07AMBHM27 - Health Law and Policies - v2

Health Laws and Policies
MBA Second Year

(Hospital Management)
Paper No. 2.7
School of Distance Education

Bharathiar University, Coimbatore - 641 046
CONTENTS
Page No.
UNIT I
Lesson 1 Introduction about Health Law 9

Lesson 2 Introduction about Code of Ethics 18
Lesson 3 Medical Council Act 26
Lesson 4 Clinical Trials 38
Lesson 5 Disability Act 44
Lesson 6 Legal Aspects of Medical Records 54
Lesson 7 Transplantation of Human Organs Act 62
Lesson 8 Prevention of Food Adulteration Act 71
Lesson 9 Medical Termination of Pregnancy (Amendment) Act, 2003 76
Lesson 10 Registration of Births and Deaths Act 81
Lesson 11 Pre-natal Diagnostic Techniques 88
Lesson 12 Indian Mental Health Act 98
UNIT II
Lesson 13 Nature of Law 109

Lesson 14 Law of Contract 117
Lesson 15 The Patient and the Consumer Protection Act, 1986 147
Lesson 16 Bio-medical Waste (Management and Handling) Rules 154
Lesson 17 Atomic Energy Act 163
Lesson 18 The Electricity Act, 2003 173
Lesson 19 Indian Boilers Act 180
Lesson 20 Pollution Control Acts and Regulations 185
Lesson 21 Regulation of Stock Exchanges 198
Lesson 22 Negotiable Instruments Act 214
Lesson 23 CENVAT (Earlier Modvat) 224
Lesson 24 Insurance Regulatory and Development Authority (IRDA) 230
Lesson 25 Service Tax 236
UNIT III
Lesson 26 Health Care Delivery System 251

Lesson 27 National Health Committees 258
Lesson 28 Health Care Infrastructure 266
Lesson 29 Private and Voluntary Organizations 287
UNIT IV
Lesson 30 Indian and International Voluntary Health Agencies 293

Lesson 31 Voluntary Health Agencies in India 296
Lesson 32 International Voluntary Health Agencies 324
UNIT V
Lesson 33 National Health Policy 347
Lesson 34 National Population Policy 2000 359
Lesson 35 Pharmacy Legislation in India 369
Lesson 36 Pharmacy Act, 1948 376
Lesson 37 Drugs and Cosmetics Rules 382
Lesson 38 Narcotic Drugs and Psychotropic Substances (Amendment) Act 387
Lesson 39 Drugs and Magic Remedies (Objectionable Advertisements) Act 392
Lesson 40 Poisons Act and Rules 398
Model Question Paper 401
HEALTH LAWS AND POLICIES
SYLLABUS
UNIT I
Code of ethics – introduction – professional ethics – personal qualities of the medical
professional – Laws related to medical practice: Medical council act – clinical trials –
disability act – legal aspects of medical records – transplantation of human organ
act – prevention of food and adulteration act – medical termination of pregnancy
act, 1971 – birth and death registration act – sex determination act – Indian mental
health act, 1987.
UNIT II
Laws related to hospital administration: Companies act – law of contracts – consumer
protection act – Laws related to support services: Biomedical waste (management
and handling rules) – atomic energy act – Indian electricity Act, 1956 – Indian
boiler act – pollution control act – Laws related to hospital finance: Securities and
exchange board of India (SEBI) – securities contract regulation act – negotiable
Instruments act – value added act (VAT) – patient bill – IRDA – service tax.
UNIT III
Overview of health care delivery system: Overview of health care delivery system –
brief history of evolution – growth of health care services after independent salient
features of various committees. Health care infrastructure – National level – state
level – district level – block level, primary health center level – sub center level –
village level – role of private sector & voluntary organization.
UNIT IV
Health care agencies – definition – function: National health care agencies – Indian
red cross / society – Hind Kusht Nivaran Sangh – Indian council for child welfare –
tuberculosis association of India – Bharat Sevak Samaj – central social welfare
board – Kasthuriba memorial fund – family planning association of India – an Indian
blind relief society – All India women's conference. International health care
agencies – UNICEF, WHO, UNDP, World Bank, CARE – Rockefeller foundation –
ford foundation Colombo plan.
UNIT V
Health policies: National health policy – salient features – population policy 2000.
Pharmaceutical legislation in India – historical development of pharmaceutical
education in India and its present status. Pharmacy act – drugs and cosmetics act –
narcotics and psychotropic substances act – drug and magic remedies act – poisons
act and rules.
8
LESSON UNIT I 9
Introduction about
Health Law
1
INTRODUCTION ABOUT HEALTH LAW
CONTENTS
1.0 Aims and Objectives
1.1 Introduction
1.2 Forensic or Legal Medicine
1.3 Medical Jurisprudence
1.4 Medical Ethics
1.5 Medical Etiquette
1.6 Indian Penal Code (I.P.C.), 1860
1.7 Criminal Procedure Code (Cr.P.C.), 1973
1.8 Indian Evidence Act (I/E/A/), 1872
1.9 Criminal Law
1.10 Civil Law
1.11 Inquest
1.12 Medical Examiner’s System
1.13 Jury
1.14 Courts of Law
1.15 Types of Magistrates
1.16 Punishments
1.17 Subpoena or Summons
1.18 Conduct Money
1.19 Capital Punishment
1.20 Chain of Custody
1.21 Medical Evidence
1.22 Documentary Evidence
1.23 Dying Declaration
1.24 Let us Sum up
1.25 Lesson End Activity
1.26 Keywords
1.27 Question for Discussion
1.28 Suggested Reading
10
Health Laws and Policies 1.0 AIMS AND OBJECTIVES
After studying this lesson, you should be able to:
z Get an idea about the law-medicine relationship
z Know about the terms in law
z Understand the documentary evidence and also dying declaration
1.1 INTRODUCTION
The legal aspects of medical practice in general and hospital administration and
management in particular are no less important than any other subject required to be
discussed in this treatise. There are two distinct aspects of law-medicine relationship:
1. Forensic medicine,
2. Medical jurisprudence.
They are essentially different subjects but are closely related.
1.2 FORENSIC OR LEGAL MEDICINE

(Forensic = of or used in Courts of Law) deals with the application of medical
knowledge to aid in the administration of justice. It is used by the legal authorities for
the solution of legal problems. Some examples are applying the medical knowledge in
deciding cases of injuries, murder, suicide, accidents, sexual offences, poisoning, etc.
In short, it deals with medical aspects of law.
1.3 MEDICAL JURISPRUDENCE

(Juris = law; prudential acknowledge) deals with legal responsibilities of the physician
with particular reference to those arising from physician – patient relationship such as
medical negligence cases. Consent, Rights and duties of doctors, serious professional
misconduct, medical ethics, etc. In short, it deals with legal aspects of practice of
medicine.
1.4 MEDICAL ETHICS

Deals with the moral principles, which should guide members of the medical
profession in their dealings with each other, their patients and the State.
1.5 MEDICAL ETIQUETTE

Deals with the conventional laws of courtesy observed between members of the
medical profession. Ethical behavior is a self-imposed duty upon each doctor. A
doctor should not criticize or denigrate the professional ability of another doctor.
While dealing with a patient. A doctor should behave with his colleagues, as he would
have them behave with himself.
1.6 INDIAN PENAL CODE (I.P.C.), 1860

It deals with substantive criminal law of India. It defines offences and prescribes
punishments.
1.7 CRIMINAL PROCEDURE CODE (CR.P.C.), 1973

It provides the mechanism for punishment of offences against the substantive criminal
law. It deals with police duties in arresting offenders, dealing with absconders, in the
production of documents etc. in investigating offences. It provides for different class
of Courts. It deals with actual procedure in trials, appeals, references, revisions, and 11
Introduction about
transfer of criminal cases. Health Law
1.8 INDIAN EVIDENCE ACT (I/E/A/), 1872

It deals with Law of Evidence and applies to all judicial proceedings in or before any
Court. It is common to both the criminal and civil procedure.
1.9 CRIMINAL LAW

Deals with offences, which are considered to be against the public interest, such as
offences against the person, property, public safety, security of the State, etc. Here the
State is a party represented by public prosecutor. And the accused is the other party.
1.10 CIVIL LAW

Deals with disputes between two individuals or parties. The party bringing the action
in a civil case is called “plaintiff”. The accused is called “defendant” in both criminal
and civil cases.
Check Your Progress 1
1. What are the two aspects of law-medicine relationship?
……………………………………………………………………………..
……………………………………………………………………………..
2. What is forensic medicine?
……………………………………………………………………………..
……………………………………………………………………………..
3. What is medical jurisprudence?
……………………………………………………………………………..
……………………………………………………………………………..
4. What is medical etiquette?
……………………………………………………………………………..
……………………………………………………………………………..
1.11 INQUEST
An inquest is an inquiry or investigation into the cause of death. It is conducted in
cases of suicide, murder, killing by an animal or machinery, accidents, and suspicious
(unnatural) deaths. Three types of inquests are held in India.
z Police Inquest: The officer in-charge of a police station conducts the inquest. The
police officer making the inquest is known as Investigating Officer (I.O.). When
the officer-in-charge of a police station receives information that a person has
committed suicide, or has been killed by another or by an animal or by machinery
or by an accident, or has died under circumstances raising a reasonable suspicion
that some other person has committed an offence, he immediately gives intimation
there of to the nearest Executive Magistrate empowered to hold inquest and
proceeds to the place where the body of so deceased person is. There, in the
presence of or more respectable persons (panchas) makes investigation. He
prepares a report of the appeared cause of death, describing wounds, fractures.
Burns and other marks of injury found on the body, a stating in what manner. Or
by what weapon instrument, such injuries appear to have been inflicted. The
inquest report (panchanama) is then signed the investigating police officer and by
12 the witness. If no foul play is suspected, the dead body is hand over to the
relatives for disposal. In cases suspected foul play or doubt the body is sent post-
mortem examination to the nearest authority Government doctor, together with a
requisition and a copy of the inquest. The report is forwarded the Magistrate.
The police officer may summon persons appear to know the facts of the case for
investigation purposes. The summoned person is bound to attend and answer
questions put to him. Refusal to answer questions is punishable with
imprisonment up to six months.
z Magistrates Inquest: This conducted by a District Magistrate, Sub-division
Magistrate, or any other Executive Magistrate especially empowered by the State
Government such as Collector, Deputy Collector or Tahsildar (Executive
Magistrates). It is done in case of (1) death in prison, (2) death in police custody
are while under police interrogation, (3) death due police firing, (4) death in a
psychiatric hospital, (5) dowry deaths, and (6) exhumation.
In any case of death, a Magistrate may conduct an inquest, instead of or in
addition to the police inquest.
z Coroner’s Inquest: This is a type of inquest done in U.K., some States in U.S.A.,
and some other countries, but not in India. Coroner conducts inquest in all
unnatural and suspicious deaths. The doctor is summoned to his Court’s give
evidence at the inquest. Coroner’s Court is a Court’s enquiry, wherein Jurors are
sworn to give a true verdict according to the evidence. He has some judicial
powers.
1.12 MEDICAL EXAMINER’S SYSTEM

This is a type of inquest conducted in most of the States in the United State of
America. A medical practitioner known as Medical Examiner is appointed to perform
the functions of Coroner. He does not have any judicial functions similar to the
Coroner and he has no authority to order the arrest of any person. As the doctor visits
the scene of crime and conducts the inquest, it is period to Coroner’s and police
inquest.
1.13 JURY
Jury is a group of responsible, educated persons of good social position called
“jurors”. It is composed of an uneven number of persons. Their verdict is binding on
the judge, but if the judge differs, the mater is referred to High Court. Trial by jury has
been abolished in India.
1.14 COURTS OF LAW

Courts of law are of two types: (1) Civil, and (2) Criminal. The Criminal Courts in
India are following types:
z Supreme Court: It is the highest judicial tribunal, and is located in New Delhi. It
has power of supervision over all Courts in India. The law declared by it is
binding on all Courts.
z The High Court: It is usually located in the capital of every State and is the
highest tribunal for the State. It may try any offence and pass any sentence
authorized by law (S.28.Cr.P.C).
z The Sessions Court: It is located at the district headquarters. It can only try cases,
which have been committed to it by a Magistrate. It can pass any sentence
authorized by law, but a sentence of death passed by it must be confirmed by the
High Court. An Assistant Sessions Court can pass sentence of imprisonment up to
ten years and unlimited fine.
13
1.15 TYPES OF MAGISTRATES Introduction about
Health Law
Magistrates are of Three Types:
1. Chief Judicial Magistrate.
2. First Class Judicial Magistrate.
3. Second Class Judicial Magistrate.
In metropolitan cities with more than one million population, the Chief Judicial
Magistrate and First Class Judicial Magistrate are designated as Chief Metropolitan
Magistrate and Metropolitan Magistrate respectively.
1.16 PUNISHMENTS
The sentences authorized by law are:
1. death
2. imprisonment for life, (regarded as equal to 20 years in prison)
3. imprisonment:
(a) rigorous, i.e., with hard labour, including solitary confinement.
(b) Simple.
4. Forfeiture of property.
5. Fine.
When a person is convicted at one trial for two or more offences, twice the amount of
punishment, which a Magistrate is authorized, can be passed.
1.17 SUBPOENA OR SUMMONS

Subpoena (sub = under; penalty) is a document compelling the attendance of witness
in a Court of law under penalty, on a particular day, time and place, for the purpose of
giving evidence. It may also require him to bring with him any books, documents or
other things under his control, that he is bound by law to produce in evidence. It is
issued by the Court in writing, in duplicate, signed by the presiding officer of the
Court and bears the seal of the Court. It is served on the witness by a police officer, by
an officer of the Court or other public servant, by delivering to him on of the copies of
the summons. The person should sign a receipt on the back of the other copy. If the
person summoned is in the active service of the Government, the Court issuing the
summons shall usually send it in duplicate to the head of the office in which such
person is employed. Such head shall cause the summons to be served on such person
and shall return it to the Court under his signature with the endorsement required by
that section. A summons must be obeyed, and the witness should produce documents
if asked for witness should produce documents if asked for. The witness will be
excused from attending the Court, if he has a valid and urgent reason. If the witness
fails to attend the Court:
1. In a civil case, he will be liable to pay damages.
2. In criminal cases where the witness fails to appear, the Court may issue notice
under S.350, Cr. P.C. and after hearing the witness, if it finds that the witness
neglected to attend the Court without any justification, may sentence him to a
fine, or the Court may issue bailable or non-bailable warrants to secure the
presence of the witness.
1.18 CONDUCT MONEY

It is fee offered or paid to a witness in civil cases, at the time of serving the summons
to meet the expenses towards attending the Court. If the fee is not paid, or if he feels
14 that the amount is less, the doctor can bring this fact to the notice of the Judge before
giving evidence in the Court. The Judge will decide the amount to be paid.
In criminal cases, no fee is paid to the witness at the time of serving the summons. He
must attend the Court and give evidence because of the interest of the State in
securing justice; otherwise he will be charged with contempt of Court. However. In
criminal cases, conveyance charges and daily allowance can be claimed by the doctor
according to Government rules.
1.19 CAPITAL PUNISHMENT

The various methods of carrying out death sentence are: hanging, electrocution, lethal
injection (i.e. sodium thiosulphate, pancuronium bromide and potassium chloride, gas
chamber, and garroting).
1.20 CHAIN OF CUSTODY

It is a method to verify the actual possession of an object from the time it was first
identified until it is offered as evidence in the Court. Each specimen when obtained
should be labeled with the victim’s name, the time and date. The nature of the
specimen. Identification number, and signed by the doctor. This information must be
documented each time the material is handled by another person, and that person must
give receipt for the material and be included in the chain of custody. The evidence
must no be damaged. Contaminated or altered in any significant way. The shorter the
chain the better.
1.21 MEDICAL EVIDENCE

Evidence means and includes:
1. all statements which the Court permits or requires to be made before it by
witnesses, in relation to matters of fact under inquiry,
2. all documents produced for inspection of the Court. For the evidence to be
accepted by the Courts, it must be properly identified as to what it is, and where it
was found. The evidence of eyewitnesses is positive. The evidence of doctor or an
expert is only an opinion, which is corroborative.
1.22 DOCUMENTRAY EVIDENCE

It is of three types.
z Medical Certificates: They refer to ill health, insanity, age, and death, etc. They
are accepted in a Court of law, only when they are issued by a qualified registered
medical practitioner. The certificate of ill-health should contain exact nature of
illness, duration of illness and probable period of expected absence. The signature
or left thumb impression of the patient should be taken at the bottom of the
certificate. A medical practitioner is legally bound to give a death certificate,
stating the cause of death without charging fee, if a person whom he has been
attending during his last illness dies (Registration of Births and Deaths Act, 1970).
Death certificate should not be issued by a doctor without inspecting the body and
satisfying himself that person is really dead. The certificate should not be delayed,
even if the doctor’s fee is not paid. The certificate should no be given if the doctor
is not sure of the cause of death, or if there is the least suspicion of foul play. In
such cases, the matter should be reported to the police. Issuing or signing a false
certificate is punishable under.
z Medical Certification of Death: In India, the International Statistical
Classification of Diseases, Injuries and Causes of Death are used. The cause of
death is divided into two main sections. (1) Immediate cause. This is subdivided 15
Introduction about
into three parts, namely (a), (b), (c). If a single morbid condition completely Health Law
explains death, this will be written on line (a) of part I. And nothing more needs
be written in the rest of Part I or in Part II, e.g. labor pneumonia. Next consider
whether the immediate cause is a complication or delayed result of some other
cause. If so, enter the antecedent cause in Part I line (b). Sometimes there will be
three stages in the course of events leading to death. If so line (c) will be
completed. The underlying cause to be tabulated is always written last in Part I.
(II) Other significant conditions contributing to the death but not related to the
disease or condition causing it.
z Medico-Legal Reports: They are reports prepared by a doctor on the request of
the investigating officer for his guidance, usually in criminal cases, e.g., assault,
rape, murder, poisoning, etc. The examination of an injured person or a dead body
is made, when there is a requisition form a police officer or Magistrate. These
reports consist of two parts: (1) the facts observed on examination (all relevant
objective descriptions including important negative findings), (2) The opinion
drawn from the facts. These reports will be attached to the file relating to the case
and the file is produced in the Court. It will not be admitted as evidence, unless
the doctor attends the Court and testifies to the facts under oath. The report will be
open to the scrutiny of the defense lawyer. Great care should be taken in writing
the reports to avoid any loose wording or careless statement. This gives a chance
to the defence lawyer to use them to his own advantage. The doctor should sign or
initial at the bottom of each page, if the report exceeds one page in length. The
report should give the date, time and place of examination and the name of
individuals who identified the person or the dead body. Exaggerated terms,
superlatives, etc. should not be used. The opinion should be based on the facts
observed by himself, and not on infonnation obtained from other sources. In an
injury case, if it is not possible to given an opinion immediately, the person should
be kept under observation, and necessary investigations should be done before
giving the report. The report should show competence, lack of bias and offer
concrete professional advice. The report should be made soon after the
examination. It should be comprehensive, legible and it should avoid technical
terms as far as possible. Relevant negative information should also be given.
Exhibits: Clothing, weapons, etc., sent for medical examination should be described
in detail, sealed and returned to the police, after obtaining a receipt.
1. What is inquest?
……………………………………………..………………………………
……………………………………………..………………………………
2. What do you mean my coroner’s inquest?
……………………………………………..………………………………
……………………………………………..………………………………
3. What is jury?
……………………………………………..………………………………
……………………………………………..………………………………
4. What are three types of documentary evidence?
……………………………………………..………………………………
……………………………………………..………………………………
16
Health Laws and Policies 1.23 DYING DECLARATION
It is a written or oral statement of a person, who is dying as a result of some unlawful
act, relating to the material facts of cause of his death or bearing on the circumstances.
If there is time, a Magistrate should be called to record the declaration. Before
recording the statement, the doctor should certify that the person is conscious and his
mental facilities are normal (compos mentis). If the condition of the victim is serious,
and there is no time to call a Magistrate the doctor should take the declaration in the
presence of two witnesses. The statement can also be recorded by the village
headman, police for any other person, but its evidential value will be less. When
recording the dying declaration, oath is not administered, because of the belief that the
dying person tells the truth. The statement should be recorded in the man’s own
words. Without any alteration of terms of phrases. Leading questions should no be
put. The declarant should be permitted to give his statement without any undue
influence, outside prompting or assistance. If a point is not clear, question may be
asked to make it clear, but the actual question and the answer received should be
recorded. It should then be read over to the declarant himself, it should be signed by
him, the doctor and the witnesses. The statement made must be of fact and not
opinion.
1.24 LET US SUM UP

