The Clinical Establishment ACT

2Regd. No. NWP/CUHN-2J2AB GOVT. GAZ. R(EeXgTdR. AN)o, M. CAHY D14/0, 2009220/2018-2020 (VYSK 24, 1942 SAKA) EEEEEXXXXXTTTTTRRRRRAAAAAOOOOORRRRRDDDDDIIIIINNNNNAAAAARRRRRYYYYY PPPPPuuuuubbbbbllllliiiiissssshhhhheeeeeddddd bbbbbyyyyy AAAAAuuuuuttttthhhhhooooorrrrriiiiitttttyyyyy CHANDIGARH, THURSDAY, MAY 14, 2020 (VAISAKHA 24, 1942 SAKA) LEGISLATIVE SUPPLEMENT Contents Pages Part - I Acts Nil Part - II Ordinances The Punjab Clinical Establishments (Registration and Regulation) Ordinance, 2020. (Punjab Ordinance No. 2 0f 2020) .. 3-27 Part - III Delegated Legislation Nil Part - IV Correction Slips, Republications and Replacements Nil ______ ( xxxvii ) PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 3 (VYSK 24, 1942 SAKA) PART II GOVERNMENT OF PUNJAB DEPARTMENT OF LEGAL AND LEGISLATIVE AFFAIRS, PUNJAB NOTIFICATION The 14th May, 2020 No. 12-Leg./2020.-The following Ordinance of the Governor of Punjab, promulgated under clause (1) of article 213 of the Constitution of India on the 9th day of May, 2020, is hereby published for general information:- THE PUNJAB CLINICAL ESTABLISHMENTS (REGISTRATION AND REGULATION) ORDINANCE, 2020 (Punjab Ordinance No. 2 of 2020) AN ORDINANCE to provide for the registration and regulation of clinical establishments in the State of Punjab and for matters connected therewith or incidental thereto. Promulgated by the Governor of Punjab in the Seventy-first Year of the Republic of India. Whereas the Legislative Assembly of the State of Punjab is not in session and the Governor is satisfied that circumstances exist, which render it necessary for him to take immediate action; Now, therefore, in exercise of the powers conferred by clause (1) of Article 213 of the Constitution of India, the Governor of Punjab is pleased to promulgate the following Ordinance, namely:- CHAPTER I PRELIMINARY 1. (1) This Ordinance may be called the Punjab Clinical Establishments Short title, (Registration and Regulation) Ordinance, 2020. application and commencement. (2) It shall apply to the entire State of Punjab. (3) It shall come into force on such date as the State Government may, by notification, appoint: Provided that different dates may be appointed for different categories and capacities of clinical establishments and for different recognised systems of medicine. 4 PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 (VYSK 24, 1942 SAKA) Definitions. 2. In this Ordinance, unless the context otherwise requires,— (a) “clinical establishment" means,- (i) a hospital, maternity home, nursing home, dispensary, clinic, sanatorium or an institution, by whatever name called, that offers services and facilities providing diagnosis, treatment or care for illness, injury, deformity, abnormality or pregnancy in any recognized system of medicine established and administered or maintained by any person or body of persons, whether incorporated or not; or (ii) a place established as an independent entity or part of a clinical establishment referred to in sub-clause (i), in connection with the diagnosis or treatment of diseases where pathological, bacteriological, genetic, radiological, chemical, biological investigations or other diagnostic or investigative services with the aid of laboratory or other medical equipment, are usually carried on, established and administered or maintained by any person or body of persons, whether incorporated or not, and shall include a clinical establishment owned, controlled or managed by,- (a) the Government or a department of the Government; (b) a trust, whether public or private; (c) a corporation (including a society) registered under a Central, Provincial or State Act, whether or not owned by the Government; (d) a local authority; and (e) a single doctor, but does not include the clinical establishments owned, controlled or managed by the Armed Forces. Explanation. — For the purpose of this clause, "Armed Forces" means the forces constituted under the Army Act, 1950, the Air Force Act, 1950 and the Navy Act, 1957; (b) "District Register of Clinical Establishments" means the register maintained by the concerned District Registration Authority; (c) "District Registration Authority" means the District Registration Authority PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 5 (VYSK 24, 1942 SAKA) for Clinical Establishments established under section 9 of this Ordinance; (d) "notification" means a notification published in the Official Gazette; (e) "prescribed" means prescribed by rules made under this Ordinance; (f) “Punjab State Appellate Authority " means the Punjab State Appellate Authority for Clinical Establishments established under section 34 of this Ordinance; (g) “Punjab State Council” means the Punjab State Council for Clinical Establishments established under section 3 of this Ordinance; (h) “Punjab State Master Register” means the Punjab State Master Register of Clinical Establishments maintained by the Punjab State Council, and compiled and updated by the State Registrar of Clinical Establishments on behalf of the said Council; (i) “qualified medical practitioner” means a medical practitioner registered in the State of Punjab with the statutory State Council or the statutory National Council constituted or established for the registration of medical practitioners in any recognised system of medicine; (j) “qualified nurse” means a nurse registered in the State of Punjab with the statutory State Council or the statutory National Council constituted or established for the registration of nurses; (k) “qualified para-medical person” means a person holding a qualification recognised by the State Government from a recognised institution wherein there is no statutory State or National Council or body for the registration of such manpower; (l) "recognised system of medicine" means Allopathy, Yoga, Naturopathy, Ayurveda, Homoeopathy, Siddha and Unani System of medicines or any other system of medicine as may be recognised by the State Government; (m) “registration” means registration of clinical establishments under this Ordinance by the State Registration Authority or the concerned District Registration Authority, as the case may be, and the expression registration or registered shall be construed accordingly; (n) “service provider” means a qualified medical practitioner, qualified nurse, qualified para-medical person, social worker or other appropriately trained and qualified person with specific skills relevant to particular health care services, including the management of clinical establishment, and any 6 PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 (VYSK 24, 1942 SAKA) reference to service provider shall mean the same unless specifically stated otherwise; (o) “service recipient” means a person who seeks, accesses