The Kerala Clinical Establishments Act mandates transparency in healthcare costs and patient safety, reinforcing constitutional rights and promoting accountability in clinical practices.

JUDGMENT :

SUSHRUT ARVIND DHARMADHIKARI, J.

1. The aforementioned two intra-Court appeals challenge the final judgment dated 23.06.2025, passed in W.P.(C) No.1365/2019 and W.P.(C) No.29353/2019. In the impugned judgment, the learned Single Judge, after a reasoned analysis, rejected the appellants’ challenge to various provisions of the Kerala Clinical Establishments (Registration and Regulation) Act, 2018 (hereinafter referred to as the “Act”) and the Kerala Clinical Establishments (Registration and Regulation) Rules, 2018 made thereunder (hereinafter referred to as the “Rules”) as neither unconstitutional nor arbitrary on multiple grounds, and ultimately dismissed the writ petitions by a common judgment.

Facts

2. The facts adumbrated herein have been briefly borrowed from W.A. No.1621/2025 and W.P.(C) No.1365/2019.

3. The first appellant is the registered association of the managements of private hospitals in the State of Kerala. The second appellant is one of the members of the first appellant. The writ petition challenges certain provisions of the Act and the Rules framed thereunder. The principal grounds of challenge raised by the appellants in the writ petition are:

(i) the mandatory requirement to furnish exhaustive details of all employees, including doctors and paramedical staff; and

(ii) the obligation to publish the list of fees to be charged for each item of treatment and for “packages”.

Appellants’ contentions

4. The appellants contended that these provisions and requirements are arbitrary, vague, impractical, and ultra vires the parent legislation, lacking adequate statutory safeguards or definitions.

5. It was argued that Sections 39(2) and 39(3), which mandate clinical establishments to display "fee rates" and "package rates" for various services, are inherently vague and undefined. The lack of clarity regarding what constitutes a "type of service" or a "package" makes compliance practically impossible and invites arbitrary enforcement, thereby violating the fundamental rights guaranteed under Articles 14 and 19(1)(g) of the Constitution of India.

5.1 For every "type of service", the components involved vary from patient to patient and from doctor to doctor. The management of each patient may follow different approaches as treatment progresses. Nothing can be predicted with certainty, especially in critical cases. Therefore, it is impossible to notify rates in advance for the various types of services. Further, it is argued that what is intended by "packages" is not clear. Treatments often involve a combination of various procedures and services, which further complicates compliance with the requirement to publish uniform "package" rates. These issues were not addressed by the learned Single Judge in the impugned judgment.

5.2 It is the argument of the learned Counsel for the appellants that, so far as Section 47 of the Act is concerned, it deals with the treatment of victims in emergencies and uses the expression "shall." This provision imposes an important obligation on clinical establishments. However, its blanket application is impractical, as many smaller institutions lack the requisite staff, infrastructure, and logistical capacity to arrange such safe transport. The requirement for "safe transport" must be interpreted contextually, taking into account the limitations of smaller clinical establishments. The learned Single Judge failed to consider this legitimate operational concern raised by the appellants. The Schedule itself catego