This lesson explains the law aspects and law medicine relationship. Forensic medicine
deals with the application of medical knowledge to aid in the administration of justice.
Medical jurisprudence deals with legal responsibilities of the physician with particular
reference to those arising from physician – patient relationship such as medical
negligence cases. Ethical behaviors are a self-imposed duty upon each doctor. A
doctor should not criticize or denigrate the professional ability of another doctor.
Courts of law are of two types: (1) Civil, and (2) Criminal. Documentary evidence and
Dying declaration also highlighted.
1.25 LESSON END ACTIVITY

What are the essentials of dying declaration and whose dying declaration is valid?
1.26 KEYWORDS
Forensic or legal medicine: It deals with the application of medical knowledge to aid
in the administration of justice.
Medical jurisprudence: It deals with legal responsibilities of the physician with
particular reference to those arising from physician – patient relationship such as
medical negligence cases.
Medical ethics: It deals with the moral principles, which should guide members of the
medical profession in their dealings with each other, their patients and the State.
Medical etiquette: It deals with the conventional laws of courtesy observed between
members of the medical profession.
Inquest: An inquest is an inquiry or investigation into the cause of death.
1.27 QUESTION FOR DISCUSSION

1. Explain the medical law relationship.
Check Your Progress: Model Answers 17
Introduction about
Health Law
CYP 1
1. There are two distinct aspects of law-medicine relationship:
Forensic medicine,
Medical jurisprudence
2. Forensic = of or used in Courts of Law. It deals with the application of
medical knowledge to aid in the administration of justice.
3. Juris = law; prudential acknowledge. It deals with legal responsibilities of
the physician with particular reference to those arising from physician –
patient relationship such as medical negligence cases.
4. Deals with the conventional laws of courtesy observed between members
of the medical profession.
CYP 2
1. An inquest is an inquiry or investigation into the cause of death. It is
conducted in cases of suicide, murder, killing by an animal or machinery,
accidents, and suspicious (unnatural) deaths.
2. Coroner conducts inquest in all unnatural and suspicious deaths.
3. Jury is a group of responsible, educated persons of good social position
called “jurors”. It is composed of an uneven number of persons.
4. Medical Certificates, The Medical Certification of Death and Medico-
Legal Reports.
1.28 SUGGESTED READING

Dr. Narayan Reddy, K.S., “The Essentials of Forensic Medicine and Toxicology”, K. Suguna
Devi, Saleemnagar, Hyderabad, 1992, 13th Edition.
18
Health Laws and Policies LESSON
2
INTRODUCTION ABOUT CODE OF ETHICS
CONTENTS
2.1 Introduction — Medical Code of Ethics
2.2 Declaration
2.3 Code
2.4 History of Medical Ethics
2.5 Ethics-determinants
2.6 Ethical Issues
2.7 Medical Negligence
2.7.1 Definition of Medical Negligence
2.7.2 Nature of Medical Negligence
2.7.3 Difference between Civil and Criminal Negligence
2.7.4 Difference between Professional Negligence and Infamous Conduct
2.7.5 Common Reasons for Allegations of Medical Negligence
2.7.6 Compensation for Medical Negligence
2.7.7 Liability for Negligence
2.7.8 Precautions against Negligence
2.8 Let us Sum up
2.10 Keywords
2.11 Questions for Discussion
2.0 AIMS AND OBJECTIVES

z Understand the medical code of ethics
z Know about medical negligence
2.1 INTRODUCTION— MEDICAL CODE OF ETHICS

It deals with the moral principles which should guide members of the medical
profession in their dealing with each other, their patients and the staff.
2.2 DECLARATION
At the time of registration each applicant should submit Geneva declaration accepted
by the General assembly of the World Medical Association at London on October 12,
1949.The applicant shall read and agree to abide by the same.
1. I solemnly pledge myself to consecrate my life to service of humanity. 19
Introduction about
2. Even under threat, I will not use my medical knowledge contrary to the laws of Code of Ethics
Humanity.
3. I will maintain the utmost respect for human life from the time of conception.
4. I will not permit considerations of religion, nationality, race, party politics or
social standing to intervene between my duty and my patient.
5. I will practice my profession with conscience and dignity.
6. The health of my patient will be my first consideration.
7. I will respect the secrets which are confined in me.
8. I will give to my teachers the respect the gratitude which if their due.
9. I will maintain by all means in my power, the honour and noble traditions of
medical profession.
10. I will treat my colleagues with all respect and dignity.
11. I shall abide by the code of medical ethics as enunciated in the Indian medical
council (Professional conduct, etiquette and ethics) Regulations 2001.
2.3 CODE
1. Honour of the Profession
2. Standard of character or morals
3. Purpose of medical society
4. Gratuitous services
5. Remuneration for services
6. Commission or Bonus
7. Services to physicians
8. State Laws
9. Reporting communicable diseases
10. Reporting dishonest practice
11. Association with practitioners registered under Statutory Act
12. Obligations to the sick
13. Termination of services
14. Behaviour towards patients
15. Guarding the patient’s confidence
16. Timely warning to patient’s family
17. Consultations
18. Punctuality in consultations
19. Conduct in consultation
20. Statement to patient after consultation
21. Treatment after consultation
22. Consultant not to take charge of the case
23. Patients referred to specialists
20 24. Appointment of a substitute
25. Visiting another physician’s case
26. Engagement for an obstetric case
27. Refusal to attend a patient
2.4 HISTORY OF MEDICAL ETHICS

The origin of medical ethics is generally traced to 5th- 4th century BC. Since when
Hippocratic oath is known to exist and guide the practice of medicine:
z Many Western Cultures considered medicine as Divine to origin.
z In Hindu Literature it is known to be mentioned in the vedic poetry and
considered to be sacred as practiced only by gods.
z Dhanvantari has long been considered the Hindu god of Medicine. It is believed
that after the beginning of Kaliyuga, when diseases increased, gods taught
medicine to a few goat men, of whom the names of “Charai” and Susrata”
outshined and are known today.
z Ethics and morality therefore have dominated the science of medicine in all
spheres.
z The Hippocratic oath itself bound to a doctor in several ways.
z It has different ‘do’s’ and ‘don’ts’ for the doctors when it may legal in medical
practice of the day.
z The oath is self-disciplinary in nature and advising the philosophy and a pure life
of virtue.
z As per the oath, a doctor has three primary obligations:
To be helpful
To indulge in any public misconduct
To maintain confidentiality
z It also prohibits and against, euthanasia, abortion, Surgery and sexual relationship
with patients.
z In the past Hippocratic Era, several other rules were added to it.
z Moral principles are more philosophical and far away from psychological
environs in which the doctor works for a particular patient. This “anti-
principalism” has challenged the very basis and ethics of the traditional medical
ethics.
2.5 ETHICS-DETERMINANTS
Medical ethics are determined by a variety of factors several of which may not be
universal in nature. They also differ depending upon the responsibilities of a doctor in
a particular position and the limitations involved in their practice.
1. Factors related to role.
2. Limitations.
3. Other Determinants.
21
2.6 ETHICAL ISSUES Introduction about
Code of Ethics
Ethical issues are divided into two types:
z Traditional Concepts:
1. Professional services-obligations and avoidance.
2. Inter- relationships with patients, colleagues and other.
3. Patient confidentiality.
4. Advertisement.
z Modern or Newer Issues:
1. Prolonging life-Incurability and medical care
2. Organ transplantation
3. Issues in reproduction
4. Medical research
5. Commercialization
2.7 MEDICAL NEGLIGENCE

Medical Negligence is not a significant problem in India, where it is an acute problem
in North America and other developed countries. It may be sometimes called as
“malpractice” or “malpraxis” which is a dispute between the doctor and patient over
the standard of medical care.
2.7.1 Definition of Medical Negligence

Medical Negligence is the breach of the duty owed by a doctor to his patient to excise
reasonable care and skill, which results in some physical, mental or financial
disability.
2.7.2 Nature of Medical Negligence

For negligence of any kind to be proved, it is must be shown that:
1. That the doctor (defendant) had a duty of care to the patient.
2. That the doctor was in breach of that duty (i.e.) failed in that duty.
3. That the patient suffered damage as a result.
Not all the three of above these conditions must be present at the same time
No action for negligence can be sustained if the patient died not suffers any
damage as a result- even if a doctor was in obvious breach of that duty.
The three elements of negligence mentioned above must be studied in more detail:
z Duty to Exercise Skill and Care: The duty exists when a doctor and patient
relationship is established. This relationship may be formed extremely easily and
is by no means depended upon any formal acceptance of a patient by a doctor, or
the payment of a fee.
z Degree of Competence of the Doctor: A doctor must posses a reasonable degree
of proficiency and he must apply the proficiency with a reasonable degree of
diligence. A highly experienced consultant may be negligent if he fails to apply
his greater knowledge with a sufficient degree of care.
z Breach of the Duty of Care: A famous statement by a Judge on the matter of
negligence stated that the categories of negligence are never closed, meaning that
22 it is impossible to draw up a complete list of all things which could cause a
negligence action, as these naturally increase every day as medical technology
advances.
2.7.3 Difference between Civil and Criminal Negligence
Trait Civil Negligence Criminal Negligence
Offence No Specific and Clear violation of Must have specifically violated a

law need to be proved particular Criminal Law in question
Negligence Simple absence of care and Skill Willful, wanton, gross or Culpable
Conduct of Compared to a generally accepted Not a single test

Physician single test
Consent for Act Good defense; cannot recover Not a defense, can be Prosecuted
damages
Trial by Civil Court Criminal Court
Evidence Preponderance of evidence is Guilt should be proved beyond

sufficient reasonable doubt
Punishment Liable to pay damage Imprisonment
Double Jeopardy Can be tried twice Cannot be tried twice for Same
2.7.4 Difference between Professional Negligence and Infamous Conduct

Trait Professional Negligence Infamous Conduct
Offence Absence of care and skill (or) Violation of Code of Medical Ethics
Willful negligence
Damage to Should be present Need not be present

Person
Duty of Care Should be present Need not be present
Trial by Courts: Civil/Criminal State Medical Council
Punishment Fine or Imprisonment Erase of name or warning
Appeal To Higher Court To state and Central Government.
2.7.5 Common Reasons for Allegations of Medical Negligence

The reasons are usually indefinite, but there are certain matters which constantly recur
in the annals of medical negligence in North America, Europe and Australia:
1. Surgical mishaps
2. Casualty and accident departments
3. Anesthesia
4. Failure to attend
5. Failure of communication
6. Drugs and therapeutic substances
7. Injection and vein puncture hazards
8. Miscellaneous causes of negligence.
Introduction about
1. What is medical code of ethics? Code of Ethics
……………………………………………………………………………...
……………………………………………………………………………...
2. Define medical negligence.
……………………………………………………………………………...
……………………………………………………………………………...
3. Mention some of the common reasons for medical negligence.
……………………………………………………………………………...
……………………………………………………………………………...
2.7.6 Compensation for Medical Negligence

a) Loss of earnings, either due to absence from work due to disability or due to
impairment of his ability to carry on his previous occupation.
b) Expenses incurred a result of the negligence may include medical treatment
following the disability, nursing care, hospital costs, special treatment etc.
c) Reduction in the expectation of life.
d) Pain and suffering due to the effects of the disability, may be used to users
damage.
e) Death may be actionable for the benefit of relatives.
2.7.7 Liability for Negligence

1. The patient may sue anyone he pleases if he believes that negligent medical
treatment has caused him some disability.
2. One reason for this is that a senior, who has responsibility for choosing his
assistants, is supposed in law to choose wisely and not to have any incompetent
assistants.
3. If a negligent action takes place in the hospital, the hospital authority or the
medical service in charge of the patient may also be joined in the legal action to
obtain damages.
4. Private practitioner is solely responsible for damages.
5. Where a doctor takes an assistant or trainee, then he is responsible for the
negligence made by them.
6. A doctor is not criminally responsible for a patient’s death unless his negligence
(or) incompetence paused beyond a mere matter of compensation.
7. When an operation for cataract is performed by a duly qualified doctor in the
recognized Indian Method of treatment with the consent of the patient and in good
faith for his benefit, but the operation is unsuccessful and the patient loss eye-
sigh, the doctor is not criminally liable.
2.7.8 Precautions against Negligence

1. Obtain informed consent of the patient.
2. Establish good report with patient.
3. Keep full and accurate complete medical records.
4. Employ ordinary skill and care at all times.
5. Confirm diagnosis by laboratory tests.
24 6. Take skiagrams in home or joint injuries.
7. Immunisation should be done wherever necessary.
8. Sensitivity tests before infection (especially for T.T.)
9. Seek consultation with appropriate.
10. In suspected cases of cancer, all laboratory tests must be done without delay.
11. Do not criticize or condemn the ability of another doctor.
12. Do not make a statement admitting fault on your part.
13. Avoid from over confident prognoses.
14. Never guarantee a case.
15. Inform the patient of any intended absence from practice.
16. Transfer the patient if facilities are in adequate.
17. The drug should be identified before being injected or used.
18. Obtain the consent for an operation or giving anesthesia.
19. In a criminal wounding- perform operation only if necessary.
20. No experimental method should be adopted without consent.
21. No procedure should be undertaken beyond one’s skill.
22. Keep yourself informed in technical advances.
23. Frequently check the condition of the equipment.
24. Proper instructions with a good post operative case to patient.
25. The patient must not be abandoned.
26. No female patient should be examined if a 3rd person is present.
27. Do not order a prescription over telephone.
28. Anesthesia should be given only by a qualified person.
29. In the case of death, during an operation- the matter should be reported to the
police authorities.
30. Do not fail to exercise case in selection of assistants.
31. Do not leave patient unattended during labour.
32. Do not fail to secure the consent of both husband and wife- if an operation on
either is likely to result in sterility.
2.8 LET US SUM UP

In this lesson medical code of ethics. It deals with the moral principles which should
guide members of the medical profession in their dealing with each other, their
patients and the staff. At the time of registration each applicant should submit
Geneva declaration. The origin of medical ethics is generally traced to 5th- 4th
century BC. Dhanvantari has long been considered the Hindu god of Medicine. Ethics
and morality therefore have dominated the science of medicine in all spheres. The
Hippocratic oath itself bound to a doctor in several ways. The oath is self-disciplinary
in nature and advising the philosophy and a pure life of virtue. As per the oath, a
doctor has three primary obligations:
1. To be helpful
2. To indulge in any public misconduct
3. To maintain confidentiality
Ethical issues are divided into two types: 1. Traditional 2. Modern.
Medical Negligence is the breach of the duty owed by a doctor to his patient to excise 25
Introduction about
reasonable care and skill, which results in some physical, mental or financial disability Code of Ethics
The three elements of negligence The Duty to Exercise Skill and Care, Degree of
Competence of the Doctor and Breach of the Duty of Care. And this chapter
emphasized the Difference between Civil and Criminal Negligence, Differences
between Professional Negligence and Infamous Conduct and also Precautions against
Negligence.

Giving Anesthesia sometimes may lead to Medical negligence. Do you agree?
Discuss.
2.10 KEYWORDS
Ethics: It deals with the moral principles which should guide members of the medical
profession in their dealing with each other, their patients and the staff.
Medical negligence: It is the breach of the duty owed by a doctor to his patient to
excise reasonable care and skill, which results in some physical, mental or financial
disability.
2.11 QUESTIONS FOR DISCUSSION

1. Explain in detail the Geneva declaration.
2. Define medical negligence. Explain the nature of medical negligence.
3. Differentiate the following:
i) Professional Negligence and Infamous Conduct
ii) Civil and Criminal Negligence
4. What are the precautions against medical negligence?
Check Your Progress: Model Answers

1. Medical code of ethics is moral principles which should guide members
of the medical profession in their dealing with each other, their patients
and the staff.
2. Medical Negligence is the breach of the duty owed by a doctor to his
patient to excise reasonable care and skill, which results in some physical,
mental or financial disability.
3. Common reasons for medical negligence are:
Surgical mishaps
Casualty and accident departments
Anesthesia
Failure to attend
Failure of communication
Drugs and therapeutic substances
Injection and vein puncture hazards
Miscellaneous causes of negligence.