or receives any treatment or health care, as an outpatient or inpatient, from any clinical establishment or service provider; (p) “standards” means such conditions, as the State Government may prescribe for the registration and regulation of clinical establishments; (q) “State Government” means the Government of the State of Punjab in the Department of Health and Family Welfare; (r) “State Register of Clinical Establishments” means the register maintained by the State Registration Authority; and (s) “State Registration Authority” means the State Registration Authority for Clinical Establishments established under section 7 of this Ordinance. CHAPTER II PUNJAB STATE COUNCIL FOR CLINICAL ESTABLISHMENTS Establishment 3. (1) With effect from such date as the State Government may, by of the Punjab notification appoint in this behalf, there shall be established for the purposes State Council. of this Ordinance, a Punjab State Council to be called the Punjab State Council for Clinical Establishments. (2) The Punjab State Council shall consist of the following, namely:- (a) Administrative Secretary, Department of : Chairperson Health and Family Welfare, Punjab; (b) Director Health and Family Welfare, : Member- Punjab; Secretary (c) Director Health Services (Family Welfare), : Member Punjab; (d) Director Health Services (Social Insurance), : Member Punjab; (e) Directors of different recognised systems of : Members medicine of the State Government, including but not limited to the Director, Ayurveda, Punjab and the Head of Homoeopathic Department, Punjab; PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 7 (VYSK 24, 1942 SAKA) (f) President of the Punjab Medical Council; : Member (g) President of the Punjab Dental Council; : Member (h) Registrar of the Punjab Nurses Registration : Member Council; (i) Registrar of the Punjab State Pharmacy : Member Council; (j) one representative to be elected by the : Member executive of the Board of Ayurvedic and Unani Systems of Medicine, Punjab; (k) one representative of the State Branch of the : Member Indian Medical Association; (l) one representative from the field of : Member paramedical systems to be nominated by the State Government; (m) two representatives from amongst the State : Members level consumer groups or reputed Non Governmental Organisations working in the field of healthcare to be nominated by the State Government; and (n) one Law Officer to be nominated by the : Member State Government. (3) The nominated and elected Members shall hold office for a term of three years, but shall be eligible for re-nomination for a maximum of one additional term not exceeding three years: Provided that the person so nominated or elected, as the case may be, shall hold office for as long as he or she holds the appointment of the office or the position by virtue of which he or she was nominated or elected to the Council. (4) The Punjab State Council may, subject to the previous approval of the State Government, make bye laws fixing a quorum and regulating its own procedure and the conduct of business to be transacted by it. (5) The Punjab State Council shall meet at least once in three months. (6) The functions of the Punjab State Council may be exercised not withstanding any vacancy therein. 8 PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 (VYSK 24, 1942 SAKA) Functions and 4. The Punjab State Council shall have the following functions and powers, powers of the namely: – Punjab State Council. (a) maintain the Punjab State Master Register; (b) sending monthly returns for updating the National Register as required by the Central Government or the National Council established under the Clinical Establishments (Registration and Regulation) Act, 2010 (Central Act No. 23 of 2010); (c) representing the State of Punjab in the National Council as may be required by the Central Government or the National Council established under the Clinical Establishments (Registration and Regulation) Act, 2010 (Central Act No. 23 of 2010); (d) publication, on an annual basis, of report regarding the status of implementation of this Ordinance; (e) constituting any Committee to perform any of its roles and functions; (f) issuing such directions, including furnishing returns, statistics and other information for the proper functioning of clinical establishments, and any such directions, as may be issued from time to time, shall be binding; (g) associating with itself, any person or body whose assistance or advice it may require in carrying out its functions under any of the provisions of this Ordinance; and (h) any other functions, as may be determined by the State Government, from time to time. Disqualification 5. A person shall be disqualified from being appointed as a Member of the of a Member of Punjab State Council, if, he,- the Punjab State Council. (a) has been convicted and sentenced to imprisonment for an offence which, in the opinion of the State Government, involves moral turpitude; or (b) is an undischarged insolvent; or (c) is of unsound mind and stands so declared by a competent court; or (d) has been removed or dismissed from the service of the Government or a Corporation owned or controlled by the PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 9 (VYSK 24, 1942 SAKA) Government or any other statutory body of the Government; or (e) has, in the opinion of the State Government, such financial or other interest in the Punjab State Council as is likely to affect prejudicially the discharge by him of his functions or duties as a Member. CHAPTER III REGISTRATION AND STANDARDS FOR CLINICAL ESTABLISHMENTS 6. (1) The Director Health and Family Welfare, Punjab shall be the State State Registrar of Clinical Registrar of Clinical Establishments. Establishments. (2) It shall be the responsibility of the State Registrar of Clinical Establishments to compile and update the Punjab State Master Register on behalf of the Punjab State Council. 7. (1) With effect from such date as the State Government may, by State Registration notification appoint in this behalf, there shall be established for the purposes Authority. of this Ordinance, a State Registration Authority to be called the State Registration Authority for Clinical Establishments. (2) The State Registration Authority shall consist of the following, namely: – (i) Director, Health and Family Welfare, : Chairperson Punjab; (ii) one Deputy Director, office of Director, : Member Health and Family Welfare, Punjab to be nominated by the State Government; (iii) one Law Officer to be nominated by : Member State Government; and (iv) Nodal Officer in the office of Director : Member Health and Family Welfare, Punjab, for this Ordinance. 