Public Health Legislations

1. Public Health Legislations

2. Legislation (Statutory law) • Enacted by a legislature or other governing body or the process of making it • Before an item of legislation becomes law - Bill • Legislation can have many purposes: to regulate, to authorize, to outlaw, to provide (funds), to sanction, to grant, to declare or to restrict

3. Need for legislations • Indian constitution - provisions for the protection, and promotion of every individual/ group/ vulnerable population w.r.t. health and nutrition • Public health also depends on law and science • Provision of legal action against those trying to jeopardize the health of the people

4. Categories of Health Legislations • To improve and maintain high standards in the medical education and services • Public registration to assess mortality and enumeration of population • To prevent public health problems • To achieve maternal health and to empower women • To safe guard the children and young • To rehabilitate and provide equal opportunity to disabled and disadvantaged groups

5. Categories of Health Legislations • To prevent drug addiction, substance abuse and safe manufacturing of drugs, distribution and storage • To protect workers and to provide social security • Environmental legislations • To promote voluntary work

6. The Indian Medical Council Act, 1956; (Professional Conduct & Ethics) Regulations, 2002 • MCI has exclusive right to grant recognition to medical colleges • Registered medical practitioners under MCI are entitled to practice Allopathic system of medicine • Made regulations for standards of professional conduct, etiquette and code of ethics • Describes about the entry of names in the register, removal, restoration and maintenance of registers

7. Consumer Protection Act (CPA) 1986 7 Rights of consumers • Right to safety • Right to be informed • Right to choose • Right to be heard • Right to seek redressal • Right to consumer education • Right to clean and healthy environment

8. CPA and Medical Profession • Who is a consumer? • Doctor-patient relationship is a contract for a personal service • Not a master-servant relationship

9. Do’s for Doctors • Mention your qualifications/ training/ experience/ designation on the prescription • Always mention date and timing of the consultation • Mention age and sex of the patient • In a pediatric prescription, weight of the patient must also be mentioned

10. Do’s for Doctors • Always face the patient. Do not stare, especially female patients • Ask the patient to come back for review on the next day, if you are not sure about the diagnosis/ treatment • Mention “diagnosis under review” until the • diagnosis is finally settled • Record history of drug allergy • Write names of drugs clearly. Use correct dosages

11. Do’s for Doctors • Whenever referring a patient, provide him with a referring note • Update your (and your staff’s) knowledge and skill from time to time • Preferably employ qualified assistants

12. Don'ts for Doctors • Don’t prescribe without examining the patient • Don’t examine a patient when you are under influence of alcohol or any intoxicated substance • When you are not sure what and why to do, consult your senior/ specialist/ colleague • Don’t refuse the patient’s right to know about the hospital rules, regulations and hospital charges

13. Don'ts for Doctors • Don’t refuse if the patient/ attendants want to leave against medical advice. Document this properly • Don’t issue death or medical certificates unless you have yourself verified it • Don’t divulge secrets you come to know during discharge of your professional duties. • Don’t deny medical care to a patient with HIV infection/ AIDS. Observe all necessary precautions

14. The Registration of Births and Deaths Act, 1969 • “birth” means live-birth or still-birth • “death” means the permanent disappearance of all evidence of life at any time after live-birth has taken place

15. The Registration of Births and Deaths Act,1969 • To be registered within 21 days after births or deaths • Delayed registration within 1month on payment of fees • After thirty days but within one year - registered only with the written permission of the prescribed authority and on payment of the prescribed fee and production of an affidavit • After one year registration is made only on an order made by a Magistrate or a class one officer after verifying the correctness of the birth or death and on payment of the prescribed fee

16. The Registration of Births and Deaths Act,1969 • Provides for medical certification of death • Medical practitioner who has attended the deceased during his last breath or illness has to certify the cause of death in a prescribed format

17. The Medical Termination of Pregnancy Act, 1971 Conditions when abortions can be done • Therapeutic • Social • Humanitarian • Eugenic reasons • Not mentally sound

18. The Medical Termination of Pregnancy Act, 1971 • Person who can conduct MTP • Place where MTP can be done • MTP Rules 2003 • Committee at the district level • 20 weeks Vs 12 weeks • Informed Consent • Use of Misoprostol

19. The Maternity Benefit Act 1961 • Every women is entitled to payment of maternity benefit at the rate of average daily wage for the period of 6 weeks before and after delivery • In case of miscarriage or MTP leave with pay for 6 weeks • After tubectomy- leave for a period of 2 weeks • Recent Bill in parliament?? Penalties • Imprisonment for 3 months to 1 year or fine of Rs 2000 to Rs 5000 or both

20. The Pre-Conception and Pre-Natal diagnostic Techniques (Prohibition of Sex Selection) Act 1994 • To prohibit sex selection before and after conception and for regulation of pre-natal diagnostic techniques • Guidelines for doing prenatal diagnostic techniques use • Laboratories where the Prenatal diagnostic techniques are used to be registered

21. PNDT Act 1994 • Regulation of Genetic Counseling Centres, Genetic Laboratories and Genetic Clinics • Regulation of pre-natal diagnostic techniques • Written consent of pregnant woman and prohibition of communicating the sex of foetus • Determination of sex prohibited • Constitution of Central Supervisory Board

22. PNDT Act 1994 Penalties • Imprisonment upto 3 years and fine upto Rs 10000 • Subsequent conviction, 3-5 years imprisonment and fine of Rs 50000 • Removal of the name of the doctor from the register for 2 years for the first offence and permanently for the subequent offence

23. The Cigarettes and Other Tobacco Products(Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supplyand Distribution) Act, 2003 • COTPA

24. COTPA 2003 • No person shall advertise, shall cause to advertise, shall take part to advertise directly or indirectly any tobacco product for consumption or use • Sale of tobacco products to less than 18 years old not allowed • Sale of tobacco products not allowed in an area within the radius of one hundred yards of any educational institution

25. COTPA 2003 • Every package of the tobacco product should have label, pictorial representation of skull and cross bones and warnings • Smoking in public places - Rs 200 • Sale to less than 18 years old - Rs 200 • First conviction be punishable with imprisonment up to one year, or with fine which may extend to one thousand rupees or with both