Dr. Narayan Reddy. K.S., “The Essentials of Forensic Medicine and Toxicology”, K. Suguna
26
3
MEDICAL COUNCIL ACT
CONTENTS
3.1 Introduction
3.2 Short Title and Commencement
3.3 Code of Medical Ethics
3.3.1 Declaration
3.3.2 Duties and Responsibilities of the Physician in General
3.4 Duties of Physicians to their Patients
3.5 Duties of Physician in Consultation
3.6 Responsibilities of Physicians to each other
3.7 Duties of Physician to the Public and to the Paramedical Profession
3.8 Unethical Acts
3.9 Punishment and Disciplinary Action
3.10 Let us Sum up
3.12 Keywords

z Understand the duties of physician
z Know about their responsibilities and medical ethics
z Study the various disciplinary actions
z Understand the legal restrictions
3.1 INTRODUCTION
An Act provides the regulations and moral principles for the physician. And it
emphasized their duties and responsibilities to the patients, to another physician and to
the community at large.
3.2 SHORT TITLE AND COMMENCEMENT

1. These Regulations may be called the Indian Medical Council (Professional
Conduct, Etiquette and Ethics) Regulations, 2002.
2. They shall come into force on the date of their publication in the Official Gazette.
27
3.3 CODE OF MEDICAL ETHICS Medical Council Act
3.3.1 Declaration
Each applicant, at the time of making an application for registration under the
provisions of the Act, shall be provided a copy of the declaration and shall submit a
duly signed. The applicant shall also certify that he/she had read and agreed to abide
by the same.
3.3.2 Duties and Responsibilities of the Physician in General

z Character of Physician (Doctors with qualification of MBBS with post graduate
degree / diploma or with equivalent qualification in any medical discipline):
A Physician shall uphold the dignity and honor of his Profession.
The Prime object of the Medical Profession is to render Service to humanity;
reward or financial gain is a subordinate consideration. Who-so-ever chooses
his profession, assumes the obligation to conduct himself in accordance with
its ideals. A physician should be an upright man, instructed in the art of
healings. He shall keep himself pure in character and be diligent in caring for
the sick; he should be modest, sober, patient, prompt in discharging his duty
without anxiety; conducting himself with propriety in his profession and in all
the actions of his life.
No person other than a doctor having qualification recognized by Medical
Council of India and registered with Medical Council of India/State Medical
Council(s) is allowed to practice Modern system of Medicine of Surgery. A
person obtaining qualification in any other system of medicine is not allowed
to practice Modern system of Medicine in any form.
z Maintaining Good Medical Practice:
The principal objective of the medical profession is to render service to
humanity with full respect for the dignity of profession and man. Physicians
should merit the confidence of parents entrusted to their care, rendering to
each a full measures of service and devotion. Physicians should try
continuously to improve medical knowledge and skills and should make
available to their patients and colleagues the benefits of their professional
attainments. The physician should practice methods of healing founded on
scientific basis and should not associate professionally with anyone who
violates this principle. The honoured ideals of the medical profession imply
that the responsibilities of the physician extend not only to individuals but
also to society.
Membership in Medical Society: For the advancement of his profession, a
physician should affiliate with associations and societies of allopathic medical
professions and involve actively in the functioning of such bodies.
A physician should participate in professional meetings as part of Continuing
Medical Education programmes, for at least 30 hours every five years,
organized by reputed professional academic bodies or any other authorized
organizations. The compliance of the requirement shall be informed regularly
to Medical Council of India or the State Medical Councils as the case may be.
z Maintenance of Medical Records:
Every physician shall maintain the medical records pertaining to his / her
indoor patients for a period of 3 years from the date of commencement of the
treatment in a standard proforma laid down by the Medical Council of India.
28 If any request is made for medical records ether by the patients / authorized
attendant or legal authorities involved, the same may be duly acknowledged
and documents shall be issued within the period of 72 hours.
A Registered medical practitioner shall maintain a Register of Medical
Certificates giving full details of certificates issued. When issuing a medical
certificate he / she shall always enter the identification marks of the patient
and keep a copy of the certificate. He / She shall not omit to record the
signature and / or thumbmark, address and at least one identification mark of
the patient on the medical certificates or report. The medical certificate shall
be prepared.
Efforts shall be made to computerize medical records for quick retrieval.
z Display of Registration Numbers:
Every physician shall display the registration number accorded to him by the
State Medical Council / Medical Council of India in his clinic and in all his
prescriptions, certificates, money receipts given to his patients.
Physicians shall display as suffix to their names only recognized medical
degrees or such certificates / diplomas and memberships / honous which
confer professional knowledge or recognizes any exemplary qualification /
achievements.
Use of Generic Names of Drugs: Every physician should, as far as possible,
prescribe drugs with generic names and he / she shall ensure that there is a
rational prescription and use of drugs.
Highest Quality Assurance in Patient Care: Every physician should aid in
safeguarding the profession against admission to it of those who are deficient
in moral character or education. Physician shall not employ in connection
with his professional practice any attendant who is neither registered nor
enlisted under the Medical Acts in force and shall not permit such persons to
attend, treat or perform operations upon patients wherever professional
discretion or skill is required.
Exposure of Unethical Conduct: A physician should expose, without fear or
favour, incompetent or corrupt, dishonest or unethical conduct on the part of
members of the profession.
Payment of Professional Services: The physician, engaged in the practice of
medicine shall give priority to the interests of patients. The personal financial
interests of a physician should not conflict with the medical interests of
patients. A physician should announce his fees before rendering service and
not after the operation or treatment is under way. Remuneration received for
such services should be in the form and amount specifically announced to the
patient at the time the service is rendered. It is unethical to enter into a
contract of “no cure no payment”. Physician rendering service on behalf of
the state shall refrain from anticipating or accepting any consideration.
Evasion of Legal Restrictions: The physician shall observe the laws of the
country in regulating the practice of medicine and shall also not assist others
to evade such laws. He should be cooperative in observance and enforcement
of sanitary laws and regulations in the interest of public health. A physician
should observe the provisions of the State Acts like Drugs and Cosmetics Act,
1940; Pharmacy Act,1948; Narcotic Drugs and Psychotropic Substances Act,
1985; Medical Termination of Pregnancy Act, 1971; Transplantation of
Human Organ Act, 1994; Mental Health Act, 1987; Environmental Protection
Act,1986; Pre-natal Sex Determination Test Act, 1994; Drugs and Magic
Remedies (Objectionable Advertisement) Act, 1954; Persons with Disabilities
(Equal Opportunities and Full Participation) Act, 1995 and Bio-Medical 29
Waste (Management and Handling) Rules, 1998 and such other Acts, Rules, Medical Council Act
Regulations made by the Central / State Governments or local Administrative

Bodies or any other relevant Act relating to the protection and promotion of
public health.
3.4 DUTIES OF PHYSICIANS TO THEIR PATIENTS

z Obligations to the Sick:
Though a physician is not bound to treat each and every person asking his
services, he should not only be ever ready to respond to the calls of the sick
and the injured, but should be mindful of the high character of his mission and
the responsibility he discharges in the course of his professional duties. In his
treatment, he should never forget that the health and the lives of those
entrusted to his care depend on his skill and attention.
Medical practitioner having any incapacity detrimental to the patient or which
can affect his performance vis-à-vis the patient is not permitted to practice his
profession.
z Patience, Delicacy and Secrecy: Patience and delicacy should characterize the
physician. Confidences concerning individual or domestic life entrusted by
patients to a physician and defects in the disposition or character of patients
observed during medical attendance should never be revealed unless their
revelation is required by the laws of the State. Sometimes, however, a physician
must determine whether his duty to society requires him to employ knowledge,
obtained through confidence as a physician, to protect a healthy person against a
communicable disease to which he is about to be exposed. In such instance, the
physician should act as he would wish another to act toward one of his own
family in like circumstances.
z Prognosis: The physician should neither exaggerate nor minimize the gravity of a
patient’s condition. He should ensure himself that the patient, his relatives or his
responsible friends have such knowledge of the patient’s condition as will serve
the best interests of the patient and the family.
z Patient must not be Neglected: A physician is free to choose whom he will serve.
He should, however, respond to any request for his assistance in an emergency.
Once having undertaken a case, the physician should not neglect the patient, nor
should he withdraw from the case without giving adequate notice to the patient
and his family. Provisionally or fully registered medical practitioner shall not
willfully commit an act of negligence that may deprive his patient or patients from
necessary medical care.
z Engagement for an Obstetric Case: When a physician who has been engaged to
attend an obstetric case is absent and another is sent for and delivery
accomplished, the acting physician is entitled to his professional fees, but should
secure the patient’s consent to resign on the arrival of the physician engaged.
3.5 DUTIES OF PHYSICIAN IN CONSULTATION

z Unnecessary Consultations should be Avoided: However in case of serious
illness and in doubtful or difficult conditions, the physician should request
consultation, but under any circumstances such consultation should be justifiable
and in the interest of the patient only and not for any other consideration.
Consulting pathologists / radiologists or asking for any other diagnostic Lab
investigation should be done judiciously and not in a routine manner.
30 z Consultation for Patient’s Benefit: In every consultation, the benefit to the
patient is of foremost importance. All physicians engaged in the case should be
frank with the patient and his attendants.
z Punctuality in Consultation: Utmost punctuality should be observed by a
physician in making themselves available for consultations.
z Statement to Patient after Consultation:
All statements to the patient or his representatives should take place in the
presence of the consulting physicians, except as otherwise agreed. The
disclosure of the opinion to the patient or his relatives or friends shall rest
with the medical attendant.
Differences of opinion should not be divulged unnecessarily but when there is
irreconcilable difference of opinion the circumstances should be frankly and
impartially explained to the patient or his relatives or friends. It would be
opened to them to seek further advice as they so desire.
z Treatment after Consultation: No decision should restrain the attending
physician from making such subsequent variations in the treatment if any
unexpected change occurs, but at the next consultation, reasons for the variations
should be discussed / explained. The same privilege, with its obligations, belongs
to the consultant when sent for in an emergency during the absence of attending
physician. The attending physician may prescribe medicine at an time for the
patient, whereas the consultant may prescribe only in case of emergency or as an
expert when called for.
z Patients Referred to Specialists: When a patient is referred to a specialist by the
attending physician, a case summary of the patient should be given to the
specialist, who should communicate his opinion in writing to the attending
physician.
z Fees and Other Charges:
A physician shall clearly display his fees and other charges on the board of his
chamber and / or the hospitals he is visiting. Prescription should also make
clear if the Physician himself dispensed any medicine.
A physician shall write his name and designation in full along with
registration particulars in his prescription letter head.
3.6 RESPONSIBILITIES OF PHYSICIANS TO

EACH OTHER
z Dependence of Physicians on Each Other: A physician should consider it as a
pleasure and privilege to render gratuitous service to all physicians and their
immediate family dependants.
z Conduct in Consultation: In consultations, no insincerity, rivalry or envy should
be indulged in. All due respect should be observed towards the physician in-
charge of the case and no statement or remark be made, which would impair the
confidence reposed in him. For this purpose no discussion should be carried on in
the presence of the patient or his representatives.
z Consultant not to take Charge of the Case: When a physician has been called for
consultation, the consultant should normally not take charge of the case,
especially on the solicitation of the patient or friends. The consultant shall not
criticize the referring physician. He / she shall discuss the diagnosis treatment
plan with the referring physician.
z Appointment of Substitute: Whenever a physician requests another physician to
attend his patients during his temporary absence from his practice, professional
courtesy requires the acceptance of such appointment only when he has the 31
capacity to discharge the additional responsibility along with his / her other duties. Medical Council Act
The physician acting under such an appointment should give the ulmost
consideration to the interests and reputation of the absent physician and all such
patients should be restored to the care of the latter upon his / her return.
z Visiting another Physician’s Case: When it becomes the duty of a physician
occupying an official position to see and report upon an illness of injury, he
should communicate to the physician in attendance so as to give him an option of
being present. The medical officer / physician occupying an official position
should avoid remarks upon the diagnosis or the treatment that has been adopted.
3.7 DUTIES OF PHYSICIAN TO THE PUBLIC AND TO

THE PARAMEDICAL PROFESSION
z Physicians as Citizens: Physicians, as good citizens, possessed of special training
should disseminate advice on public health issues. They should play their part in
enforcing the laws of the community and in sustaining the institutions that
advance the interests of humanity. They should particularly co-operate with the
authorities in the administration of sanitary / public health laws and regulations.
z Public and Community Health: Physicians, especially those engaged in public
health work, should enlighten the public concerning quarantine regulations and
measures for the prevention of epidemic and communicable diseases. At all times
the physician should notify the constituted public health authorities of every case
of communicable disease under his care, in accordance with the laws, rules and
regulations of the health authorities. When an epidemic occurs a physician should
not abandon his duty for fear of contracting the disease himself.
z Pharmacists / Nurses: Physicians should recognize and promote the practice of
different paramedical services such as, pharmacy and nursing as professions and
should seek their cooperation wherever required.
3.8 UNETHICAL ACTS

z Advertising: Soliciting of patients directly or indirectly, by a physician, by a
group of physicians or by institutions or organizations is unethical. A physician
shall not make use of him / her (or his / her name) as subject of any form or
manner of advertising or publicity through any mode either alone or in
conjunction with others which is of such a character as to invite attention to him
or to his professional position, skill, qualification, achievements, attainments,
specialties, appointments, associations, affiliations or honours and/or of such
character as would ordinarily result in his self aggrandisement. A physician shall
not give to any person, whether for compensation or otherwise, any approval,
recommendation, endorsement, certificate, report or statement with respect of any
drug, medicine, nostrum remedy, surgical, or therapeutic article, apparatus or
appliance or any commercial product or article with respect of any property,
quality or use thereof or any test, demonstration or trial thereof, for use in
connection with his name, signature, or photograph in any form or manner of
advertising through any mode nor shall he boast of cases, operations, cures or
remedies or permit the publication of report thereof through any mode. A medical
practitioner is however permitted to make a formal announcement in press
regarding the following:
On starting practice.
On change of type of practice.
On changing address.
32 On temporary absence from duty.
On resumption of another practice.
On succeeding to another practice.
Public declaration of charges.
Printing of self-photograph, or any such material of publicity in the letter head or
on sign board of the consulting room or any such clinical establishment shall be
regarded as acts of self advertisement and unethical conduct on the part of the
physician., However, printing of sketches, diagrams, picture of human system
shall not be treated as unethical.
z Patent and Copy Rights: A physician may patent surgical instruments, appliances
and medicine or Copyright applications, methods and procedures. However it
shall be unethical if the benefits of such patents or copyrights are not made
available in situations where the interest of large population is involved.
z Running an Open Shop (Dispensing of Drugs and Appliances by Physicians): A
physician should not run an open shop for sale of medicine for dispensing
prescriptions prescribed by doctors other than himself or for sale of medical or
surgical appliance. It is not unethical for a physician to prescribe or supply drugs,
remedies or appliances as long as there is no exploitation of the patient. Drugs
prescribed by a physician or brought from the market for a patient should
explicitly state the proprietary formulae as well as generic name of the drug.
z Rebates and Commission: A physician shall no give, solicit, or receive nor shall
he offer to give solicit or receive any gift, gratuity, commission or bonus in
consideration of or return for the referring, recommending or procuring of any
patient for medical, surgical or other treatment.
z Secret Remedies: The prescribing or dispensing by a physician of secret remedial
agents of which he does not know the composition, or the manufacture or
promotion of their use is unethical and as such prohibited. All the drugs
prescribed by a physician should always carry a proprietary formula and clear
name.
z Human Rights: The physician shall not aid or abet torture nor shall he be a party
to either infliction of mental or physical trauma or concealment of torture inflicted
by some other person or agency in clear violation of human rights.
z Euthanasia: Practicing euthanasia shall constitute unethical conduct. However on
specific occasion, the question of withdrawing supporting devices to sustain
cardio-pulmonary function even after brain death, shall be decided only by a team
of doctors and not merely by the treating physician alone.
z Misconduct: The following acts of commission or omission on the part of a
physician shall constitute professional misconduct rendering him / her liable for
disciplinary action.
z Violation of the Regulations:
If he / she commits any violation of these Regulations.
If he/she does not maintain the medical records of his/her indoor patients for a
period of three years and refuses to provide the same within 72 hours when
the patient or his/her authorized representative makes a request for it.
If he/she does not display the registration number accorded to him her by the
State Medical Council or the Medical Council of India in his clinic,
prescriptions and certificates etc. issued by him or violates the provision.
z Adultery or Improper Conduct: Abuse or professional position by committing
adultery or improper conduct with a patient or by maintaining an improper
association with a patient will render a physician liable for disciplinary action as 33
provided under the Indian Medical Council Act, 1956 or the concerned State Medical Council Act
Medical Council Act.

z Conviction by Court of Law: Conviction by a Court of Law for offences
involving moral turpitude / Criminal acts.
z Sex Determination Tests: On no account sex determination test shall be
undertaken with the intent to terminate the life of a female foetus developing in
her mother’s womb, unless there are other absolute indications for termination of
pregnancy as specified in the Medical Termination of Pregnancy Act, 1971. Any
act of termination of pregnancy of normal female foetus amounting to female
foeticide shall be regarded as professional misconduct on the part of the physician
leading to penal erasure besides rendering him liable to criminal proceedings as
per the provisions of the Act.
z Signing Professional Certificates, Reports and Other Documents: Registered
medical practitioners are in certain cases bound by law to give, or may from time
to time be called upon or requested to give certificates, notification, reports and
other documents of similar character signed by them in their professional capacity
for subsequent use in the courts or for administrative purpose etc.
z A registered medical practitioner shall not contravene the provisions of the Drugs
and Cosmetics Act and Regulations made thereunder.
Accordingly:
a) Prescribing steroids/psychotropic drugs when there is no absolute medical
indication;
b) Selling Schedule ‘H’ & ‘L’ drugs and poisons to the public except to his patient.
In contravention of the above provisions shall constitute gross professional
misconduct on the part of the physician.
z Performing or enabling unqualified person to perform an abortion or any illegal
operation for which there is no medical, surgical or psychological indication.
z A registered medical practitioner shall not issue certificates of efficiency in
modern medicine to unqualified or non-medical person. (Note: The foregoing
does not restrict the proper training and instruction of bona fide students,
midwives, dispensers, surgical attendants, or skilled mechanical and technical
assistants and therapy assistants under the personal supervision of physicians.)
z A physician should not contribute to the lay press articles and give interviews
regarding diseases and treatments which may have the effect of advertising
himself of soliciting practices; but is open to write to the lay press under his own
name on matters of pubic health, hygienic living or to deliver public lectures, give
talks on the radio/TV/internet chat for the same purpose and send announcement
of the same to lay press.
z An institution run by physician for a particular purpose such as a maternity home,
nursing home, private hospital, rehabilitation centre or any type of training
institution etc. may be advertised in the lay press, but such advertisements should
not contain anything more than the name of the institution, type of patients
admitted, type of training and other facilities offered and the fees.
z It is improper for a physician to use an unusually large sign board and write on it
anything other than his name, qualifications obtained from a University or a
statutory body, titles and name of his specialty, registration number including the
name of the State Medical Council under which registered. The same should be
the contents of his prescription papers. It is improper to affix a sign-board on a
chemist’s shop or in places where he does not reside or work.
34 z The registered medical practitioner shall not disclose the secrets of a patient that
have been learnt in the exercise of his/her profession except:
1. In a court of law under orders of the Presiding Judge;
2. In circumstances where there is serious and identified risk to a specific person
and / or community; and
3. Notifiable diseases.
In case of communicable / notifiable disease, concerned public health authorities
should be informed immediately.
z The registered medical practitioner shall not refuse on religious grounds alone to
give assistance in or conduct of sterility, birth control, circumcision and medical
termination of Pregnancy when there is medical indication, unless the medical
practitioner feels himself/herself incompetent to do so.
z Before performing an operation the physician should obtain in writing the consent
from the husband or wife, parent or guardian in the case of minor, or the patient
himself as the case may be. In an operation which may result in sterility the
consent of both husband and wife is needed.
z A registered medical practitioner shall not publish photographs or case reports of
his / her patients without their permission, in any medical or other journal in a
manner by which their identity could be made out. If the identity is not to be
disclosed, the consent is not needed.
z In the case of running of a nursing home by physician and employing assistants to
help him / her, the ultimate responsibility rests on the physician.
z A Physician shall not use touts or agents for procuring patients.
z A Physician shall not claim to be specialist unless he has a special qualification in
that branch.
z No act of invitro fertilization or artificial insemination shall be undertaken without
the informed consent of the female patient and her spouse as well as the donor.
Such consent shall be obtained in writing only after the patient is provided, at her
own level of comprehension, with sufficient information about the purpose,
methods, risks, inconveniences, disappointments of the procedure and possible
risks and hazards.
z Research: Clinical drug trials or other research involving patients or volunteers as
per the guidelines of ICMR can be undertaken, provided ethical considerations are
borne in mind. Violation of existing ICMR guidelines in this regard shall
constitute misconduct. Consent taken from the patient for trial of drug or therapy
which is not as per the guidelines shall also be construed as misconduct.
z If a physician posted in rural area is found absent on more than two occasions
during inspection by the Head of the District Health Authority or the Chairman,
Zila Parishad, the same shall be construed as a misconduct if it is recommended to
the Medical Council of India/State Medical Council by the State Government for
action under these Regulations.
Check Your Progress
1. List out the important duties of physician in consultation.
…………………………………………..…………………………………
…………………………………………..…………………………………
2. List out some unethical acts of a physician.
…………………………………………..…………………………………
…………………………………………..…………………………………
35
3.9 PUNISHMENT AND DISCIPLINARY ACTION Medical Council Act
z It must be clearly understood that the instances of offences and of professional

misconduct which are given above do not constitute and are not intended to
constitute a complete list of the infamous acts which calls for disciplinary action,
and that by issuing this notice the Medical Council of India and or State Medical
Councils are in no way precluded from considering and dealing with any other
form of professional misconduct on the part of a registered practitioner.
Circumstances may and do arise from time to time in relation to which there may
occur questions of professional misconduct which do not come within any of
these categories. Every care should be taken that the code is not violated in letter
or spirit. In such instances as in all others, the Medical Council of India and/or
State Medical Councils have to consider and decide upon the facts brought before
the Medical Council of India and / or State Medical Councils.
z It is made clear that any complaint with regard to professional misconduct can be
brought before the appropriate Medical Council for Disciplinary action. Upon
receipt of any complaint of professional misconduct, the appropriate Medical
Council would hold an enquiry and give opportunity to the registered medical
practitioner to be heard in person or by pleader. If the medical practitioner is
found to be guilty of committing professional misconduct, the appropriate
Medical Council may award such punishment as deemed necessary or may direct
the removal altogether or for a specified period, from the register of the name of
the delinquent registered practitioner. Deletion from the Register shall be widely
publicized in local press as well as in the publications of different Medical
Associations/Societies/Bodies.
z In case the punishment of removal from the register is for a limited period, the
appropriate Council may also direct that the name so removed shall be restored in
the register after the expiry of the period for which the name was ordered to be
removed.
z Decision on complaint against delinquent physician shall be taken within a time
limit of 6 months.
z During the tendency of the complaint the appropriate Council may restrain the
physician from performing the procedure or practice which is under scrutiny.
z Professional incompetence shall be judged by peer group as per guidelines
prescribed by Medical Council of India.
3.10 LET US SUM UP