8. The State Registration Authority shall perform the following functions, Functions of the namely:- State Registration Authority. (i) registration of clinical establishments with one hundred or more beds; 10 PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 (VYSK 24, 1942 SAKA) (ii) publish, in a manner, as may be prescribed,- (a) a list of provisionally registered clinical establishments with one hundred or more beds; (b) a list of clinical establishments, with one hundred or more beds, who submit evidence for permanent registration; and (c) a list of expired registrations; (iii) enter and search unregistered clinical establishments with one hundred or more beds after due notice, as may be prescribed; (iv) inspection and inquiry of the registered clinical establishments with one hundred or more beds through a multi-member inspection team in such manner, as may be prescribed; (v) recover penalties; (vi) compile and maintain the State Register of Clinical Establishments; (vii) establish a Grievance Redressal Cell for any grievances or complaints related to the clinical establishments with one hundred or more beds, in such manner, as may be prescribed; (viii) any other work related to the registration of clinical establishments with one hundred or more beds; and (ix) such other functions, as may be determined by the State Government from time to time. District 9. (1) With effect from such date as the State Government may, by Registration notification appoint in this behalf, there shall be established for the purposes Authority. of this Ordinance, a District Registration Authority for each district to be called the District Registration Authority for Clinical Establishments. (2) Each District Registration Authority shall consist of the following, namely:– (i) Civil Surgeon of the respective district; : Chairperson (ii) District Family Welfare Officer of the : Member respective district; (iii) one representative of the District Attorney : Member of the respective district; and (iv) District Nodal Officer in the office of Civil : Member Surgeon of the respective district, for this Ordinance. PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 11 (VYSK 24, 1942 SAKA) 10. Each District Registration Authority shall perform the following functions, Functions of the namely:- District Registration Authority. (i) registration of all clinical establishments of the respective district, except the clinical establishments having one hundred or more beds; (ii) publish, in a manner, as may be prescribed,- (a) a list of clinical establishments registered by it provisionally; (b) a list of clinical establishments, who submit evidence for permanent registration; and (c) a list of expired registrations; (iii) enter and search any unregistered clinical establishment of the respective district, except the clinical establishment having one hundred or more beds after due notice, as may be prescribed; (iv) inspection and inquiry of the clinical establishments registered under it through a multi-member inspection team in such manner, as may be prescribed; (v) recover penalties; (vi) compile and maintain the District Register of Clinical Establishments of the respective District; (vii) establish a Grievance Redressal Cell in the respective district for any grievances or complaints related to the clinical establishments, in such manner, as may be prescribed; (viii) any other work related to the registration of clinical establishments to be registered by it; and (ix) such other functions, as may be determined by the State Government from time to time. 11. No person shall keep or carry on a clinical establishment without Registration being duly registered by the concerned registration authority in respect thereof certificates for clinical and except under and in accordance with the terms of registration granted establishments. thereof. Explanation I.—For the purpose of this section “person” includes a body, group or association of individuals, an organization, a firm, a trust or society (whether registered or not) or a company registered under any law for the time being in force. 12 PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 (VYSK 24, 1942 SAKA) Explanation II.—For the purposes of this section, “carry on” means to provide the service recipient in a clinical establishment with any kind of service including consultation, treatment, diagnosis, or nursing care. Classification of 12. (1) Clinical establishments shall be classified into such categories, as clinical may be prescribed from time to time. establishments (2) Different standards may be prescribed for various categories of clinical establishments. Application for 13. (1) Every person intending to open, keep or carry on a clinical provisional establishment shall submit an application in the prescribed proforma along with certificate of the prescribed fee to the concerned registration authority for the purposes of registration. registration in respect of a clinical establishment. The concerned registration authority shall make provisions for submission of applications also and registration thereto. (2) Every application made under sub-section (1) shall contain such particulars and be accompanied by such declarations and documents of the clinical establishment and the standards of services and skills being provided by it, as may be prescribed. (3) Any change in address or other particulars mentioned under sub- section (2) shall be communicated by the applicant or the person carrying on the clinical establishment to the concerned registration authority not later than thirty days after such change with a specific mention as to the exact date when such change occurred. (4) No applicant under sub-section (1) shall try to obtain the registration by means of misrepresentation of facts, fraudulent practices, falsifying documents, or using unfair means. Provisional 14. The concerned registration authority shall, within a period of thirty days certificate. from the date of receipt of such application, grant to the applicant a certificate of provisional registration in such form and containing such particulars and such information, as may be prescribed. No inquiry prior 15. (1) The concerned registration authority shall not conduct any inquiry to grant of prior to the grant of provisional registration. provisional registration. (2) Notwithstanding the grant of the provisional certificate of registration, the concerned registration authority shall, within the prescribed period from the grant of provisional registration, cause to be published in such manner, as PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 13 (VYSK 24, 1942 SAKA) may be prescribed, all particulars of the clinical establishment so registered provisionally. 16. Subject to the provisions of section 18, every provisional registration shall Validity of provisional be valid for a period of six months from the date of issue of the certificate of registration. provisional registration. 