps against a clinical establishment, such as the cancellation of registration.
The judgment is a vindication of the stance adopted by the Kerala government that the sole intention of the KCE Act was to safeguard public health and patient safety and that the Act was enacted to promote ethical standards in clinical practice by introducing a regulatory framework that provides for transparency.
The State argued that when private interest is pitted against public interest, particularly in the field of public health, the larger public interest is the one that should be considered. The mere 'possibility' of abuse/misuse of a statutory provision is not to be a guiding factor in considering the constitutionality of a statute.
End of 7-year legal battle
While the petitioners are free to go on appeal, the judgment marks the end of the seven-year legal battle that the private sector clinical establishments have been waging against the State, ever since it attempted to bring in regulations in the private health sector through the KCE Act in 2018.
Kerala Private Hospital Association and others were primarily challenging the Sections 16(2) and 39(2) and (3) of the Act as arbitrary and violative of Part III of the Constitution. They had also sought for a declaration that they are not liable to furnish the data required under the Act and its Rules.
Section 16(2) of KCE Act states that no clinical establishment would be allowed to operate without registration. Section 39(2) and (3) is about displaying the rate and 'package rate' charged for various treatments, procedures and facilities available.The Indian Dental Association, Kerala Private Clinics Association and the Indian Medical Association had raised similar contentions
The court opined that there is no 'uncanalised power' bestowed on the Authority (Kerala State Council for Clinical Establishments) with respect to the cancellation of registration of a hospital, as argued by the petitioners because the said proviso (sub section 3 of Section 25) is evoked only under extraordinary circumstances. Even then, there was always the provision for hospitals to approach the appellate authority
The government has all along tried its best to take the private sector clinical establishments into confidence in implementing the KCE, the single most public health measure which was expected to bring in more transparency and accountability in the functioning of clinical establishments in both public and private sector.
'The Act merely insisted on mandatory registration, maintenance of certain minimum standards and that the hospitals display their rates for various procedures openly, so that patients would have the choice of choosing suitable options. However, it would seem that the private sector was worried about the government scrutiny on many unhealthy practices in the sector, including performance of surgical or cosmetic procedures in clinics without adequate facilities or the employment of unqualified personnel in small clinics and labs,' a Health official said.
He pointed out that quackery was rampant in Kerala, with many unqualified persons performing cosmetic procedures like hair transplants or PRP (platelet-rich plasma injections to tackle hair loss). Home care is another area which is mushrooming in Kerala, often without mandatory registrations. There are also many clinical establishments employing doctors or technicians, whose qualifications might not be the recognised ones.
'This judgment is a milestone in our attempt to implement KCE Act because most of the private hospitals who are members of the KPHA have been resisting even registration under the Act. In 2019, KPHA secured an interim order that no coercive action be taken by the State against private hospitals with regard to the Act. Now that the legal hurdles have been removed, the Government can focus on the proper implementation of the Act,' J.S. Sanil Kumar, secretary of the Kerala State Council for Clinical Establishments said.
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A single bench of the Kerala High Court on Monday (June 23, 2025) dismissed six petitions filed by the Kerala Private Hospitals' Association, Indian Medical Association, and others against various provisions of the Kerala Clinical Establishments (Registration and Regulations) Act 2018, which they claimed were arbitrary and a violation of the Constitution. In dismissing the petitions, the court ruled that nothing in the Act seemed arbitrary or a violation of the Constitution, as the Act clearly gives opportunities for the clinical establishments for a hearing before the authorities can take dire steps against a clinical establishment, such as the cancellation of registration. The judgment is a vindication of the stance adopted by the Kerala government that the sole intention of the KCE Act was to safeguard public health and patient safety and that the Act was enacted to promote ethical standards in clinical practice by introducing a regulatory framework that provides for transparency. The State argued that when private interest is pitted against public interest, particularly in the field of public health, the larger public interest is the one that should be considered. The mere 'possibility' of abuse/misuse of a statutory provision is not to be a guiding factor in considering the constitutionality of a statute. End of 7-year legal battle While the petitioners are free to go on appeal, the judgment marks the end of the seven-year legal battle that the private sector clinical establishments have been waging against the State, ever since it attempted to bring in regulations in the private health sector through the KCE Act in 2018. Kerala Private Hospital Association and others were primarily challenging the Sections 16(2) and 39(2) and (3) of the Act as arbitrary and violative of Part III of the Constitution. They had also sought for a declaration that they are not liable to furnish the data required under the Act and its Rules. Section 16(2) of KCE Act states that no clinical establishment would be allowed to operate without registration. Section 39(2) and (3) is about displaying the rate and 'package rate' charged for various treatments, procedures and facilities Indian Dental Association, Kerala Private Clinics Association and the Indian Medical Association had raised similar contentions The court opined that there is no 'uncanalised power' bestowed on the Authority (Kerala State Council for Clinical Establishments) with respect to the cancellation of registration of a hospital, as argued by the petitioners because the said proviso (sub section 3 of Section 25) is evoked only under extraordinary circumstances. Even then, there was always the provision for hospitals to approach the appellate authority The government has all along tried its best to take the private sector clinical establishments into confidence in implementing the KCE, the single most public health measure which was expected to bring in more transparency and accountability in the functioning of clinical establishments in both public and private sector. 'The Act merely insisted on mandatory registration, maintenance of certain minimum standards and that the hospitals display their rates for various procedures openly, so that patients would have the choice of choosing suitable options. However, it would seem that the private sector was worried about the government scrutiny on many unhealthy practices in the sector, including performance of surgical or cosmetic procedures in clinics without adequate facilities or the employment of unqualified personnel in small clinics and labs,' a Health official said. He pointed out that quackery was rampant in Kerala, with many unqualified persons performing cosmetic procedures like hair transplants or PRP (platelet-rich plasma injections to tackle hair loss). Home care is another area which is mushrooming in Kerala, often without mandatory registrations. There are also many clinical establishments employing doctors or technicians, whose qualifications might not be the recognised ones. 'This judgment is a milestone in our attempt to implement KCE Act because most of the private hospitals who are members of the KPHA have been resisting even registration under the Act. In 2019, KPHA secured an interim order that no coercive action be taken by the State against private hospitals with regard to the Act. Now that the legal hurdles have been removed, the Government can focus on the proper implementation of the Act,' J.S. Sanil Kumar, secretary of the Kerala State Council for Clinical Establishments said.