These Regulations may be called the Indian Medical Council (Professional Conduct,
Etiquette and Ethics) Regulations, 2002.
The prime object of the Medical Profession is to render service to humanity. No
person other than a doctor having qualification recognized by Medical Council of
India. Medical practitioner having any incapacity detrimental to the patient or which
can affect his performance vis-à-vis the patient is not permitted to practice his
profession.
z A medical practitioner is however permitted to make a formal announcement in
press regarding the following:
On starting practice.
On change of type of practice.
On changing address.
On temporary absence from duty.
36 On resumption of another practice.
On succeeding to another practice.
Public declaration of charges.
The physician shall not aid or abet torture nor shall he be a party to either infliction of
mental or physical trauma or concealment of torture inflicted by some other person or
agency in clear violation of human rights.

Do you come across the advertisements of Hospitals and Doctors in any media? Is it
Ethical or Unethical? Justify.
3.12 KEYWORDS
Maintenance of Medical Records: Every physician shall maintain the medical
records pertaining to his / her indoor patients for a period of 3 years from the date of
commencement of the treatment in a standard pro forma laid down by the Medical
Council of India.
Prognosis: The physician should neither exaggerate nor minimize the gravity of a
patient’s condition.
Patience, Delicacy and Secrecy: Patience and delicacy should characterize the
physician. Confidences concerning individual or domestic life entrusted by patients to
a physician and defects in the disposition or character of patients observed during
medical attendance should never be revealed unless their revelation is required by the
laws of the State.

1. Explain the duties and responsibilities of physician towards patient, general to
another physician.
2. Explain the unethical acts under Medical Council Act.

1. Duties of physician in consultation:
unnecessary consultations should be avoided
consultation for patient’s benefit
punctuality in consultation
statement to patient after consultation
treatment after consultation
patients referred to specialists
fees and other charges
2. Some of the unethical acts are:
advertising
patent and copy rights
running an open shop (dispensing of drugs and appliances by physicians)
rebates and commission
secret remedies
Contd….
misconduct 37
Medical Council Act
euthanasia
violation of the regulations
adultery or improper conduct
conviction by court of law
sex determination tests

38
4
CLINICAL TRIALS
CONTENTS
4.1 Introduction
4.2 Meaning of Clinical Trial
4.3 Participants in a Clinical Trial
4.4 Considerations before Participating a Clinical Trial
4.5 Preparations for Meeting the Research Coordinator or Doctor
4.6 Quitting Clinical Trial after it has Begun
4.7 Where do the Ideas for Trials Come from?
4.8 Sponsors of Clinical Trials
4.9 Meaning of Protocol
4.10 Meaning of Placebo
4.11 Control and Control Group
4.12 Different Types of Clinical Trials
4.13 Phases of Clinical Trials
4.14 Let us Sum up
4.16 Keywords

z Know about clinical trials
z Understand its advantages
z Evaluate its disadvantages
z Understand the procedure of clinical trials
z Study the various considerations in it
4.1 INTRODUCTION
Choosing to participate in a clinical trial is an important personal decision. It is a
clinical research. Participate in clinical trials can play a more active role in their own
health care, gain access to new research treatments before they are widely available
and help others.
39
4.2 MEANING OF CLINICAL TRIAL Clinical Trials
A clinical trial is a research study in human volunteers to answer specific health

questions. It is otherwise known as clinical research. Carefully conducted clinical
trials are the fastest and safest way to find treatment that work in people and ways to
improve health interventional trials determine whether experimental treatments or new
ways of using known therapies are safe and effective under controlled environments.
Observational trials address health issues in large groups of people or population in
natural settings.
4.3 PARTICIPANTS IN A CLINICAL TRIAL

All clinical trials have guidelines about who can participate. Using inclusion/exclusion
criteria is an important principle of medical research that helps to produce reliable
results. The factors that allow someone to participate in a clinical trial are called
“inclusion criteria” and those that disallow someone from participating are called
“exclusion criteria”.
These criteria are based on such factors as:
z Age
z Gender
z Type and stage of a disease.
4.4 CONSIDERATIONS BEFORE PARTICIPATING A

CLINICAL TRIAL
People should know as much as possible about the clinical trial and feel comfortable
asking the members of the health care team questions about it, the care expected while
in a trial, and the cost of the trial. The following questions might be helpful for the
participant to discuss with the health care team. Some of the answers to these
questions are found in the informed consent document.
z What is the purpose of the study?
z Who is going to be in the study?
z Why do researchers believe the experimental treatment being tested may be
effective? Has it been tested before?
z What kinds of tests and experimental treatments are involved?
z How do the possible risks, side effects, and benefits in the study compare with my
current treatment?
z How might this trial affect my daily life?
z How long will the trial last?
z Will hospitalization be required?
z Who will pay for the experimental treatment?
z Will I be reimbursed for other expenses?
z What type of long-term follow up care is part of this study?
z How will I know that the experimental treatment is working? Will results of the
trials be provided to me?
z Who will be in charge of my care?
40
Health Laws and Policies 4.5 PREPARATIONS FOR MEETING THE RESEARCH
COORDINATOR OR DOCTOR
z Plan ahead and write down possible questions to ask.
z Ask a friend or relative to come along for support and to hear the responses to the
questions.
z Bring a tape recorder to record the discussion to replay later.
4.6 QUITTING CLINICAL TRIAL AFTER IT HAS BEGUN

A participant can leave a clinical trial, at any time. When withdrawing from the trial,
the participant should let the research team know about it, and the reasons for leaving
the study.
4.7 WHERE DO THE IDEAS FOR TRIALS COME FROM?

Ideas for clinical trials usually come from researchers. After researchers test new
therapies or procedures in the laboratory and in animal studies, the experimental
treatments with the most promising laboratory results are moved into clinical trials.
During a trial, more and more information is gained about a experimental treatment,
its risks and how well it may or may not work.
4.8 SPONSORS OF CLINICAL TRIALS

Clinical trials are sponsored or funded by a variety of organizations or individuals
such as physicians, medical institutions, foundation, voluntary groups and
pharmaceutical companies, in addition to federal agencies such as the National
Institutes of Health (NIH), the Department of Defense (DOD) and the Department of
Veteran’s Affairs (VA). Trials can take place in a variety of locations, such as
hospitals, universities, doctor’s offices or community clinics.
4.9 MEANING OF PROTOCOL

A protocol is a study plan on which all clinical trials are based. The plan is carefully
designed to safeguard the health of the participants as well as answer specific research
questions. A protocol describes what types of people may participate in the trial; the
schedule of tests, procedures, medications, and dosages and the length of the study.
While in a clinical trial, participants following a protocol are seen regularly by the
research staff to monitor their health and to determine the safety and effectiveness of
their treatment.
4.10 MEANING OF PLACEBO

A placebo is an inactive pill, liquid or powder that has no treatment value. In clinical
trials, experimental treatments are often compared with placebos to assess the
experimental treatment’s effectiveness. In some studies, the participants in the control
group will receive a placebo instead of an active drug or experimental treatment.
4.11 CONTROL AND CONTROL GROUP

A control is the standard by which experimental observations are evaluated. In many
clinical trials, one group of patients will be given an experimental drug or treatment,
while the control group is given either a standard treatment for the illness or a
placebo.
41
4.12 DIFFERENT TYPES OF CLINICAL TRIALS Clinical Trials
The different types of clinical trials are:

z Treatment trials: Test experimental treatments, new combinations of drugs or
new approaches to surgery or radiation therapy.
z Prevention trials: Look for better way to prevent disease in people who have
never had the disease or to prevent a disease from returning. These approaches
may include medicines, vitamins, vaccines, minerals or lifestyle changes.
z Diagnostic trials: These are conducted to find better tests or procedures for
diagnosing a particular disease or condition.
z Screening trials: These are test the best way to detect certain diseases or health
conditions.
z Quality of life trials: It is otherwise known as Supportive care trials. It explores
ways to improve comfort and the quality of life for individuals with a chronic
illness.
4.13 PHASES OF CLINICAL TRIALS

Clinical trials are conducted in different phases. The trials at each phase have a
different purpose:
z In Phase I trials the researchers test a experimental drug or treatment in a small
group of people (20-80) for the first time to evaluate its safety, determine a safe
dosage range, and identify side effects.
z In Phase II trials the experimental study drug or treatment is given to a larger
group of people (100-300) to see if it is effective and to further evaluate its safety.
z In Phase III trials, The experimental study drug or treatment is given to large
group of people (1000-3000) to confirm its effectiveness, monitor side effects,
compare it to commonly used treatments, and collect information that will allow
the experimental drug or treatment to be used safely.
z In Phase IV trials, Post marketing studies delineate additional information
including the drug’s risks, benefits and optimal use.
4.14 LET US SUM UP

A clinical trial is a research study in human volunteers to answer specific health
questions. The factors that allow someone to participate in a clinical trial are called
“inclusion criteria” and those that disallow someone from participating are called
“exclusion criteria”. People should know as much as possible about the clinical trial
and feel comfortable asking the members of the health care team questions about it,
the care expected while in a trial, and the cost of the trial. A participant can leave a
clinical trial, at any time. When withdrawing from the trial, the participant should let
the research team know about it, and the reasons for leaving the study. Ideas for
clinical trials usually come from researchers. Clinical trials are sponsored or funded
by a variety of organizations or individuals such as physicians, medical institutions,
foundation, voluntary groups and pharmaceutical companies, in addition to federal
agencies such as the National Institutes of Health (NIH), the Department of Defense
(DOD) and the Department of Veteran’s Affairs (VA). Trials can take place in a
variety of locations, such as hospitals, universities, doctor’s offices or community
clinics. A placebo is an inactive pill, liquid or powder that has no treatment value A
protocol is a study plan on which all clinical trials are based A control is the standard
by which experimental observations are evaluated. In many clinical trials, one group
of patients will be given an experimental drug or treatment, while the control group is
given either a standard treatment for the illness or a placebo.
42 Check Your Progress
1. What is clinical trial?
…………………………………………………….………………………
…………………………………………………….………………………
2. What do you mean by protocol?
…………………………………………………….………………………
…………………………………………………….………………………
3. What is placebo?
…………………………………………………….………………………
…………………………………………………….………………………
4. What is control and control group?
…………………………………………………….………………………
…………………………………………………….………………………

Collect information from a Hospital Administrator regarding the procedure to
approach the Sponsors for Clinical trials.
4.16 KEYWORDS
Clinical trial: A clinical trial is a research study in human volunteers to answer
specific health questions.
Inclusion criteria: The factors that allow someone to participate in a clinical trial are
called “inclusion criteria”.
Exclusion criteria: Those that disallow someone from participating are called
“exclusion criteria”.
Protocol: It is a study plan on which all clinical trials are based.
Placebo: It is an inactive pill, liquid or powder that has no treatment value.
Control: It is the standard by which experimental observations are evaluated.

1. What is clinical trial? Who are all the participants in clinical trial?
2. What are the important considerations before participating the clinical trial?
3. Explain the different types of clinical trials.
4. What are the different phases of clinical trial? Explain.

1. A clinical trial is a research study in human volunteers to answer specific
health questions. It is otherwise known as clinical research.
2. A protocol is a study plan on which all clinical trials are based. The plan
is carefully designed to safeguard the health of the participants as well as
answer specific research questions. A protocol describes what types of
people may participate in the trial; the schedule of tests, procedures,
medications, and dosages and the length of the study.
Contd….
3. A placebo is an inactive pill, liquid or powder that has no treatment value. 43
In clinical trials, experimental treatments are often compared with Clinical Trials
placebos to assess the experimental treatment’s effectiveness.

4. A control is the standard by which experimental observations are
evaluated. In many clinical trials, one group of patients will be given an
experimental drug or treatment, while the control group is given either a
standard treatment for the illness or a placebo.

44
5
DISABILITY ACT
CONTENTS
5.1 Introduction
5.2 Short Title, Extent and Commencement
5.3 Definitions
5.4 Central Coordination Committee
5.5 Term of Office of Members
5.6 Disqualifications
5.7 Vacation of Seats by Members
5.8 Meetings of the Central Coordination Committee
5.9 Functions of the Central Coordination Committee
5.10 Functions of the Central Executive Committee
5.11 Meetings of the Central Executive Committee
5.12 Meetings of the State Coordination Committee
5.13 Functions of the State Coordination Committee
5.14 Functions of the State Executive Committee
5.15 Meetings of the State Executive Committee
5.16 Appropriate Governments and Local Authorities to take certain Steps for the
Prevention of Occurrence of Disabilities
5.17 Let us Sum up
5.19 Keywords

z Get a clear idea about the Disability Act and its applicability
z Understand the Central and State committees and its functions and meetings
z Know about the steps for the prevention of occurrence of disabilities
5.1 INTRODUCTION
An Act provides the regulations and functions of different Central and State
Coordination Committees for the well being of the disabled persons.
45
5.2 SHORT TITLE, EXTENT AND COMMENCEMENT Disability Act
z This Act may be called the Persons with Disabilities (Equal Opportunities,
Protection of Rights and Full Participation) Act, 1995.
z It extends to the whole of India except the State of Jammu and Kashmir.
z It shall come into force on such date as the Central Government may, by
notification, appoint.
5.3 DEFINITIONS
z “Appropriate Government” means:
i) In relation to the Central Government or any establishment wholly or
substantially financed by that the Cantonment Act, 1924, 2 of 1924 the
Central Government;
ii) In relation to a State Government or any establishment wholly or substantially
financed by that Government, or any local authority, other than a Cantonment
Board, the State Government;
iii) In respect of the Central Coordination Committee and the Central Executive
Committee, the Central Government;
iv) In respect of the State Coordination Committee and the State Executive
committee, the State Government;
z “Blindness” refers to a condition where a person suffers from any of the following
conditions, namely;
i) Total absence of sight; or
ii) Visual acuity sharpness not exceeding 6/60 or 20/200 (snellen) in the better
eye with correcting lenses; or
iii) Limitation of the field of vision subtending an angel of 20 degree or worse;
z “Central Coordination Committee” means the Central Coordination Committee
constituted under sub-section (1) of section 3;
z “Central Executive Committee” means the Central Executive Committee
z “Impaired condition of limbs” means a group of non-progressive conditions of a
person characterized by abnormal motor control posture resulting from brain
insult or injuries occurring in the pre-natal, per-natal or infant period of
development;
z “Chief Commissioner” means the Chief Commissioner appointed under sub-
section (1) of section 57;
z “Commissioner” means the Commissioner appointed under sub-section (1) of
section 60;
z “Competent authority” means the authority appointed under section 50;
z “Disability” means – disease refines who have the factious problems:
i) Blindness;
ii) Low vision;
iii) Leprosy-cured;
iv) Hearing impairment;
46 v) Loco motor disability;
vi) Mental retardation;
vii) Mental illness;
z “Employer” means:
i. In relation to a Government, the authority notified by the Head of the
Department in this behalf or where no such authority is notified, the Head of
the Department; and
ii. In relation to an establishment, the chief executive officer of that
establishment;
z “Establishment” means a corporation established by or under a Central, Provincial
or State Act, or an authority or a body owned or controlled or aided by the
Government or a local authority or a Government company’s defined in Section
617 of the Companies Act, (1 of 1956) and includes Departments a Government;
z “Hearing impairment” means loss of sixty decibels or more in (unit for measuring
the unity of sound) the better year in the conversational range of frequencies;
z “Institution for persons with disabilities” means an institution for the reception,
care, protection, education, training, rehabilitation or any other service of persons
with disabilities;
z “Leprosy cured person” means any person who has been cured of leprosy but is
suffering from:
Loss of sensation in hands or feet as well as loss of sensation and paresis in
the eye and eye-lid but with no manifest deformity;
Manifest deformity and paresis but having sufficient mobility in their hands
and feet to enable them to engage in normal economic activity;
Extreme physical deformity as well as advanced age which prevents him from
undertaking any gainful occupation; and the expression “leprosy cured” shall
be construed accordingly;
z “Loco motor disability” means disability of the bones, joints or muscles leading to
substantial restriction of the movement of the limbs or any form of cerebral palsy;
z “Medical authority” means any mental disorder other than mental retardation;
z “Mental illness” means any mental disorder other than mental retardation;
z “Mental retardation” means a condition of arrested or incomplete development of
mind of a person which is specially characterized by sub-normality or
intelligence;
z “Notification” means a notification published in the Official Gazette;
z “Person with disability” means a person suffering from not less than forty per cent
of any disability as certified by a medical authority;
z “Person with low vision” means a person with impairment of visual functioning
even after treatment of standard refractive correction but who uses or is
potentially capable of using vision for the planning or execution of a task with
appropriate assertive device;
z “Prescribed” means prescribed by rules made under this Act;
z “Rehabilitation” refers to a process aimed at enabling persons with disabilities to
reach and maintain their optimal physical, sensory, intellectual, psychiatric or
social functional levels;
z “Special Employment Exchange” means any office or place established and 47
Disability Act
maintained by the Government for the collection and furnishing of information,
either by keeping of registers or otherwise, respecting:
Persons who seek to engage employees from amongst the persons suffering
fro disabilities;
Persons with disability who seek employment;
Vacancies to which person with disability seeking employment may be
appointed;
z “State Coordination Committee” means the State Coordination Committee
z “State Coordination Committee” means the State Executive Committee
constituted under sub-section (1) of Section 19.
5.4 CENTRAL COORDINATION COMMITTEE