17. (1) Only in unavoidable or special circumstances, the provisional Extension of provisional registration may be extended for such period, in such manner and subject to registration. the payment of such fees, as may be prescribed. (2) The application for extension of provisional registration shall be made thirty days before the expiry of the validity of the certificate of provisional registration and in case the application for extension is made after the expiry of the provisional registration, the concerned registration authority shall allow the extension of provisional registration upon the payment of such enhanced fees, as may be prescribed. 18. Where the categories of clinical establishments in respect of which Time limit for standards have been notified by the State Government, provisional registration provisional registration. shall not be granted or extended beyond,- (i) the period of two years from the date of notification of the standards in case of clinical establishment which came into existence before the commencement of this Ordinance; (ii) the period of two years from the date of notification of the standards for clinical establishments which come into existence after the commencement of this Ordinance but before the notification of the standards; and (iii) the period of six months from the date of notification of standards for clinical establishments which come into existence after standards have been notified. 19. Application for permanent registration by a clinical establishment shall Application for be made to the concerned registration authority in such form and be permanent registration. accompanied by such fees, as may be prescribed. 20. The clinical establishment shall submit evidence of having complied with Verification of the prescribed minimum standards in such manner, as may be prescribed. application. 21. (1) No permanent registration shall be granted in respect of a clinical Conditions for establishment, unless it has, - permanent registration. (a) provided such minimum standards of accommodation, as may be prescribed; 14 PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 (VYSK 24, 1942 SAKA) (b) engaged such minimum number of service providers and other categories of employees with such qualification(s), as may be prescribed; (c) made arrangements for such minimum standards of facilities and services including emergency care and referral services, as may be prescribed; (d) installed such equipment and machineries, as may be prescribed; (e) made such arrangements for the disposal of Bio-Medical Waste as prescribed under the Bio-Medical Waste Management Rules, 2016 made by the Government of India, Ministry of Environment, Forest and Climate Change; (f) made provisions for maintenance of such records and registers in such form and containing such particulars, as may be prescribed; and (g) fulfilled such other condition(s), as may be prescribed. (2) Every registration granted under sub-section (1) shall be subject to the following terms and conditions, namely:- (a) conditions laid down in sub-section (1) are continuously complied with; (b) necessary precautions are observed so as to ensure that the clinical establishment is not being used for any unsocial or immoral purpose; (c) the clinical establishment does not resort to any unethical practices whatsoever; (d) all such measures are taken to keep the clinical establishment in such satisfactorily, sanitary and hygienic condition, as may be prescribed; (e) all such information is displayed in such manner, as may be prescribed; (f) all such reports in such form containing such particulars and such necessary documents are submitted to such authorities at such intervals or on demand, as may be prescribed; (g) such medical and other reports, records and documents are PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 15 (VYSK 24, 1942 SAKA) made available to the registration authority or the service recipient or his representative on demand, as may be prescribed; (h) a report is submitted to the concerned authority immediately in case a person, who has been received in or accommodated or both in the clinical establishment, is found to be suffering from any such infectious or dangerous disease or other condition, as may have been notified by the State Government, especially those covered under the Epidemic Diseases Act, 1897; (i) every clinical establishment maintains a Public Grievance Redressal Mechanism for lodging of any complaint regarding treatment, improper billing, deficiency in service, attending staff's behaviour etc. and for timely assured redressal thereof; (j) every clinical establishment sets up a proper Help Desk to maintain regular and proper communication with the service recipients or their representatives regarding treatment being provided, recipient’s condition, regular billing etc. and their proper counseling; (k) every clinical establishment immediately after coming into force of this Ordinance, maintains comprehensive medical records and provides a set of all medical records and treatment details along with the discharge summary at the time of discharge of the service recipient; (l) every clinical establishment having more than one hundred beds may endeavour to set up a Fair Price Medicine Shop and a Fair Price Diagnostic Centre; (m) no person is subject to any discrimination in any form or manner, by the clinical establishment in access to facilities, goods, care and services, including admission, on any of the grounds of nationality, sex/gender, physical or mental disability, occupation, religion, sect, language, caste, political or other opinion or affiliation, actual or perceived health status and disease condition like Human Immunodeficiency Virus (HIV) infection or Acquired Immunodeficiency Syndrome (AIDS) or such other diseases like Covid-19 and other emerging and 16 PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 (VYSK 24, 1942 SAKA) as yet unknown infectious diseases, as may be prescribed, or such other arbitrary grounds; (n) the clinical establishment actively participates in the implementation of all National and State Health Programmes including the prevention of spread of communicable diseases in such manner as the State Government may specify from time to time and furnish periodical reports related thereto as per prescribed formats to the authorities concerned; (o) the clinical establishment at all times, ensures compliance with all the applicable laws including any rules, regulations, instructions, guidelines, notifications, circulars, by-laws, etc.; (p) the clinical establishment provides treatment within the staff and facilities available, to provide first aid to all