The Clinical Establishment (Registration and Regulation) Act was enacted by the Union government to ensure that uniform and acceptable standard of health care is meted to the citizens in the private sector [1]. Till date, only 5 States and 4 Union territories have implemented it. As a part of providing standard treatment by private hospitals, treatment guidelines have been formulated for most broad specialties and super specialties. The standard treatment policy is intended to provide a ring of protection for both patients and doctors [2]. For the patients, it assures the delivery of a rational, safe, standard and uniform treatment. For the doctors who follow standard guidelines, it offers protection against medico-legal issues arising out of non-standard treatment. For Pediatrics and Pediatric surgery, the standard treatment guidelines (published at www.clinicalestablishments.nic.in) cover only a limited number of conditions [3]. There is no mention of management of common ailments like respiratory infection, diarrhea, malaria, typhoid, hepatitis, HIV, tuberculosis, envenomations and chronic diseases like asthma, diabetes and epilepsy. Similarly, developmental disorders like cerebral palsy, attention deficit hyper-activity disorder and autism have not found a place. Delivery room management of perinatal asphyxia, neonatal sepsis and screening for metabolic diseases have also been ignored.

We assume that the standard guidelines available through the website are only a sample and not an exhaustive list of common pediatric and pediatric surgical conditions. There is a haste in implementing the above program in various states. Standard guidelines need to be elaborate, focusing on common clinical conditions, and conditions associated with serious morbidity and mortality if not identified or treated appropriately. We urge the Academy to share the common pediatric protocols, that are already in place, with the appropriate authorities, so that the same can also be incorporated in the website.

Acknowledgement: BS Sanjay Kumar Bommidi.

1. Kumar R. Healthcare and medical education reforms in India: What lies ahead? J Family Med Prim Care. 2013;2:123-7.

2. Phadke A. The Indian Medical Association and the Clinical Establishment Act, 2010: irrational opposition to regulation. Indian J Med Ethics. 2010;7:229-32.