z The Central Government shall by notification constitute a body to be known as
the Central Coordination Committee to exercise the powers conferred on, and to
perform the functions assigned to it, under this Act.
z The Central Coordination Committee shall consist of:
The Minister in-charge of the Department of Welfare in the Central
Government, Chairperson, ex officio;
The Minister of State in-charge of the Department of Welfare in the Central
Government, Vice-Chairperson, ex officio;
Secretaries to the Government of India in-charge of the Departments of
Welfare, Education, Woman and Child Development, Expenditure, Personnel,
Training and Public Grievances, Health, Rural Development, Industrial
Development, Urban Affairs and Employment, Science and Technology,
Legal Affairs, Public Enterprises, Members, ex officio;
Chief Commissioner, Member, ex officio;
Chairman Railway Board, Member, ex officio;
Director-General of Labour, Employment and Training, Member, ex officio;
Director, National Council for Educational Research and Training, Member,
ex officio;
Three Members of Parliament, of whom two shall be elected by the House of
the People and one by the Council of States, Members;
Three persons to be nominated by the Central Government to represent the
interests, which in the opinion of that Government ought to be represented,
Members; Directors of the:
National Institute for the Visually Handicapped, Dehradun;
National Institute for the Mentally Handicapped, Secundrabad;
National Institute for the Orthopaedically Handicapped, Calcutta;
Ali Yavar Jung National Institute for the Hearing Handicapped, Bombay;
z Four Members to be nominated by the Central Government by rotation to
represent States and the Union territories in such manner as may be prescribed by
the Central Government;
48 z Provided that no appointment under this clause shall be made except on the
recommendation of the State Government or, as the case may be, the Union
territory;
z Five persons as far as practicable, being persons with disabilities, to represent
non-governmental organizations or associations which are concerned with
disabilities, to be nominated by the Central Government, one from each area of
disability, members;
z Joint Secretary to the Government of India in the Ministry of Welfare dealing
with the welfare of the handicapped, Member-Secretary, ex officio;
z The office of the Member of the Central Coordination Committee shall not
disqualify its holder for being chosen as or for being a member of other House or
Parliament.
5.5 TERM OF OFFICE OF MEMBERS

z Save as otherwise provided by or under this Act a Member of Central
Coordination Committee nominated under clause (i) or clause (1) of sub-section
(2) of Section 3 shall hold office for a term of three years from the date of his
nomination:
Provided that such a Member shall, notwithstanding the expiration of his term,
continue to hold office until his successor enters upon his office.
z The term of office of an ex officio Member shall come to an end as soon as he
ceases to hold the office by virtue of which he was so nominated.
z The Central Government may if it thinks fit remove any Member nominated under
clause (i) or clause (1) of sub-section (2) of section.
z A Member nominated under clause (i) or clause (1) of sub-section (2) of section 3,
may at any time resign his office by writing under his hand addressed to the
Central Government and the sea of the said member shall thereupon become
vacant.
z A casual vacancy in the Central Coordination Committee shall be filled by a fresh
nomination and the person nominated to fill the vacancy shall hold office only for
the remainder of the term for which the member in whose place he was so
nominated.
z A Member nominated under (i) or clause (1) of sub-section (2) of section 3 shall
be eligible for re-nomination.
z Members nominated under clause (i) and clause (1) sub-section (2) of Section 3
shall receive such allowances as may be prescribed by the Central Government.
5.6 DISQUALIFICATIONS
z No person shall be a member of the Central Coordination Committee, who:
a) Is, or at any time has been, adjudged insolvent or has suspended payment of
his debts or has compounded with his creditors, or
b) Is of unsound mind and stands so declared by a competent court, or
c) Is or has been convicted of an offence which, in the opinion of the Central
Government, involves moral turpitude, or
d) Is or at any time has been convicted of an offence under this Act, or
e) Has so abused in the opinion of the Central Government his position as a
Member as to render his continuance in the Central Coordination Committee
detrimental to the interests of the general public.
z No order of removal shall be made by the Central Government under this section 49
Disability Act
unless the Member concerned has been given a reasonable opportunities of
showing cause against the same.
Notwithstanding anything contained in sub-section (1) or sub-section (6) of Section 4,
a Member who has been removed under this section shall not be eligible for
renomination as a Member.
5.7 VACATION OF SEATS BY MEMBERS

If a Member of the Central Coordination Committee becomes subject to any of the
disqualifications specified in section 5, his seat shall become vacant.
5.8 MEETINGS OF THE CENTRAL COORDINATION

COMMITTEE
The Central Coordination Committee shall meet at least once in every six months and
shall observe such rules of procedure in regard to the transaction of business at its
meetings as may be prescribed by the Central Government.
5.9 FUNCTIONS OF THE CENTRAL COORDINATION

COMMITTEE
z Subject to the provisions of this Act, the function of the Central Coordination
Committee shall be to serve as the national focal point on disability matters and
facilitate the continuous evolution of a comprehensive policy towards solving the
problems faced by persons with disabilities.
z In particular and without prejudice to the generality of the foregoing, the Central
Coordination Committee may perform all or any of the following functions,
namely:
a) Review and coordinate the activities of all the Departments of Government
and other Governmental and non-Governmental Organizations which are
dealing with matters relating to persons with disabilities;
b) Develop a national policy to address issues faced by persons with disabilities;
c) Advise the Central Government on the formulation of policies, programmes,
legislation and projects with respect to disability;
d) Take up the cause of persons with disabilities with the concerned authorities
and the international organizations with a view to provide for schemes and
projects for the disabled in the national plans and other programmes and
policies evolved by the international agencies;
e) Review in consultation with the donor agencies their funding policies from
the perspective of their impact on persons with disabilities;
f) Take such other steps to ensure barrier free environment in public places,
work places, public utilities, schools and other Institutions;
g) Monitor and evaluate the impact of policies and programmes designed for
achieving equality and full participation of persons with disabilities;
h) To perform such other functions as may be prescribed by the Central
Government.
50
Health Laws and Policies 5.10 FUNCTIONS OF THE CENTRAL EXECUTIVE
COMMITTEE
z The Central Executive Committee shall be the executive body of the Central
Coordination Committee and shall be responsible for carrying out the decisions of
the Central Coordination Committee.
z Without prejudice to the provisions of sub-section (1), the Central Executive
Committee shall also perform such other functions as may be delegated to it by
the Central Coordination Committee.
5.11 MEETINGS OF THE CENTRAL EXECUTIVE

COMMITTEE
The Central Executive Committee shall meet at least once in three months and shall
observe such rules of procedure in regard to the transaction of business at its meetings
as may be prescribed by the Central Government.
5.12 MEETINGS OF THE STATE COORDINATION

COMMITTEE
The State Coordination Committee shall meet at least once in every six months and
shall observe such rules of procedure in regard to the transaction of business at its
meetings as may be prescribed.
5.13 FUNCTIONS OF THE STATE COORDINATION

COMMITTEE
z Subject to the provisions of this Act, the function of the State Coordination
Committee shall be to serve as the state focal point on disability matters and
facilitate the continuous evolution of a comprehensive policy towards solving
problems face by persons with disabilities.
z In particular and without prejudice to the generality of the foregoing function the
State Coordination Committee may within the State perform all or any of the
following functions, namely:
a) Review and coordinate the activities of all the Departments of Government
and other Governmental and non-Governmental Organizations which are
dealing with matters relating to persons with disabilities;
b) Develop a State policy to address issues faced by persons with disabilities;
c) Advise the State Government on the formulation of policies, programmes,
legislation and projects with respect to disability;
d) Review in consultation with the donor agencies, their funding policies from
the perspective of their impact on persons with disabilities;
e) Take such other steps to ensure barrier free environment in public places,
work places, public utilities, schools and other institutions;
f) Monitor and evaluate the impact of policies and programmes designed for
achieving equality and full participation of persons with disabilities;
g) To perform such other functions as may be prescribed by the State
Government.
Disability Act
1. What do you mean by disability?
…………………………………………………………………………….
…………………………………………………………………………….
2. What is hearing impartment?
…………………………………………………………………………….
…………………………………………………………………………….
3. What is loco motor disability?
…………………………………………………………………………….
…………………………………………………………………………….
5.14 FUNCTIONS OF THE STATE EXECUTIVE

COMMITTEE
The State Executive Committee shall be the executive body of the State Coordination
Committee and shall be responsible for carrying out the decisions of the State
Coordination Committee.
Without prejudice to the provisions of sub-section (1) the State Executive Committee
shall also perform such other functions as may be delegated to it by the State
Coordination Committee.
5.15 MEETINGS OF THE STATE EXECUTIVE

COMMITTEE
The State Executive Committee shall meet at least once in three months and shall
observe such rules of procedure in regard to the transaction of business at its meetings
as may be prescribed by the State Government.
5.16 APPROPRIATE GOVERNMENTS AND LOCAL

AUTHORITIES TO TAKE CERTAIN STEPS FOR THE
PREVENTION OF OCCURRENCE OF DISABILITIES
Within the limits of their economic capacity and development, the appropriate
Governments and the local authorities, with a view to preventing the occurrence of
disabilities, shall:
a) Undertake or cause to be undertaken surveys, investigations and research
concerning the cause of occurrence of disabilities;
b) Promote various methods of preventing disabilities;
c) Screen all the children at least once in a year for the purpose of identifying “at-
risk” cases;
d) Provide facilities for training to the staff at the primary health centers;
e) Sponsor or cause to be sponsored awareness campaigns and disseminate or cause
to be disseminated information for general hygiene, health and sanitation;
f) Take measures for pre-natal, perinatal and post-natal care of mother and child;
g) Educate the public through the pre-schools, schools, primary health centers,
village level workers and anganwadi workers;
h) Create awareness amongst the masses through television, radio and other mass
media on the causes of disabilities and the preventive measures to be adopted.
52
Health Laws and Policies 5.17 LET US SUM UP
Disabilities (Equal Opportunities, Protection of Rights and Full Participation) act was
passed on 1995. As per this Act, disability means – disease refines who have the
factious problems blindness; low vision; leprosy-cured; hearing impairment; loco
motor disability; mental retardation; mental illness; etc., and rehabilitation refers to a
process aimed at enabling persons with disabilities to reach and maintain their optimal
physical, sensory, intellectual, psychiatric or social functional levels. Various
committees were constituted under this act such as the central coordination
committee, the Central Executive Committee, the State Coordination Committee and
The State Executive Committee. Functions and terms of this committee are also
regulated. Appropriate governments and local authorities take certain steps for the
prevention of occurrence of disabilities under this Act.

List out the few programmes conducted by the State Coordination Committee under
this Act recently.
5.19 KEYWORDS
Blindness: “Blindness” refers to a condition where a person suffers from any of the
following conditions, namely:
1. Total absence of sight; or
2. Visual acuity sharpness not exceeding 6/60 or 20/200 (snellen) in the better eye
with correcting lenses; or
3. Limitation of the field of vision subtending an angel of 20 degree or worse.
Central Coordination Committee: It means the Central Coordination Committee
constituted under sub-section (1) of Section 3.
Central Executive Committee: It means the Central Executive Committee constituted
under sub-section (1) of Section 9.

1. Explain the Disability Act in India.
2. Explain the various committees under Disability Act.
3. What are the steps taken to prevent the occurrence of disabilities?

1. Disability means – disease refines who have the factious problems:
i) Blindness;
ii) Low vision;
iii) Leprosy-cured;
iv) Hearing impairment;
v) Loco motor disability;
vi) Mental retardation;
vii) Mental illness;
2. Hearing impairment means loss of sixty decibels or more in (unit for
measuring the unity of sound) the better year in the conversational range
of frequencies.
3. Loco motor disability means disability of the bones, joints or muscles
leading to substantial restriction of the movement of the limbs or any
form of cerebral palsy.
53
5.21 SUGGESTED READING Disability Act
54
6
LEGAL ASPECTS OF MEDICAL RECORDS
CONTENTS
6.1 Introduction
6.2 Confidential Communication
6.2.1 Personal Document
6.2.2 Impersonal Document
6.3 Insurance Cases
6.4 Workmen’s Compensation Cases
6.5 Personal Injury Suits
6.6 Malpractice Suits
6.7 Will Cases
6.8 Income-tax Act
6.9 Authorization for Operation
6.10 Specific Consent
6.11 Patient Leaves the Hospital against Medical Advice
6.12 Certificate of Birth and Death
6.13 Criminal Cases
6.14 Impact of the Consumer Protection Act in Medical Field
6.15 Documentation of the Medical Records
6.16 Let us Sum up
6.18 Keywords

z Study the various legal aspects of medical records
z Know the role of medical records in criminal cases
z Study the difference between personal and impersonal documents
z Know its role in insurance claims
55
6.1 INTRODUCTION Legal Aspects of Medical
Records
The medical record is who, what, why, where and when of patient care in the hospital.
With the advancement in medical knowledge and complexity of modern medical and
surgical treatment existing in hospital today, an accurate and adequate medical record
is essential as documentary reference of the care and treatment which the patient
received in the hospital.
M E Gibony has said, A chronicle of the pageantry of medical and scientific progress
is found in the hospital records. They may be found the running story, disconnected; it
is true, of the drama, the comedy, the mystery, and the miracles of medicine and
hospitals of the twentieth century.
Each medical record reveals information, always centered around a patient (who may
be a man woman or a child). The patient is the recipient of the medical care, which is
offered to him by a team, which usually consists of the doctor, the nurse and the
paramedical worker. This care is offered by the team to the recipient (patient) in a
particular location, this being the hospital. All activities by the team in this location
are for the benefit of the patient and this is recorded, thus making the existence of the
hospital medical record possible.
The hospital compiles and keeps medical records primarily for the benefit of the
patient, and the protection of the hospital and physician. However, the personal data
contained therein, considered as a confidential communication, is a property interest
of the patient. In addition to being kept for the benefit of the patient, medical records
are also kept as a guide to consultants, for the education of undergraduates and
postgraduates, for the training of the nurses, medical statistics research and the
protection of the physician, hospital staff and hospital against unjust criticism.
When the hospital admits a patient, it enters into an implied contract to render services
necessary in the care and treatment of the patient. This necessitates keeping a
chronological record of the care and treatment rendered by the personnel.
6.2 CONFIDENTIAL COMMUNICATION

Medico legal problems often concern the hospital administrator but he, in turn,
transmits the responsibility to the records department personnel, (if there is a medical
records department) otherwise this responsibility’s usually vested on the casualty
medical officer. The treating of medico legal cases are day-to-day problems and it is
necessary that policies governing the release of confidential information should be
clearly defined by the administrator, and the medical record must be safely guarded
form unauthorized inspections. The medical record is used either as a personal or an
impersonal document.
6.2.1 Personal Document

As a personal document the record is sued to identify the patient with the history of
his illness, the physical findings and the treatment given to this one individual. The
information is confidential and may not be released to anyone without the patient’s
permission. However, the executors of an estate or their legal representatives, in as
much as they are supposed to act in the best interest of the deceased, should be
allowed access to the record if this becomes necessary for the performance of their
duties. This access to the records may be permitted only after presenting proof of
authority. Neither relatives nor friends of the patient, not even the husband or wife,
have any right to review a record unless authorization has been received from the
patient. The authorization should always be in writing and should be filed with the
record, together with a carbon copy of the information released.
56 It must be recognized that if a record is subpoenaed it must be produced in court.
Usually a member of the records department represents the hospital in producing this
record in court. It is recommended original sent to the court. Past experience has being
that, at times, the court retained the original record for an indefinite time and in such
occasions the Photostat copy fulfils the purpose.
If the patient should be readmitted under the care of a second physician, the second
physician should be allowed access to the record of the previous hospitalization. If the
patient is subsequently admitted to another hospital, a summary may be sent upon
request form the hospital or the physician. In such an instance, an authorization is not
usually considered necessary as the information is being released in the interest of
better patient care.
In case the patient personally requests information from his own, record, it is not
always in the best interest of the patient that he knows, all the details concerning his
illness. It is a wise policy, in all such instances, to consult the physician. It is doubtful,
however, whether the hospital would be justified in refusing the information to the
patient even against the advice of the attending physician. It must always be kept in
mind that laws differ from country to country and even from state to state, and
therefore one should acquaint himself with the legal requirements of the particular
state.
6.2.2 Impersonal Document

As a impersonal document, the record may be used for research or study, when such
cautions need not be exercised as when it is used as a personal document because it
has no connection with the patient as an individual. Moreover, it is used in this
manner only by physicians, house Surgeons, Under-graduate and Post-graduate
students, nurses and paramedical staff all of whom are bound by the code of
professional secrecy. In such instances, the record of the individual loses its identity as
a personal document and only the record number and so it is unnecessary to obtain the
patient permission.
If the research is being done by a staff physician and is not for publication, it is not
necessary to obtain the permission of the attending physician to use the record,
although this is done as a matter of courtesy. If the record is being studied preparatory
to publication, the permission of the attending physician must be secured, as it might
be his intention to use the data for his own publication. It is very essential, when a
physician, who is not a staff member, wishes to review a case or series of cases, that
the consent of the attending physician and permission form the hospital administrator
must be secured.
Hospital medical records can be documentary evidence as per the Indian Evidence
Act, 1872, as amended up to August 1952, 1961 and medical records are generally
subpoenaed to court in the following types of cases.
6.3 INSURANCE CASES

Frequent requests come from the Life Insurance Corporation regarding details of the
hospitalization of a patient. This is done with the purpose of disposing of claims that
may have arisen for settlement as the patient is insured with the corporation. With the
help of the hospital medical record, various forms of life insurance are completed.
Though the information that is made available from the hospital medical record is
privileged communication and the document in this respect is used as a personal
document, yet the release of such information without the prior consent of the patient
is permissible because the patient had waived his claim of this privilege at the time of
taking out a policy with the corporation.
57
6.4 WORKMEN’S COMPENSATION CASES Legal Aspects of Medical
Records
The Workmen’s Compensation Act of 1923 as amended up to 1942, provides for the
payment, by certain classes of employee to their workmen, of compensation for injury
caused by accident arising out of and in the course of employment. A Commissioner
appointed under section 20 of the above Act awards the compensation as prescribed in
the Act. Alight from the onset is therefore of paramount importance. The medical
record in such instances is used as evidence to show the date, the type and seventy of
the injury, the period of disability and the prognosis.
6.5 PERSONAL INJURY SUITS

In this type of suit, the claim is made by the individual for damages sustained as the
result of injuries which were due to the fault or neglect of another. The patient may
show the extent of the injuries, the treatment rendered and the duration of the care
required. The medical record is used to obtain the required data for this purpose.
6.6 MALPRACTICE SUITS