the victims of road traffic accidents, rail accidents, air accidents, explosions, natural disasters and calamities who come or are brought to the clinical establishment. After providing the first aid and making all possible available efforts to stabilize such patients, the clinical establishment shall be at liberty to refer them to an appropriate Government hospital/medical college; and (q) such other terms and conditions, as may be prescribed. Standards for 22. Permanent registration shall be granted only when a clinical establishment permanent fulfils the prescribed standards for registration by the State Government. registration. Allowing or 23. The concerned registration authority shall pass an order immediately after disallowing of the expiry of the prescribed period and within the next thirty days thereafter registration. either:- (a) allowing the application for permanent registration; or (b) disallowing the application: Provided that the concerned registration authority shall record its reasons in writing, if it disallows an application for permanent registration. Certificate of 24. (1) The concerned registration authority shall, if it allows an application of permanent the clinical establishment, issue a certificate of permanent registration in such form registration and and containing such particulars, as may be prescribed. its renewal. (2) The certificate shall be valid for a period of five years from the date of issue. PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 17 (VYSK 24, 1942 SAKA) (3) The application for renewal of permanent registration shall be made within three months before the expiry of the validity of the certificate of permanent registration in such form and alongwith such fees, as may be prescribed. (4) In case the application of renewal referred in sub-section (3) is not submitted within the stipulated period, the concerned registration authority may allow renewal of permanent registration on payment of such enhanced fees and penalties, as may be prescribed. 25. The certificate shall be affixed in a conspicuous place in the clinical Display of establishment in such manner so as to be visible to everyone visiting such certificate of registration. establishment. 26. In case the certificate is lost, destroyed, mutilated or damaged, the Duplicate concerned registration authority shall issue a duplicate certificate on the request certificate. of the clinical establishment and on the payment of such fees, as may be prescribed. 27. (1) The certificate of registration shall be non-transferable. Certificate to be non-transferable. (2) In the event of change of ownership or management, or change of category, or location, or upon the withdrawal or addition of some facility provided, the clinical establishment shall inform the concerned registration authority of such change in such manner, as may be prescribed and such clinical establishment shall apply afresh for the grant of certificate of registration alongwith such fees, as may be prescribed. (3) In the event of ceasing to function as a clinical establishment, the certificate of registration in respect of such clinical establishment shall be surrendered to the concerned registration authority. 28. The concerned registration authority shall cause to be published within Publication of such time and in such manner, as may be prescribed, the names of such clinical expiry of registration. establishments whose registration has expired. 29. (1) If, at any time after any clinical establishment has been registered Cancellation or suspension of and the concerned registration authority on receiving a complaint and on getting registration. such complaint duly investigated in the manner prescribed, is satisfied,— (a) that the conditions of the registration are not being complied with; or (b) that there exists any of the grounds which would have entitled the concerned registration authority to refuse the application 18 PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 (VYSK 24, 1942 SAKA) for registration; or (c) that the person entrusted with the management of the clinical establishment has violated any of the directions including any notice of improvement from the concerned registration authority; or (d) that the person entrusted with the management of the clinical establishment has contravened any of the provisions of this Ordinance or rules made thereunder; or (e) that the clinical establishment has not complied with the improvement notice issued under section 31 of this Ordinance, the concerned registration authority, may issue a show cause notice as to why its registration under this Ordinance should not be cancelled or suspended for the reasons to be mentioned in the notice. (2) If after giving a reasonable opportunity of being heard to the clinical establishment, the concerned registration authority is satisfied that there has been a breach of any of the provisions of this Ordinance or the rules made thereunder, it may, by an order, without prejudice to any other action that it may take against such clinical establishment, cancel or suspend its registration. Inspection of 30. (1) Inspection by the concerned registration authority or a multi-member clinical inspection team referred to in sub-section (2) shall be mandatory before the establishment. issuance of certificate of permanent registration. (2) The concerned registration authority or a multi-member inspection team authorised by it, which shall comprise of at least three members of impeccable integrity, shall have the right to cause an inspection of, or inquiry in respect of any registered clinical establishment, its building, laboratories and equipment and also of the work conducted or done by the clinical establishment, in such manner as may be prescribed and to cause an inquiry to be made in respect of any other matter connected with the clinical establishment and such clinical establishment shall be entitled to be represented thereat: Provided that such inquiry can be conducted only after a complaint for breach of the declarations or terms and conditions, is received by the concerned registration authority. (3) Every inspection team authorized under this section shall conduct the inspection and submit a report to the concerned registration authority within seven days of completion of such inspection in such manner, as may be PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 19 (VYSK 24, 1942 SAKA) prescribed. (4) The inspection team conducting the inspection shall record its observation or inspection note in the inspection book to be kept at the clinical establishment for this purpose. 31. If the concerned registration authority has reasonable ground by way of Improvement the receipt of any complaint, for believing that any clinical establishment has notice. failed to comply with any provision of this Ordinance or the rules made thereunder, the concerned registration authority may, after ascertaining the opinion of the concerned clinical establishment thereon, by an improvement notice served on that clinical establishment, – (a) state the grounds for believing that the clinical establishment has failed to comply with any provision of this Ordinance or the rules made thereunder; (b) specify the matters which constitute the clinical establishment’s failure to comply; (c) specify the measures which, in the opinion of the concerned registration authority, the clinical establishment must take, in order to ensure compliance; and (d) require the clinical establishment to take those measures, or measures which are at least equivalent to them, within a reasonable period (not more than one month) as may be specified in the notice. 32. (1) If,- Prohibition order. (a) any clinical establishment is convicted of an offence under this Ordinance; or (b) the clinical establishment is being kept or carried on without a valid certificate of registration; or (c) the registration of the clinical establishment is cancelled or suspended; or (d) the concerned registration authority is satisfied that an imminent danger to the health and safety of any member of the public or patient exists with respect to that clinical establishment, the concerned registration authority may, after giving such clinical establishment an opportunity of being heard, by an order, impose the following prohibitions, namely:- 20 PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 (VYSK 24, 1942 SAKA) (i) a prohibition on the use of the process or treatment for the purposes of the service delivery by the clinical establishment; (ii) a prohibition on the use of the premises or equipment for the purposes of the service delivery by the clinical establishment. (2) Every order made under sub-section (1) shall take immediate effect: Provided that the concerned registration authority, after issuance of prohibition order shall take such steps, to restrain immediately the clinical establishment from carrying on health care related services, as may be prescribed. Power to enter. 33. The concerned registration authority or such officers as may be authorised by it, may, if there is any reason to suspect that anyone is carrying on a clinical establishment without due registration, enter and search in the manner prescribed, at any reasonable time and the clinical establishment, shall offer reasonable facilities for inspection or inquiry and be entitled to be represented thereat: Provided that no such person shall enter the clinical establishment without an authority letter from the concerned registration authority. CHAPTER IV PUNJAB STATE APPELLATE AUTHORITY Punjab State 34. (1) With effect from such date as the State Government may, by Appellate notification appoint in this behalf, there shall be established for the purposes Authority. of this Ordinance, the Punjab State Appellate Authority to be called the Punjab State Appellate Authority for Clinical Establishments. (2) The Punjab State Appellate Authority shall consist of the following, namely:- (i) Administrative Secretary, Department of : Chairperson Health and Family Welfare, Punjab; (ii) Director Health Services (Family Welfare), : Member Punjab; and (iii) one Law Officer to be nominated by the : Member State Government. Functions of 35. The Punjab State Appellate Authority shall,- Punjab State (i) be the appellate authority to hear appeals against the orders of the State Appellate Authority. Registration Authority and the District Registration Authority; and PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 21 (VYSK 24, 1942 SAKA) (ii) perform such other functions, as may be determined by the State Government. 36. (1) Any person, aggrieved by,– Appeal and revocation. (i) the failure of the concerned registration authority in communicating the allowing or disallowing of an application for registration to a clinical establishment within the prescribed period; or (ii) an order of the concerned registration authority refusing to allow registration or extend or renew a registration certificate; or (iii) an order of cancellation or suspension of a registration certificate; or (iv) an improvement notice; or (v) prohibition order; (vi) or any other order of the concerned registration authority, may, prefer an appeal to the Punjab State Appellate Authority. (2) Every appeal under sub-section (1) shall be made in such manner, in such form, within such period and shall be accompanied by such fee, as may be prescribed: Provided that the Punjab State Appellate Authority may entertain an appeal referred to in sub-section (1) after the expiry of the prescribed period if it is satisfied that the appellant was prevented by sufficient cause from preferring the appeal in time. (3) Cancellation of registration may be revoked by the Punjab State Appellate Authority after considering the appeal. (4) The decision of the Punjab State Appellate Authority shall be final and binding. CHAPTER V REGISTERS OF CLINICAL ESTABLISHMENTS 37. (1) The concerned District Registration Authority shall maintain in such District Register of Clinical form and containing such particulars, as may be prescribed, a register to be Establishments. known as the District Register of Clinical Establishments in respect of all the clinical establishments of that District, except the clinical establishments having one hundred or more beds. 22 PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 (VYSK 24, 1942 SAKA) (2) The concerned District Registration Authority shall within a period of two years from its establishment, compile, publish and maintain in digital format a register of clinical establishments registered by it and enter the particulars of the certificates so issued in a register to be maintained for such purpose. State Register of 38. (1) The State Registration Authority shall maintain in such form and Clinical containing such particulars, as may be prescribed, a register to be known as Establishments. the State Register of Clinical Establishments in respect of the clinical establishments having one hundred or more beds. (2) The State Registration Authority shall within a period of two years from its establishment, compile, publish and maintain in digital format a register of clinical establishments registered by it and enter the particulars of the certificates so issued in a register to be maintained for such purpose. Punjab State 39. (1) The Punjab State Council shall maintain in such form and containing Master Register. such particulars, as may be prescribed, a register to be known as the Punjab State Master Register of Clinical Establishments in respect of all the clinical establishments registered in the State of Punjab. (2) It shall be the responsibility of the State Registrar of Clinical Establishments to compile and update the Punjab State Master Register on behalf of the Punjab State Council. (3) The Punjab State Master Register would be subsequently digitized within two years. (4) The Punjab State Council on behalf of the State Government shall supply to the Central Government, a copy of the Punjab State Master Register and inform the Central Government of all additions to and other amendments in the said register, for a particular month by the 15thday of the following month. CHAPTER VI PENALTIES Penalty. 