Malpractice is defined as want of reasonable care and skill or willful negligence on
the part of a doctor, nurse or other staff of hospital in the treatment of a patient so as
to lead to his bodily injury or to the loss of his life. An action for malpractice may be
brought against the hospital and its employees in a civil or criminal court. This danger
is not so acutely felt in our country at this time, but with the common man beginning
to realize his rights and privileges, it will not be long before such things may create
problems to the doctor and hospital. The hospital medical record is here used to show
whether there was negligence and the treatment rendered was adequate and proper or
otherwise.
6.7 WILL CASES

A patient may have made a will during his hospital stay. After death of the patient an
attempt may be made to set the will aside by seeking to prove that the patient was
mental stage of the patient at the time of making the will.
6.8 INCOME-TAX ACT

Requests of confidential information concerning a patient are frequently required by
the hospital from the Income-tax Officer. This information is a available in the
medical record. Here, again the medical record is used as a personal document and yet
the information has to be made available to the Income-tax Officer by virtue of the
power conferred on him under the Section 38 (5) of the Income-tax Act 1922 and no
prior permission from the patient is necessary.
6.9 AUTHORIZATION FOR OPERATION

An operation, or even a medical examination carried out without consent-expressed or
implied of the person concerned, will usually amount to actionable assault. A form of
consent to a operation should be obtained in all cases although there may be certain
occasions when it cannot be done, for example when as emergency operatic has to be
performed to save life. In some cases the patient will sign the form in others, such as
those involving children and persons of unsound mind, those who are unable to use
their hands or are unconscious, the consent of spouse, relative or guardian may be
obtained. The consent of the husband needed. If the operation will deprive the wife of
her marital functions and is wise to obtain the consent of the relatives if there is any
58 possibility that the outcome of the operation may leave the patient in a state
of distress.
Usually, the completion of such a form is done as a routine either in Admission
Officer or certain surgical wards, and the procedure should such as to ensure that it is
not omitted. Some members of the staff should ensure, before any operation is done,
that the form is completed.
6.10 SPECIFIC CONSENT

For amputation of a part, enucleating of an eye, sterilization therapeutic abortion, etc.
Should be sought for and properly authorizes writing by the patient so that it may be
incorporated in the record and become available as documentary evidence. Though
this is routinely done, as far in-patients are concerned, it has not yet been introduced
in the outpatient service in all hospitals but some hospitals, are serious about obtaining
consent from outpatients also whenever surgical procedures are performed on the
patient.
6.11 PATIENT LEAVES THE HOSPITAL AGAINST

MEDICAL ADVICE
If a patient is being discharged against medical advice, the signature of patient or
relative should be obtained in a prescribed form usually printed on the reverse side of
the record. The patient should also be informed of the consequences or risk involved
and that the hospital and its employees will not be held responsible for any ill effects,
which may result. In the event that the patient refuses to sign a release, the clinical
record should contain a statement signed by the physician and duly witnessed setting
forth the circumstances, reasons and warning against the premature departure. It is the
experience of many hospitals that some patients not appear to have any medico legal
problem during admission, but la the hospital case records of such patients are
subpoenaed by the count for various reasons. Therefore, it is advisable that, every
patient, whether he appears on admission to be a medico-legal or non-medico-legal
cast should always be dealt with keeping the medico-legal problems in view to avoid
later complications.
6.12 CERTIFICATE OF BIRTH AND DEATH

Registration certificates provide information for the establishment of parentage, for
proof of identity for proof of birth date for school entrance, insurance for licenses
(many kinds, for proof of place as well as date of birth in establishing citizenship and
other purposes).
Death registration certificates prove the death of a person of life insurance claims,
sickness insurance claims, settlement of estates circumstances, time and place of birth,
etc. Because of the value of the information in these certificates in the lives of people
who may need the data, they should be compiled with absolute accuracy and should
be communicated to the Office of the Birth and Death Registrar. Duplicate copies of
birth and death certificates should be filed in the appropriate hospital records.
6.13 CRIMINAL CASES

Hospital medical records are used for the following types of criminal cases:
1. In murder cases, to show that death did or did not result from natural causes.
2. In assault to show the extent of injuries sustained.
3. In mayhem cases, to prove the history given by the patient on admission and the
character and extent of the injuries sustained.
4. In rape cases, to prove the condition of prosecutrix on admission and also her 59
Legal Aspects of Medical
history as related on admission. Records
5. In certain cases to prove deficient mental condition and to show that the defendant
should be confined to an institution for the mentally ill or feeble-minded rather
than imprisoned in a penal institution.
6. In conspiracy case, to show that a fraud was perpetrated on a person being sued
for damages.
Check Your Progress
1. What is a medical record?
…………………………………….………………………………………..
…………………………………….………………………………………..
2. Give two examples of use of medical records in criminal cases.
…………………………………….………………………………………..
…………………………………….………………………………………..
6.14 IMPACT OF THE CONSUMER PROTECTION ACT IN

MEDICAL FIELD
Since 1986, the Consumer Protection Act came into existence the health care
providers including doctors; nurses, paramedics and hospital administrators have to be
meticulously careful in understanding the full responsibilities that they have to fulfill
in the legal and administrative sense. This becomes imperative to ensure whatever the
services rendered have to be properly documented in patient records to safe guard the
staff involved in the consumer service. After enacting the Consumer Protection Law,
innumerable negligent cases have resulted, which earlier would have been surfaced.
When an injured patient seeks legal advice about filing a medical malpractice lawsuit,
the attorney’s first task is to review the medical records. They attorney is looking for
both specific acts of negligence and at the overall quality of the record. The strongest
medical malpractice lawsuits are based on well-documented specific acts of
negligence. In most cases, however, the negligence is inferred from documented and
undocumented events. If the patient’s case depends at least partially on assuming that
certain events were not recorded, then the attorney must be able to cast doubt on the
credibility of the record.
The last credible records are those that are internally inconsistent. An example would
be the situation where the physician’s progress notes records indicate that the patient
had developed a high fever and appeared to have a major infection. More commonly,
the credibility of the records is attacked by demonstrating that it is incomplete. If it is
clear that medically important information is missing from the record, then it is easy
to convince a jury that the missing information supports the patient’s claims.
6.15 DOCUMENTATION OF THE MEDICAL RECORDS

1. Each and every patient record must contain complete and accurate patient
identification data history, physical examination conducted, progress notes,
investigations carried out, diagnosis, consultations, treatment including
medications, therapy, medical, surgical procedures and end results.
2. In the course of treatment, necessary investigation reports carried out, including,
lab, X-Ray, Ultrasound, CT scan, MRI including photographs etc. Have to be
clearly documented and the original reports have to be made available.
60 3. The general informed consent for routine treatment in OPD, inpatient,
investigations, minor surgical procedures, treatments should be obtained from the
patient/authorized patient attendant by the medical record staff at the time of
registration in outpatient or inpatient or day care cases.
4. A special informed consent has to be obtained by the concern surgeon before
performing any surgical procedures.
5. The attending/treating physicians are responsible to ensure that the documentation
of the pertinent information has to be recorded comprehensively and promptly to
justify the diagnosis treatment, and end results, which in turn will protect doctor
and the health institutions from any legal litigation’s.
6. The policies and procedures suggested in this book have to be meticulously
followed to safeguard the doctors from any legal actions.
6.16 LET US SUM UP

The medical record is the property of the hospital, while the personal data contained in
the record is considered as a confidential communication in which the patient has a
property interest. It is compiled, preserved and protected from unauthorized inspection
for the benefit of the patient, doctor, hospital and its employees. Miles and miles of
data are entered in medical records. To some it may mean a waste of paper. But it is
obvious that each statement made in the.
The medical record is who, what, why, where and when of patient care in the hospital.
A chronicle of the pageantry of medical and scientific progress is found in the hospital
records. Medico legal problems often concern the hospital administrator but he, in
turn, transmits the responsibility to the records department personnel, (if there is a
medical records department) otherwise this responsibility’s usually vested on the
casualty medical officer. As a personal document the record is sued to identify the
patient with the history of his illness, the physical findings and the treatment given to
this one individual. As an impersonal document, the record may be used for research
or study, when such cautions need not be exercised as when it is used as a personal
document because it has no connection with the patient as an individual. Frequent
requests come from the Life Insurance Corporation regarding details of the
hospitalization of a patient. This is done with the purpose of disposing of claims that
may have arisen for settlement as the patient is insured with the corporation .The
Workmen’s Compensation Act of 1923 as amended up to 1942, provides for the
payment, by certain classes of employee to their workmen, of compensation for injury
caused by accident arising out of and in the course of employment.

Approach the nearest hospital and know-how the medical records are useful in various
legal issues.
6.18 KEYWORDS
Medical Record: It is who, what, why, where and when of patient care in the hospital.
Personal Injury Suits: In this type of suit, the claim is made by the individual for
damages sustained as the result of injuries which were due to the fault or neglect of
another.
Malpractice: It is defined as want of reasonable care and skill or willful negligence on
the part of a doctor, nurse or other staff of hospital in the treatment of a patient so as
to lead to his bodily injury or to the loss of his life.
61
6.19 QUESTION FOR DISCUSSION Legal Aspects of Medical
Records
1. Describe the importance of medical records in legal issues.

1. Medical record is a document which includes who, what, why, where and
when of patient care in the hospital.
2. In murder cases, to show that death did or did not result from natural
causes and in assault to show the extent of injuries sustained.

62
7
TRANSPLANTATION OF HUMAN ORGANS ACT
CONTENTS
7.1 Introduction
7.2 Commencement
7.3 Definitions
7.4 Authority for Removal of Human Organs
7.5 Removal of Human Organs not to be Authorised in Certain Cases
7.6 Removal Organs in Case of Unclaimed Bodies
7.7 Removal Organs from Bodies Sent for Postmortem Examination for Medicological
or Pathological Purposes
7.8 Preservation of Human Organs
7.9 Restricitions on Removal and Transplantation of Human Organs
7.10 Regulation of Hospitals Conducting the Removal, Storage or Transplantation
7.11 Prohibition of Removal or Transplantation for any Purpose other than Therapeutic
Purposes
7.12 Explaining Effects, etc., to Donor and Recipient
7.13 Registration of Hospitals Engaged in Removal, Storage or Transplantation
7.14 Certificate of Registration
7.15 Suspension or Cancellation of Registration
7.16 Appeals
7.17 Punishment for Removal of Human Organ without Authority
7.18 Punishment for Commercial Dealings in Human Organs
7.19 Punishment for Contravention of any Provision of this Act
7.20 Offences by Companies
7.21 Let us Sum up
7.23 Keywords

z Get a clear idea about transplantation of Human Organs Act
z Know the various Government policies in regards to the Act 63
Transplantation of Human
z Know the various punishments on violation of the Act Organs Act
z Protect the consumer rights
7.1 INTRODUCTION
Transplantation means the grafting of any human organ from any living person or
deceased person to some other living person for therapeutic purposes. It is a life
threatening activity. Some of the medical practitioners are abusing the transplantation
of the human organs for commercial purpose. This Act is provides the regulation of
transplantation and removal of human organs.
7.2 COMMENCEMENT
This Act may be called the Transplantation of Human Organs Act, 1994.
7.3 DEFINITIONS
In this Act, unless the context otherwise requires:
z “Advertisement” includes any from of advertising whether to the public generally
or to any section of the public or individually to selected persons;
z “Appropriate Authority” mean the Appropriate Authority appointed under
Section 13;
z “Authorisation committee” means the committee constituted under clause (a) or
clause (b) of sub-section (4) of Section 9;
z “Brain-stem death” means the stage at which all functions of the brain - stem have
permanently and irreversibly ceased and is so certified under sub-section (6) of
Section 3;
z “Deceased person” means a person in whom permanent disappearance of all
evidence of life occurs, by reason of brain stem death or in a cardio-pulmonary
sense, at any time after live birth has taken place;
z “Donor” means any person, not less than eighteen years of age, who voluntarily
authorizes the removal of any of his human organs for therapeutic purposes under
sub-section (1) of sub-section (2) of Section 3;
z “Hospital” includes a nursing home, clinic, medical centre, medical or teaching
institution for therapeutic purposes and other like institution;
z “Human organ” means any part of a human body consisting of a structured
arrangement of tissues which, if wholly, removed, cannot be replicated by the
body;
z “Near relative” means spouse, son, daughter, father, mother brother or sister;
z “Notification” means a notification published in the Official Gazette;
z “Payment” means payment in money or money’s worth but does not include any
payment for defraying or reimbursing;
The cost removing, transporting or preserving the human organ to be,
supplied; or
Any expenses or less of earnings incurred by a person so far as reasonably
and directly attributable to his supplying any human organ from his body.
64 z “Recipient” means a person into whom any human organ is, or is proposed to be
transplanted;
z “Registered medical practitioner” means a medical practitioner who possesses any
recognized medical qualification as defined in clause (h) of Section 2 of the
Medical Council Act, 1956, who is enrolled on a State Medical Register as
defined in clause (k) of that section;
z “Therapeutic purpose” means systematic treatment of any disease or the measures
to improve health according to any particular method or modality;
z “Transplantation” means the grafting of any human organ from any living person
or deceased person to some other living person for therapeutic purposes.
7.4 AUTHORITY FOR REMOVAL OF HUMAN ORGANS

z Any donor may, in such manner and subject to such conditions as may be
prescribed, authorize the removal, before his death, of any human organs of his
body for therapeutic purposes.
z If any donor had, in writing and in the presence of two or more witnesses (at least
one of whom is a near relative of such person), unequivocally authorized at any
time before his death, the removal of any human organ of his body, after his
death, for therapeutic purposes, the person lawfully in possession of the dead body
of the donor shall, unless he has any reason of believe that the donor had
subsequently revoked the authority aforesaid, grant to a registered medical
practitioner all reasonable facilities for the removal, for therapeutic purposes, of
that human organ from the dead body of the donor.
z Where no such authority as is referred to in sub-section (2), was made by any
person before his death but no objection was also expressed by such person to any
of his human organs being used after his death for therapeutic purposes, authorize
the removal of any human organ of the deceased person for its use for therapeutic
purposes.
z The authority given under sub-section (1) or sub-section (2) or, as the case may
be, sub-section (3) shall be sufficient warrant for the removal, for therapeutic
purposes, of the human organ; but no such removal shall be made by any person
other than the registered medial practitioner.
z Where any human organ is to be removed from the body of a deceased person, the
registered medical practitioner shall satisfy himself, before such removal, by a
personal examination of the body from which any human organ is to be removed,
that life is extinct in such body, or where it appears to be a case of brain-stem
death, that such death has been certified under sub-section (6).
z Where any human organ is to be removed from the body of a person in the event
of his brain-stem death, no such removal shall be undertaken unless such death is
certified, in such form and in such manner and on satisfaction of such conditions
and requirements as may be prescribed, by a Board of medical experts consisting
of the following, namely:
the registered medical practitioner in charge of the hospital in which brain-
stem death has occurred;
an independent registered medical practitioner, being a specialist, to be
nominated by the registered medical practitioner specified in clause (1), from
the panel of names approval by the Appropriate Authority;
a neurologist or a neurosurgeon to be nominated by the registered medical
practitioner specified in clause (1), form the panel of names approved by the
Appropriate Authority; and
the registered medical practitioner treating the person whose brain-stem death 65
has occurred. Organs Act
Notwithstanding anything contained in sub-section (3) where brain-stem death of any
person, less than eighteen years of age, occurs and is certified under sub-section (6)
any of the parents of the deceased person may give authority, in such form and in such
manner as may be prescribed, for the removal of any human organ from the body of
the deceased person.
7.5 REMOVAL OF HUMAN ORGANS NOT TO BE

AUTHORISED IN CERTAIN CASES
No facilities shall be granted for the removal of any human organ from the body of a
deceased person, if the person required to grant such facilities, or empowered to give
such authority has reason to believe that an inquest may be required to be held in
relation to such body in pursuance of the provisions of any law for the time being in
force.
7.6 REMOVAL OF ORGANS IN CASE OF UNCLAIMED

BODIES
In the case of a dead body lying in a hospital or prison and not claimed by any of the
near relatives of the deceased person within forty-eight hours from the time of the
death of the concerned person the authority for the removal of any human organ from
the dead body which so remains unclaimed may be given in the prescribed form, by
the person in charge for the time being of the management or control of the hospital or
prison, or by an employee of such hospital or prison authorized in this behalf by the
person in charge of the management or control thereof.
7.7 REMOVAL OF ORGANS FROM BODIES SENT FOR

POSTMORTEM EXAMINATION FOR
MEDICOLOGICAL OR PATHOLOGICAL PURPOSES
Where the body of a person has been sent for post-mortem examination:
z For medico-legal purposes by reason of the death of such person having been
caused by accident or any other unnatural cause; or
z For pathological purposes the person competent under this act to give authority
for the removal of any human organ from such dead body may if he has reason to
believe that such human organ will not be required for the purposes for which
such body has been sent for post-mortem examination, authorize the removal for
therapeutic purpose, of that human organ of the deceased person provided that he
is satisfied that the deceased person had not expressed, before his death, any
objection to any of his human organs being used for therapeutic purposes after his
death or where he had granted an authority for the use of any of his human organs
for therapeutic purposes after his death, such authority had not been revoked by
him before his death.
7.8 PRESERVATION OF HUMAN ORGANS

After the removal of any human organ from the body of any person, the registered
medical practitioner shall take such steps for the preservation of the human organ so
removed as may be prescribed.
1. Define human organ.
……………………………………….……………………………………..
……………………………………….……………………………………..
2. What is transplantation?
……………………………………….……………………………………..
……………………………………….……………………………………..
3. What is brain-stem death?
……………………………………….……………………………………..
……………………………………….……………………………………..
7.9 RESTRICITIONS ON REMOVAL AND

TRANSPLANTATION OF HUMAN ORGANS
1. Save as otherwise provided in sub-section (3) no human organ removed from the
body of a donor before his death shall be transplanted into a recipient unless the
donor is a near relative of the reception.
2. Where any donor authorizes the removal of any of his human organs his death
under sub-section (2) of Section (3) of any person competent or empowered to
give authority for the removal of any human organ from the body of any deceased
person authorizes such removal the human organ may be removed and
transplanted into the body of any recipient who may be in need of such human
organ.
3. If any donor authorizes the removal of any of his human organs before his death
under sub-section (1) of Section 3 for transplantation into the body of such
recipient not being a near relative as is specified by the donor by reason of
affection or attachment towards the recipient or for any other special reasons such
human organ shall not be removed and transplanted without the prior approval of
the Authorisation Committee.
4. The Central Government shall constitute by notification one or more Authoriation
Committee consisting of such members as may be nominated by the Central
Government on such terms and conditions as may be specified in the notification
for each of the Union territories for the purposes of the section.
5. On an application jointly made in such form and in such manner as may be
prescribed by the donor and the recipient the Authorisation Committee shall after
holding an inquiry and satisfying itself that the applicants have complied with all
the requirements of this Act and the Rules made thereunder grant to the applicants
approval for the removal and transplantation of the human organ.
6. If after the inquiry and after giving an opportunity of being heard the
Authorisation Committee is satisfied that the applicants have not complied with
the requirements of this Act and the Rules made thereunder, it shall for reasons to
be recorded in writing reject the application for approval.
7.10 REGULATION OF HOSPITALS CONDUCTING THE