40. Whosoever contravenes any provision of this Ordinance shall, if no penalty is provided elsewhere, be punishable in accordance with the rules made under this Ordinance. Monetary 41. (1) Whosoever carries on a clinical establishment without registration penalty for non- shall, on first contravention, be liable to a monetary penalty which may extend registration. PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 23 (VYSK 24, 1942 SAKA) to fifty thousand rupees, for second contravention with a monetary penalty which may extend to two lakh rupees and for any subsequent contravention with a monetary penalty which may extend to five lakh rupees and may also invite disciplinary action, as may be prescribed. (2) Whosoever knowingly serves in a clinical establishment which is not duly registered under this Ordinance shall, on first contravention, be liable to a monetary penalty which may extend to twenty-five thousand rupees, for second contravention with a monetary penalty which may extend to one lakh rupees and for third contravention with a monetary penalty which may extend to two lakh and fifty thousand rupees. (3) For the purpose of adjudging under sub-sections (1) and (2), the concerned registration authority shall hold an inquiry in the prescribed manner after giving any person concerned a reasonable opportunity of being heard for the purpose of imposing any monetary penalty. (4) While holding an inquiry, the concerned registration authority shall have the power to summon and enforce the attendance of any person acquainted with the facts and circumstances of the case to give evidence or to produce any document which in the opinion of the concerned registration authority, may be useful for or relevant to the subject matter of the inquiry and if, upon such inquiry, it is satisfied that the person has failed to comply with the provisions specified in sub-sections (1) and (2), it may by order impose the monetary penalty as specified in the said sub-sections to be deposited within thirty days of the order in the account referred to in sub-section (8) of section 42. (5) While determining the quantum of monetary penalty, the concerned registration authority shall take into account the category, size and type of the clinical establishment and local conditions of the area in which the clinical establishment is situated. (6) Any person aggrieved by the decision of the concerned registration authority may prefer an appeal to the Punjab State Appellate Authority within such period, as may be prescribed. (7) The manner of filing the appeal referred to in sub-section (6) shall be such, as may be prescribed. (8) The Punjab Medical Council or the concerned Registering Council or body shall be informed about the name of the doctor or service provider who has committed more than three offences. 24 PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 (VYSK 24, 1942 SAKA) Disobedience of 42. (1) Whosoever wilfully disobeys any direction lawfully issued by the direction, concerned registration authority or by any person empowered under this obstruction and Ordinance to give such direction, or obstructs any person or authority in the refusal of information. discharge of any duty or functions which such person or authority is required or empowered under this Ordinance to discharge, shall be liable to such monetary penalty, as may be prescribed. (2) Whosoever being required by or under this Ordinance to supply any information, wilfully withholds such information or wilfully provides such information which he knows to be false or which he does not believe to be true, shall be liable to such monetary penalty, as may be prescribed. (3) For the purpose of adjudging under sub-sections (1) and (2), the concerned registration authority shall hold an inquiry in the prescribed manner after giving the concerned person a reasonable opportunity of being heard for the purpose of imposing any monetary penalty. (4) While holding an inquiry, the concerned registration authority shall have the power to summon and enforce the attendance of any person acquainted with the facts and circumstances of the case to give evidence or to produce any document which in the opinion of the concerned registration authority, may be useful for or relevant to the subject matter of the inquiry and if, on such inquiry, it is satisfied that the person has failed to comply with the provisions specified in sub-sections (1) and (2), it may by order impose the monetary penalty referred to in the said sub-sections to be deposited within thirty days of the order in the account referred to in sub-section (8). (5) While determining the quantum of monetary penalty, the concerned registration authority shall take into account the category, size and type of the clinical establishment and local conditions of the area in which the clinical establishment is situated. (6) Any person aggrieved by the decision of the concerned registration authority may prefer an appeal to the Punjab State Appellate Authority within such period, as may be prescribed. (7) The manner of filing the appeal referred to in sub-section (6) shall be such, as may be prescribed. (8) All monetary penalties levied under this Ordinance shall be credited to such account as the State Government may by order specify in this regard. Penalty for 43. Whosoever contravenes any provision of this Ordinance or any rule minor made thereunder resulting in deficiencies that do not pose any imminent deficiencies. PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 25 (VYSK 24, 1942 SAKA) danger to the health and safety of any patient and can be rectified within a reasonable time, shall be liable for such punishment, as may be prescribed alongwith monetary penalty which may extend upto ten thousand rupees for first contravention, upto fifty thousand rupees for second contravention and upto one lakh rupees for third contravention. 44. (1) Where a person committing contravention of any of the provisions Contravention of this Ordinance or of any rule made thereunder, is a company, every person by companies. who, at the time the contravention was committed, was in charge of, and was responsible to the company for the conduct of the business of the company, as well as the company itself, shall be deemed to be guilty of such contravention and shall be liable to pay such monetary penalty, as may be prescribed: Provided that nothing contained in this sub-section shall render any such person liable to any punishment if he proves that the contravention was committed without his knowledge or that he had exercised all due diligence to prevent the commission of such contravention.