REMOVAL, STORAGE OR TRANSPLANTATION OF
HUMAN ORGANS
On and from the commencement of this Act:
z No hospital unless registered under this Act, shall conduct, or associate with or
help in the removal storage or transplantation of any human organ;
z No medical practitioner or any other person shall conduct or cause to be 67
conducted or aid in conducting by himself or through any other person any Organs Act
activity relating to the removal storage or transplantation of any human organ at a
place other than a place registered under this Act; and
z No place including a hospital registered under sub-section (1) of section shall be
used or cause to be used by any person for the removal storage or transplantation
of any human organ except for therapeutic purposes.
z Notwithstanding anything contained in sub-section (1) the eyes or the ears may be
removed at any place from the dead explanation–for the purposes of this sub-
section, “ears” includes ear drums and ear bones.
7.11 PROHIBITION OF REMOVAL OR

TRANSPLANTATION OF HUMAN ORGANS FOR ANY
PURPOSE OTHER THAN THERAPEUTIC PURPOSES
No donor and no person empowered to give authority for the removal of any organ
shall authorize the removal of any human organ for any purpose other than therapeutic
purposes.
7.12 EXPLAINING EFFECTS, ETC., TO DONOR AND

RECIPIENT
No registered medical practitioner shall undertake the removal or transplantation of
any human organ unless he has explained in such manner as may be prescribed all
possible effects complications and hazards connected with the removal and
transplantation to the donor and the recipient respectively.
7.13 REGISTRATION OF HOSPITAL ENGAGED IN

REMOVAL, STORAGE OR TRANSPLANTATION
No hospital shall commence any activity relating to the removal, storage or
transplantation of any human organ for therapeutic purposes after the commencement
of this Act unless such hospital is duly registered under this Act provided that every
hospital engaged either party or exclusively in any activity relating to the removal,
storage or transplantation of any human organ for therapeutic purposes immediately
before the commencement of this Act, shall apply for registration within sixty days
from the date of such commencement provided further that every hospital engaged in
any activity relating to the removal, storage or transplantation of any human organ
shall cease to engage in any such activity on the expiry of three months from the date
of commencement of this Act unless such hospital has appeared for registration and is
so registered or till such application is disposed or, whenever is earner.
7.14 CERTIFICATE OF REGISTRATION

The Appropriate Authority shall after holding an inquiry satisfying itself that the
applicant has complied with all the requirements of this Act and the Rules made there-
under grant to the hospital a certificate of registration in such form for such period and
subject to such conditions as may be prescribed.
If after the inquiry and after giving as opportunity to the applicant of being heard the
appropriate Authority is satisfied that the applicant has not complied with the
requirements of this Act and the Rules made thereunder it shall for reasons to be
recorded in writing reject the application for registration.
Every certificate of registration shall be renewed in such manner and on payment of
such fees as may be prescribed.
68
Health Laws and Policies 7.15 SUSPENSION OR CANCELLATION OF
REGISTRATION
The appropriate authority may suo motu or on complaint issue a notice to nay hospital
to show cause why its registration under this Act should not be suspended or cancelled
for the reasons mentioned in the notice.
If after giving a reasonable opportunity of being heard to the hospital, the appropriate
authority is satisfied that there has been a breach of any of the provisions of this Act
or the Rules made thereunder it may with out prejudice to any criminal action that it
may take against such hospital suspend its registration for such period as it may take
against such hospital suspend its registration for such period as it may think fit or
cancel its registration.
Provided that where the appropriate authority is of the opinion that it is necessary or
expedient so to do in the public interest it may for reasons to be recorded in writing
suspend the registration of any hospital without issuing any notice.
7.16 APPEALS
Any person aggrieved by an order of the Authorisation Committee rejecting an
application for approval under sub-section (6) of Section 9 or any hospital aggrieved
by an order of the Appropriate rejecting an application for registration under sub-
section (2) of Section 15 or an order of suspension or cancellation or registration
under sub-section (2) of Section 16, may within thirty day of the receipt of the order,
prefer an appeal in such manner as may be prescribed against such order to:
z The Central Government where the appeal is against the order of the
Authorisation Committee constituted under clause (a) of sub-section (4) of
Section 9 or against the order of the Appropriate Authority appointed under sub-
Section (1) of Section 13; or
z The State Government where the appeal is against the order of the authorization
committee under clause (b) of sub-section (4) of Section 9 or against the order of
the Appropriate Authority appointed under sub-section (2) of Section 13.
7.17 PUNISHMENT FOR REMOVAL OF HUMAN ORGAN

WITHOUT AUTHORITY
z Any person who renders his services to or at any hospital and who for purposes of
transplantation conducts associates with or helps in any manner in the removal of
any human organ without authority shall be punishable with imprisonment for a
term which may extend to five years and with fine which may extend to ten
thousand rupees.
z Where any person convicted under sub-section (1) is a registered medical
practitioner his name shall be reported by the Appropriate Authority to the
respective State Medical Council for taking necessary action including the
removal of his name from the registrar of the Council for a period of two years for
the first offence and permanently for the subsequent offence.
7.18 PUNISHMENT FOR COMMERCIAL DEALINGS IN

HUMAN ORGANS
Whoever:
1. Makes or receives any payment for the supply of or for an offer to supply any
human organ;
2. Seeks to find a person willing to supply for payment any human organ;
3. Offers to supply nay human organ for payment; 69
4. Initiates or negotiation any arrangement involving the making of any payment for Organs Act
the supply of an offer to supply any human organ;
5. takes part in the management or control of a body of persons whether a society
firm or company whose activities consist of or include the initiation or negotiation
of any arrangement referred to in clause (d); or
6. Publishes or distributes or causes to be published or distributed any
advertisement:
a) inviting persons to supply for payment of any human organ;
b) offering to supply any human organ for payment; or
c) indicating that the advertiser in willing to initiate or negotiate any
arrangement referred to in clause (d) shall be punished with imprisonment for
a term which shall not be less than two years but which may extend to seven
years and shall be liable to fine which shall not be less than ten thousand
rupees but may extend to twenty thousand rupees.
Provided that the court may for any adequate and special reason to be mentioned in
the judgment impose a sentences of imprisonment for a term of less than two years
and a fine less than ten thousand rupees.
7.19 PUNISHMENT FOR CONTRAVENTION OF ANY

PROVISION OF THIS ACT
Whoever contravenes any provision of this Act or any made of any condition of the
registration granted there under for which no punishment is separately provided in this
Act, shall be punishable with imprisonment for a term which may extend to three
years or with fine which may extend to five thousand rupees.
7.20 OFFENCES BY COMPANIES

Where any offence punishable under this act has been committed by a company every
person who at the time the offence 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 shall be deemed to be guilty of the offence and shall be liable to
proceeded against and punished accordingly.
Provided that nothing contained in this sub-section shall render any such person liable
to any punishment if he proves that the offences was committed without his
knowledge or that he had exercised all due diligence to prevent the commission of
such offence.
Notwithstanding anything contained in sub-section (1) where any offence punishable
under this act has been committed by a company and it is proved that the offence has
been committed 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 that
offence and shall be liable to be processed against and punished accordingly:
a) “Company” means any body corporate and includes a firm or other association of
individual; and
b) “director” in relation to a firm means a partner in the firm.
7.21 LET US SUM UP

The transplantation of Human Organs Act was passed on 1994. As per this Act human
organ means any part of a human body consisting of a structured arrangement of
70 tissues which, if wholly, removed, cannot be replicated by the body. And
transplantation means the grafting of any human organ from any living person or
deceased person to some other living person for therapeutic purposes. This Act
explains the authority for removal of human organs, removal of human organs not to
be authorised in certain cases, authority for removal organs in case of unclaimed
bodies in hospital or prison, authority for removal organs from bodies sent for
postmortem examination for medicological or pathological purposes, restrictions on
removal and transplantation of human organs, regulation of hospitals conducting the
removal, storage or transplantation of human organs, certificate of registration etc. If
any one contravenes the act-punishment for removal of human organ without
authority, punishment for commercial dealings in human organs are also explained
under this Act.

Discuss how some of the medical practitioners are abusing the patients in organ
transplantation?
7.23 KEYWORDS
Brain-stem death: It means the stage at which all functions of the brain-stem have
permanently and irreversibly ceased and is so certified under sub-section (6) of
Section 3.
Deceased person: It means a person in whom permanent disappearance of all
evidence of life occurs, by reason of brain stem death or in a cardio-pulmonary sense,
at any time after live birth has taken place.
Donor: It means any person, not less than eighteen years of age, who voluntarily
authorizes the removal of any of his human organs for therapeutic purposes under sub-
section (1) of sub-section (2) of Section 3.

1. Explain the authority and restrictions of transplantation of human organs.
2. Describe the registration of hospital engaged in removal, storage or
transplantation of human organs.
3. Elaborate the punishment for contravention of this Act.
1. Human organ means any part of a human body consisting of a structured
arrangement of tissues which, if wholly, removed, cannot be replicated by
the body.
2. Transplantation means the grafting of any human organ from any living
person or deceased person to some other living person for therapeutic
purposes.
3. Brain – stem death means the stage at which all functions of the brain -
stem have permanently and irreversibly ceased.

71
LESSON Prevention of Food
Adulteration Act
8
PREVENTION OF FOOD ADULTERATION ACT
CONTENTS
8.1 Introduction
8.2 Commencement
8.3 Definitions
8.4 Prohibition of Import of Certain Articles of Food
8.5 Prohibition of Manufacture, Sale, Etc….of Certain Articles of Food
8.6 Penalties
8.8 Let us Sum up
8.10 Keywords

z Know about food adulteration
z Understand the various concepts in regard to this Act
z Get a clear idea about adulterants
z Study the various punishment and penalties for the violation of this Act
8.1 INTRODUCTION
An Act provides regulations for manufacturing, distributing, sale and importing for
certain food and food articles. To prevent the adulteration of food and food articles.
8.2 COMMENCEMENT
z This Act may be called the Prevention of Food Adulteration Act, 1954.
z It extends to the whole of India.
The Central Government may, by notification in the Official Gazette, appoint.
8.3 DEFINITIONS
z “Adulterant” means any material which is or could be employed for the purpose
of adulteration.
72 z “Adulterated”-An article of food shall be deemed to be adulterated if the article
sold by the vendor is not of nature, if the article contains any other substance
injurious in nature, if any inferior or cheaper substance has been substituted, if
any constituent of the article has been wholly or in part abstracted so as to affect
injuriously the nature, substance or quality thereof, if the article has been
prepared, packed or kept under unsanitary condition, if the article consists wholly
or in part of any filthy putrid, rotten, decomposed or diseased animal or vegetable
substance or is insect infested or is other wise unfit for human consumption.
z “Central food laboratory” means any laboratory or institute established or
specified under Section 4.
z “Committee” means the Central Committee for food standards constituted under
Section 3.
z “Director of the central food laboratory” means the person appointed by the
Central Government by notification in the Official Gazette as the Director of the
Central Food Laboratory.
z “Food” means any article used as food or drink for human consumption other than
drugs and water.
z “Food (Health) Authority” means the director of medical and health service or the
chief officer in-charge of health administration in a state, by whatever designation
he is known, and includes any officer empowered by the Central Government or
the State Government, by notification in the Official Gazette, to exercise the
powers and perform the duties of the food authority under this Act with respect to
such local area as may be specified in the notification.
z “Local area” means any area; whether urban or rural declared by the central
Government or the State Government by notification is the Official Gazette, to be
a local area for the purposes of this Act.
z “Local authority” means in the case of, a local area which is a municipality, the
Municipal Board or the Municipal Corporation. A cantonment, the cantonment
authority, a notified area, the notified area committee.
z “Local (Health) authority” in relation to a local areas, means the officer appointed
by the Central Government or the State Government, by notification in the
Official Gazette, to be In-charge of Health Administration in such area with such
designation as may be specified therein.
z “Manufacture” includes any process incidental or ancillary to the manufacture of
an article of food.
z “Misbranded” an article of food shall be deemed to be misbranded if it is falsely
stated to be a product of any place or country.
z “Package” means box, bottle, casket, tin, barrel, case, respectable, sack, bag,
wrapper or other thing in which an article of food is sold or manufactured or
stored for sale.
z “Premises” include any shop, stall or place where any article of food is sold or
manufactured or stored for sale.
z “Prescribed” means prescribed by rules made under this Act.
z “Primary food” means any article of food, being a produce of agriculture or
horticulture in its natural form.
z “Sale” with its grammatical variations and cognate expressions, means the sale of
any article of food, whether for cash or on credit or by any other means for human
consumption.
z “Sample” means a sample of any article of food taken under the provisions of this 73
Prevention of Food
Act or of any rules made thereunder. Adulteration Act
8.4 PROHIBITION OF IMPORT OF CERTAIN ARTICLES

OF FOOD
No person shall import into India:
a) any adulterated food;
b) any misbranded food;
c) any article of food for the import of which a license is prescribed, except in
accordance with the conditions of the license; and
d) any article of food in contravention of any other provision of this Act or of any
Rules made thereunder.
8.5 PROHIBITION OF MANUFACTURE, SALE, ETC….OF

CERTAIN ARTICLES OF FOOD
No person shall himself or by any person on his behalf manufacture for Sale, or store,
sell or distribute:
a) any adulterated food;
b) any misbranded food;
c) any article of food for the sale of which a license is prescribed, except in
accordance with the conditions of the license;
d) any article of food the sale of which is for the time being prohibited by the food
authority in the interest of public health;
e) any article of food in contravention of any other provision of this Act or of any
Rules made thereunder; or
f) any adulterant.
Check Your Progress
1. What do you mean by adulterant?
………………………………………….…………………………………..
………………………………………….…………………………………..
2. What do you mean by primary food?
………………………………………….…………………………………..
………………………………………….…………………………………..
8.6 PENALTIES
1. If any person whether by himself or by any other person on his behalf, import into
India or manufactures for sale, or stores, sells or distributes any article of food:
which is adulterated, misbranded, which is injurious to health or which is
prohibited under any provision of this act or by an order of food authority.
2. Prevents a food inspector from taking a sample as authorized by this act or from
excising any other power conferred on him.
3. Whether by himself or by any other person on his behalf, gives to vendor a false
warranty in writing in respect of any article of food sold by him.
74 He shall, in addition to the penalty to which he may be liable under the provisions, be
punishable with imprisonment for term which shall not be less than six months but
which may extend to 3 years, and with fine which shall not be less than 1000 rupees.

Where a company has different establishments or branches or different units in any
establishment or branch, different persons may be nominated under this sub-section in
relation to different establishment or branches or units and the person nominated in
relation to any establishment, branch or unit shall be deemed to be the person
responsible in respect of such establishment, branch or unit.
8.8 LET US SUM UP

The Prevention of Food Adulteration Act was passed on 1954. This Act deals with the
food adulteration and its prohibitions. An article of food shall be deemed to be
adulterated, if the article sold by the vendor is not of nature, if the article contains any
other substance injurious in nature, if any inferior or cheaper substance has been
substituted, if any constituent of the article has been wholly or in part abstracted so as
to affect injuriously the nature, substance or quality there of, if the article has been
prepared, packed or kept under unsanitary condition, if the article consists wholly or
in part of any filthy putrid, rotten, decomposed or diseased animal or vegetable
substance or is insect infested or is other wise unfit for human consumption. And an
article of food shall be deemed to be misbranded- if it is falsely stated to be a product
of any place or country. Under this Act no person shall be import, manufacture,
distribute or sale of any adulterated food, any misbranded food, any article of food for
the import of which a license is prescribed, except in accordance with the conditions
of the license; and, any article of food in contravention of any other provision of this
act or of any Rules made thereunder. If any person contravene this Act will be
penalized.

Make a survey among your neighbors about the awareness of this Act and how many
of them used this act in their issues?
8.10 KEYWORDS
Adulterant: It means any material which is or could be employed for the purpose of
adulteration.
Central food laboratory: It means any laboratory or institute established or specified
under Section 4.
Committee: It means the central committee for food standards constituted under
Section 3.
Director of the central food laboratory: It means the person appointed by the Central
Government by notification in the Official Gazette as the Director of the Central Food
Laboratory.
Food: It means any article used as food or drink for human consumption other than
drugs and water.

Explain in detail the Prevention of Food Adulteration Act.
Prevention of Food
Adulteration Act
1. Adulterant means any material which is or could be employed for the
purpose of adulteration.
2. Primary food means any article of food, being a produce of agriculture or
horticulture in its natural form.