(2) Notwithstanding anything contained in sub-section (1), where a contravention of any of the provisions of this Ordinance or of any rule made thereunder has been committed by a company and it is proved that such contravention has taken place with the consent or connivance of, or is attributable to any neglect on the part of, any director, manager, secretary or other officer of the company, such director, manager, secretary or other officer shall also be deemed to be guilty of such contravention and shall be liable to pay such monetary penalty, as may be prescribed. Explanation.- For the purpose of this section,— (a) “company” means a body corporate and includes a firm or other association of individuals; and (b) “director”, in relation to a firm, means a partner in the firm. 45. (1) Where an offence under this Ordinance has been committed by Offences by Government any Department of Punjab Government within such period, as may be Departments. prescribed after the commencement of this Ordinance, the concerned service provider employed or engaged by such Department shall be deemed to be guilty of such offence and shall be liable to be proceeded against and punished according to the provisions of this Ordinance and the rules made thereunder: Provided that nothing contained in this section shall render such service provider liable to any punishment if he proves that the offence was committed without his knowledge or that he exercised all due diligence to 26 PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 (VYSK 24, 1942 SAKA) prevent the commission of such offence. (2) Notwithstanding anything contained in sub-section (1), whereby an offence under this Ordinance has been committed by a Department of Punjab Government and it is proved that the offence has been committed by a service provider with the consent or connivance of, or is attributable to any neglect on the part of any officer, such officer shall also be deemed to be guilty of that offence and shall be liable to be proceeded against and punished according to the provisions of this Ordinance and the rules made thereunder. Recovery of 46. Whosoever fails to pay any fine, the Punjab State Council may prepare fine. a certificate signed by an officer duly authorised by it specifying the amount of the fine due from such person and send it to the Collector of the District in which such person owns any property or resides or carries on his business and the said Collector, upon receipt of such certificate, shall proceed to recover from such person the amount specified thereunder, as if it were an arrear of land revenue. Grievance 47. There shall be such grievance redressal mechanism, as may be prescribed, redressal. whereby any member of the public may file a complaint regarding non- compliance with any provision of this Ordinance. CHAPTER VII MISCELLANEOUS Protection of 48. (1) No suit, prosecution or other legal proceedings shall lie against any action taken in authority or any Member of the Punjab State Council or any officer duly good faith. authorized in this behalf in respect of anything, which is in good faith done or intended to be done in pursuance of the provisions of this Ordinance or any rule made thereunder. (2) No suit or other legal proceedings shall lie against any officer of the State Government in respect of any loss or damage caused or likely to be caused by anything which is in good faith done or intended to be done in pursuance of the provisions of this Ordinance or any rule made thereunder. Furnishing of 49. Every clinical establishment shall, within such time or within such extended returns etc. time, as may be prescribed in that behalf, furnish to the concerned registration authority or the Punjab State Council, such returns or the statistical and other information in such manner, as may be prescribed. Power to give 50. Without prejudice to the foregoing provisions of this Ordinance, the Punjab directions. State Council shall have the power to issue such directions, including furnishing PUNJAB GOVT. GAZ. (EXTRA), MAY 14, 2020 27 (VYSK 24, 1942 SAKA) returns, statistical and other information for the proper functioning of clinical establishments and such directions shall be binding. 51. Every employee of the registration authorities, the Punjab State Council Employees of and the Punjab State Appellate Authority shall be deemed to, when acting or the registration authorities etc., purporting to act in pursuance of any of the provisions of this Ordinance, be to be public public servants as per the provisions of section 21 of the Indian Penal Code. servants. 52. (1) If any difficulty arises in giving effect to the provisions of this Power to Ordinance, the State Government may, by order so published in the Official remove difficulties. Gazette, make such provisions not inconsistent with the provisions of this Ordinance as may appear to it to be necessary or expedient for removal of the difficulty: Provided that no such order shall be made after the expiry of a period of two years from the date of commencement of this Ordinance. (2) Every order made under this section shall, as soon as may be after it is made, be laid before the State Legislature. 53. (1) The State Government may, by notification in the Official Gazette, Power of State make rules for carrying out the purposes of this Ordinance. Government to make rules. (2) Every rule made under this section, shall be laid, as soon as may be, after it is made, before the House of the State Legislature while it is in session for a total period of ten days, which may be comprised in one session or in two or more successive sessions and if, before the expiry of the session in which it is so laid or the successive sessions as aforesaid, the House agrees in making any modification in the rule or the House agrees that the rule should not be made, the rule shall thereafter, have effect only in such modified form or be of no effect, as the case may be. However, any such modification or annulment shall be without prejudice to the validity of anything previously done or omitted to be done under that rule. V.P. SINGH BADNORE, Governor of Punjab. S.K. AGGARWAL, Secretary to Government of Punjab, Department of Legal and Legislative Affairs. 2018/5-2020/Pb. Govt. Press, S.A.S. Nagar