Dr. Narayan Reddy. K.S., The Essentials of Forensic Medicine and Toxicology, K. Suguna
76
9
MEDICAL TERMINATION OF PREGNANCY
(AMENDMENT) ACT, 2003
CONTENTS
9.1 Introduction
9.3 Definitions
9.4 Composition and Tenure of District Level Committee
9.5 Experience and Training
9.6 Place where Pregnancy may be Terminated
9.7 Approval of a Place
9.8 Inspection of a Place
9.9 Cancellation or Suspension of Certificate of Approval
9.10 Review
9.11 Let us Sum up
9.13 Keywords

z Understand the act and its amendments
z Know about the qualification of a physician, facilities required and the place for
approval of MTP
9.1 INTRODUCTION
The termination of pregnancy by a person who is not a registered medical practitioner
shall be an offence punishable. And whoever terminates any pregnancy in a place
other that that mentioned in the Act shall be punishable. This Act provides the
regulations for the medical termination of pregnancy.

z This Act may be called the Medical Termination of Pregnancy (Amendment) Act,
2003.
notification in the Official Gazette, appoint.
77
9.3 DEFINITIONS Medical Termination of Pregnancy
(Amendment) Act, 2003
In this rules, unless the context otherwise requires:
z “Act” means the Medical Termination of Pregnancy Act, 1971 (34 of 1971) and
the Medical Termination of Pregnancy (Amendment) Act, 2002 (64 of 2002).
z “Chief Medical Officer of the District” means the Chief Medical Officer of a
District, by whatever name called;
z “Form” means a form appended to these rules;
z “Owner” in relation to a place means any person who is the administrative head or
otherwise responsible for the working or maintenance of a hospital or place, by
whatever name called, where the pregnancy may be terminated under this Act;
z “Committee” means a committee constituted at the district level under the proviso
to clause (b) of Section 4 read rule 3.
9.4 COMPOSITION AND TENURE OF DISTRICT LEVEL

COMMITTEE
z One member of the District Level Committee shall be the Gynaecologist/Surgeon/
Anaesthetist and other members from the local medical profession, non-
governmental organization, and Panchayat Raj Institution of the district:
Provided that one of the members of the Committee shall be a woman.
z Tenure of the committee shall be for two calendar years and the tenure of the non-
government members shall not be more than two terms.
9.5 EXPERIENCE AND TRAINING

A registered medical practitioner shall have one or more of the following experience
or training in gynecology and obstetrics, namely:
z In the case of a medical practitioner, who was registered in a state Medical
Register immediately before the commencement of the Act, experience in the
practice of gynecology and obstetrics for a period of not less than three years;
z In the case of a medical practitioner, who is registered in a state Medical Register:
(i) if he has completed six months of house surgency in gynecology and
obstetrics; or
(ii) unless the following facilities are provided therein, if he had experience at any
hospital for a period of not less than one year in the practice of obstetrics and
gynecology; or
z If he has assisted a registered medical practitioner in the performance of twenty-
five cases of medical termination of pregnancy of which at least five been
performed independently, in a hospital established or maintained or a training
institute approved for this purpose by the Government:
(i) This training would enable the Registered Medical Practitioner (RMP) to do
only 1st trimester terminations (up to 12 weeks of gestation)
(ii) For terminations up to 20 weeks the experience or training as prescribed
under sub rules (a), (b) & (d) shall apply.
z In case of a medical practitioner who has been registered in a state medical
register and who holds a post graduate degree or diploma in gynaecology and
obstetrics, the experience or training.
78
Health Laws and Policies 9.6 PLACE WHERE PREGNANCY MAY BE TERMINATED
No termination of pregnancy shall be made in accordance with this Act substituted
namely:
z A hospital established or maintained by Government.
z A place for the time being approved for the purpose of this Act by Government or
a District Level Committee constituted by that Government with the Chief
Medical Officer or District Health Officer as the Chairperson of the said
Committee.
Provided that the District Level Committee shall consist of not less than three and not
more than five members including the Chairperson, as the Government may specify
from time to time.
9.7 APPROVAL OF A PLACE

1. No place shall be approved:
unless the government is satisfied that termination of pregnancies may be
done therein under sage and hygienic conditions; and
unless the following facilities are provided therein namely
In case of first trimester that is up to 12 weeks of pregnancy:
a gynecology examination labour table resuscitation and sterilization
equipment drugs and parental fluid back up facilities for treatment of shock
and facilities for transportation and
In case of second trimester that is up to 20 weeks of pregnancy:
An operation table and instruments for performing abdominal or
gynecological surgery.
Anesthetic equipment resuscitation equipment and sterilization equipment.
Drugs and parental fluids for emergency use notified by Government of India
from time to time.
2. Every application for the approval of a place shall be in a form a and shall be
addressed to the Chief Medical Officer of the district.
3. On receipt of an application under sub-rule the Chief Medical Officer of the
district may verify and information contained in any such application or inspect
any such place with a view to satisfying himself that the facilities referred to in
sub-rule are provided and that termination of pregnancies may be made under safe
and hygienic conditions.
4. Every owner of the place which is inspected by the Chief Medical Officer of the
district shall afford all reasonable facilities for the inspection of the place.
5. The Chief Medical Officer of the district may if he is satisfied after such
verification enquiry or inspection as may be considered necessary that termination
of pregnancies may be done under safe and hygienic conditions at the place
recommended the approval of such place to the committee.
6. The committee may after considering the application and the recommendations of
the chief medical officer of the district approve such place and issue a certificate
of approval in form b.
7. The certificate of approval issued by the committee shall be conspicuously
displayed at the place to be easily visible to persons visiting the place.
8. The place shall be inspected within 2 months of receiving the application and
certificate of approval may be issued within the next 2 months or in case any
deficiency has been noted with in 2 months of the deficiency having been rectified 79
Medical Termination of Pregnancy
by the applicant. (Amendment) Act, 2003
9. On the commencement of these rules a place approved in accordance with the
Medical Termination of Pregnancy Rules, 1975 shall be deemed to have been
approved under these Rules.
Check Your Progress
1. Who are all the members in the District Level Committee under MTP
Act.
…………………………………….………………………………………..
…………………………………….………………………………………..
2. What are the facilities required to get approval of a place for MTP?
…………………………………….………………………………………..
…………………………………….………………………………………..
9.8 INSPECTION OF A PLACE

z A place approved under rule 5 may be inspected by the Chief Medical Officer of
the district as often as may be necessary with a view to verify whether termination
of pregnancies is being done therein under safe and hygienic conditions.
z If the Chief Medical Officer has reason to believe that has been death of or injury
to a pregnant woman at the place or that termination of pregnancies is not being
done at the place under safe and hygienic conditions, he may call for any
information or may seize any article medicine, ampule, admission register or other
document maintained kept or found at the place.
z The provisions of the Code of Criminal Procedure, 1973 (2 of 1974) relating to
seizure shall so far as it may apply to seizure made under sub-rule (2).
9.9 CANCELLATION OR SUSPENSION OF CERTIFICATE

OF APPROVAL
z If after inspection of any place approved under rule 5 the Chief Medical Officer of
the District is satisfied in rule 5 are not being properly maintained therein and the
termination of pregnancy at such cannot be made under safe and hygienic
conditions he shall make a report of the fact to the committee giving the detail of
the deficiencies or defects found at the place and the committee may if it is
satisfied suspend or cancel the approval provided that the committee issued under
rule 5 is cancelled.
z Where a certificate issued under the rule 5 is cancelled the owner of the place may
make such additions or improvements in the place and there after he may make an
application to the committee for grant of approval under rule 5.
z In the event of suspension of a certificate of approval the place shall not be
deemed to be an approved place during the suspension for the purposes of
termination of pregnancy from the date of communication of the order of such
suspension.
9.10 REVIEW
z The owner of a place who is aggrieved by an order made under rule 7 may make
an application for review of the order to the Government within a period of sixty
days from the date of such order.
80 Provided that the Government may condone any delay in case it is satisfied that
applicant was prevented by sufficient cause to make application within time.
z The Government may giving the owner an opportunity of being heard confirm
modify or reverse the order.
9.11 LET US SUM UP

The Medical Termination of Pregnancy (Amendment) Act, 2003. The termination of
pregnancy by a registered medical practitioner, who shall have the experience and
training specified under this Act. No termination of pregnancy shall be made in
accordance with this Act substituted namely-A hospital established or maintained by
Government, A place for the time being approved for the purpose of this Act by
Government or a District Level Committee constituted by that Government with the
Chief Medical Officer or District Health Officer as the Chairperson of the said
Committee. The contravention of this Act shall be punishable with rigorous
imprisonment for a term which shall not be less than two years but which may extend
to seven years.

Know how many hospitals are approved by the concerned authorities to done MTP in
your city.
9.13 KEYWORDS
RMP: Registered Medical Practitioner.
MTP: Medical Termination of Pregnancy.

1. Explain in detail about MTP Act.
2. Write the rules for approval of a place for medical termination of a pregnancy.

1. One member of the District Level Committee shall be the
Gynaecologist/Surgeon/Anaesthetist and other members from the local
medical profession, non-governmental organization, and Panchayati Raj
Institution of the District:
Provided that one of the members of the Committee shall be a woman.
2. In case of first trimester that is up to 12 weeks of pregnancy:
a gynaecology examination labour table resuscitation and sterilization
equipment drugs and parental fluid back up facilities for treatment of
shock and facilities for transportation and in case of second trimester
that is up to 20 weeks of pregnancy.
an operation table and instruments for performing abdominal or
gynaecological surgery.
anaesthetic equipment resuscitation equipment and sterilization
equipment.
drugs and parental fluids for emergency use notified by government
of India from time to time.

81
LESSON Registration of Births and
Deaths Act
10
REGISTRATION OF BIRTHS AND DEATHS ACT
CONTENTS
10.1 Introduction
10.2 Commencement
10.3 Definitions
10.4 Registrar-General of India
10.5 Chief Registrar
10.6 Registration Divisions
10.7 District Registrar
10.8 Registrars
10.9 Persons Required to Register Births and Deaths
10.10 Revision Regarding Births and Deaths in a Plantation
10.11 Persons to Notify Births and Deaths
10.12 Informant to Sign the Register
10.13 Extracts of Registration Entries to be Given to Informant
10.14 Delayed Registration of Births and Deaths
10.15 Registration of Name of Child
10.16 Correction or Cancellation of Entry
10.17 Registrars to Keep Registers in the Prescribed Form
10.18 Let us Sum up
10.20 Keywords

z Get an idea about the importance of Birth and Death Registration
z Understand the procedure for registering birth and death
z Know about the delayed registration of birth and death
10.1 INTRODUCTION
An Act provides norms for the Registration of Birth and Death. And provide
regulations to the Registrars from Central Government to District level.
82
Health Laws and Policies 10.2 COMMENCEMENT
1. This Act may be called the Registration of Births and Deaths Act, 1969.
2. It extends to the whole of India.
3. It shall come into force in a State on such date 1 as the Central Government may,
by notification in the Official Gazette, appoint.
Provided that different dates may be appointed for different parts of a State.
10.3 DEFINITIONS
z “Birth” means live-birth or still-birth;
z “Death” means the permanent disappearance of all evidence of life at any time
after live-birth has taken place;
z “Focal Death” means absence of all evidence of life prior to the complete
expulsion or extraction from its mother of a product of conception irrespective of
the duration of pregnancy;
z “Live-birth” means the complete expulsion or extraction from its mother of a
product of conception, irrespective of the duration of pregnancy, which, after such
expulsion or extraction, breathes or shows any other evidence of life, and each
product of such birth is considered live-born;
z “State Government” in relation to a Union territory, means the Administrator
thereof;
z “Still-birth” means foetal death where a product of conception has attained at least
the prescribed period of gestation.
10.4 REGISTRAR-GENERAL OF INDIA

z The Central Government may, by notification in the Official Gazette, appoint a
person to be known as the Registrar-General of India.
z The Central Government may also appoint such other officers with such
designations as it thinks fit for the purpose of discharging, under the
superintendence and direction of the Registrar-General, such functions of the
Registrar-General under this Act as he may, from time to time, authorize them to
discharge.
z The Registrar-General may issue general directions regarding registration of
births and deaths in the territories to which this Act extends, and shall take steps
to co-ordinate and unify the activities of Chief Registrars in the matter of
registration of births and deaths and submit to the Central Government an annual
report on the working of this act in the said territories.
10.5 CHIEF REGISTRAR

z Government may, by notification in the Official Gazette, appoint a Chief
Registrar for the State.
z The State Government may also appoint such other officers with such
designations at it thinks fit for the purpose of discharging, under the
superintendence and direction of the Chief Registrar, Such of his functions as he
may, from time to time, authorize them to discharge.
z The Chief Registrar shall be the chief executive authority in the State for caring 83
Registration of Births and
into execution the provisions of this Act and the Rules and orders made Deaths Act
thereunder subject to the directions, if any, given by the State Government.
z The Chief Registrar shall take steps, by the issue of suitable instructions or
otherwise, to co-ordinate, unify and supervise the work of registration in the State
for securing an efficient system of registration and shall prepare and submit to the
State Government, in such manner and at such intervals as may be prescribed, a
report on the working of this Act in the State along with the statistical report
referred to in sub-section (2) of Section 19.
10.6 REGISTRATION DIVISIONS

The State Government may, by notification in the Official Gazette, divide the territory
within the State into such registration division as it may think fit and prescribe
different rules for different registration divisions.
10.7 DISTRICT REGISTRAR

z The State Government may appoint a District Registrar for each revenue district
and such number of Additional District Registrars as it thinks fit who shall,
subject to the general control and direction of the District Registrar, discharge
such functions of the District Registrar as the District Registrar may, from time to
time, authorize them to discharge.
z The District Registrar shall superintend, subject to the direction of the Chief
Registrar, the registration of births and deaths in the district and shall be
responsible for carring into execution in the district the provisions of this Act and
the orders of the Chief Registrar issued from time to time for the purposes of
this Act.
10.8 REGISTRARS
z The State Government may appoint a Registrar for each local area comprising the
area within the jurisdiction of a municipality, panchayat or other local authority or
any other area or a combination of any two or more of them.
z Provided that the State Government may appoint in the case of a municipality,
panchayat or other local authority, any officer or other employee thereof as a
Registrar.
z Every Registrar shall, without fee or reward, enter in the register maintained for
the purpose all information given to him under Section 8 or Section 9 and shall
also take steps to inform himself carefully of every birth and of every death which
takes place in his jurisdiction and to ascertain and register the particulars required
to be registered.
z Every Registrar shall have an office in the local area for which he is appointed.
z Every Registrar shall attend his office for the purpose of registering births and
deaths on such days and at such hours as the Chief Registrar may direct and shall
cause to be placed in some conspicuous place on or near the outer door of the
office of the Registrar a board bearing in the local language, his name with the
addition of Registrar of Births and Deaths for the local area for which he is
appointed and the days and hours of his attendance.
z The Registrar may, with the prior approval of the Chief Registrar, appoint Sub-
Registrars and assign to them any or all of his power and duties in relation to
specified areas within his jurisdiction.
84
Health Laws and Policies 10.9 PERSONS REQUIRED TO REGISTER BIRTHS AND
DEATHS
z It shall be the duty of the persons specified below to give or cause to be given,
either orally or in writing, according to the best of their knowledge and belief,
within such time as may be prescribed, information to the Registrar of the several
particulars required to be entered in the forms prescribed by the State Government
under sub-section (1) of Section 16:
(a) In respect of births and deaths in a house, whether residential or on-
residential, not being any place referred to in clauses (b) to (e), the head of the
house or, in case more than one household live in the house, the head of the
household, the head being the person, who is so recognized by the house or
the household, and if he is not present in the house at any time during the
period within which the birth or death has to be reported, the nearest relative
of the head present in the house, and in the absence of any such person, the
oldest adult male person present therein during the said period;
(b) In respect of births and deaths in a hospital, health center, maternity or
nursing home or other like institution, the medical officer in charge or any
person authorized by him in the behalf;
(c) In respect of births and deaths in a jail, the jailor in charge;
(d) In respect of births and deaths in choultry, chattram, hostel, dharmasala,
boarding-house, lodging-house, tavern, barrack, toddy shop or place of public
resort the person in charge thereof;
(e) In respect of any new-born child or dead body found deserted in a public
place, the head-man or other corresponding officer of the village in the case of
a village and the other in charge of the local police station elsewhere:
Provided that any person who finds such child or dead body, or in whose
charge such child or dead body may be placed, shall notify such fact to the
headman or officer aforesaid;
(f) In any other place, such person as may be prescribed.
10.10 REVISION REGARDING BIRTHS AND DEATHS IN A

PLANTATION
In the case of births and deaths in a plantation, the superintendent of the plantation
shall give or cause to be given to the Registrar the information referred to in Section 8.
Provided that the persons referred to in clauses (a) to (f) of sub-section (1) of section 8
shall furnish the necessary particulars to the superintendent of the plantation.
Explanation: In the section, the expression “Plantation” means any land not less than
four hectares in extent which is being prepared for the production of, of actually
produces, tea, coffee, paper, rubber, cardamom, cinchona or such other products as the
State Government may, by notification in the Official Gazette, specify and the
expression “Superintendent of the plantation” means the person having the charge or
supervision of the labourers and work in the plantation, whether called a manager,
superintendent or by any other name.
10.11 PERSONS TO NOTIFY BIRTHS AND DEATHS

z It shall be the duty of:
(i) The midwife or any other medical or health attendant at a birth or death,
(ii) The keeper or the owner of a place set apart for the disposal of dead bodies or 85
any person required by a local authority to be present at such place, or Deaths Act
(iii) Any other person whom the State Government may specify in this behalf by
his designation, to notify every birth or deaths or both at which he or she
attended or was present, or which occurred in such areas as may be
prescribed, to the Registrar within such time and in such manner as may be
prescribed.
z In any area, the State Government, having regard to the facilities available therein
in this behalf, may require that a certificate as to the cause of death shall be
obtained by the Registrar from such person and in such form as may be
prescribed.
z Where the State Government has required under sub-section (2) that a certificate
as to the cause of deaths shall be obtained, in the event of the death of any person
who, during his last illness, was attended by a medical practitioner, the medical
practitioner shall, after the death of that person, forthwith, issue without charging
any fee, to the person required under this Act to give information concerning the
death, a certificate in the prescribed form stating to the best of his knowledge and
belief the cause of death; and the certificate shall be received and delivered by
such person to the Registrar at the time of giving information concerning the
death as required by this Act.
Check Your Progress
1. What is focal death?
……………………………………………………………………………...
……………………………………………………………………………...
2. What is still-birth?
……………………………………………………………………………...
……………………………………………………………………………...
3. What is live-birth?
……………………………………………………………………………...
……………………………………………………………………………...
10.12 INFORMANT TO SIGN THE REGISTER

Every person who has orally given to the Registrar any information required under
this Act shall write in the register maintained in this behalf, his name, description and
place of abode, and, if he cannot write, shall put his thumb mark in the register against
his name, description and place of abode, the particulars being in such a case entered
by the Registrar.
10.13 EXTRACTS OF REGISTRATION ENTRIES TO BE

GIVEN TO INFORMANT
The Registrar shall, as soon as the registration of a birth or deaths has been completed,
give, free of charge, to the person who gives information under Section 8 or section 9
an extract of the prescribed particulars under his hand from the register relating to
such birth or death.
86
Health Laws and Policies 10.14 DELAYED REGISTRATION OF BIRTHS AND
DEATHS
z Any birth or death or which information is given to the Registrar after the expiry
of the period specified therefore, but within thirty days of its occurrence, shall be
registered on payment of such late fee as may be prescribed.
z Any birth or death of which delayed information is given to the Registrar after
thirty days but within one year of its occurrence shall be registered only with the
written permission of the prescribed authority and on payment of the prescribed
fee and the production of an affidavit made before a notary public or nay other
officer authorized in this behalf by the State Government.
z Any birth or death, which has not been registered within one year of its
occurrence, shall be registered only on an order made by a Magistrate of the first
class or a Presidency Magistrate after verifying the correctness of the birth or
death and on payment of the prescribed fee.
z The provisions of this section shall be without prejudice to any action that may be
taken against a person for failure on his part to register any birth or death within
the time specified therefore and any such birth or death may be registered during
the pendency of any such action.
10.15 REGISTRATION OF NAME OF CHILD

Where the birth of any child has been registered without a name, the parent or
guardian of such child shall within the prescribed period give information regarding
the name of the child to the registrar either orally or in writing and thereupon the
Registrar shall enter such name in the register and initial and date the entry.
10.16 CORRECTION OR CANCELLATION OF ENTRY

If it is proved to the satisfaction of the Registrar that any entry of a birth or death in
any register kept by him under this Act is erroneous in form or substance, or has been
fraudulently or improperly made, he may, subject to such rules as may be made by the
State Government with respect to the conditions on which and the circumstances in
which such entries may be corrected or cancelled, correct the error or cancel the entry
by suitable entry in the margin, without any alteration of the original entry, and shall
sign the marginal entry and add thereto the date of the correction or cancellation.
10.17 REGISTRARS TO KEEP REGISTERS IN THE

PRESCRIBED FORM
z Every Registrar shall keep in the prescribed form a register of births and deaths
for the registration area or any part thereof in relation to which he exercises
jurisdiction.
z The Chief Registrar shall cause to be printed and supplied a sufficient number of
register books for making entries of births and deaths according to such forms and
instructions as may, from time to time, be prescribed; and a copy of such forms in
the local language shall be posted in some conspicuous place on or near the outer
door of the office of every Registrar.
10.18 LET US SUM UP

Registration of Births and Deaths Act, 1969. As per this Act Birth means live-birth or
still-birth. Death means the permanent disappearance of all evidence of life at any
time after liver-birth has taken place. This Act also gives meaning about focal death,
live-birth and still-birth. It explains the norms and responsibilities of registrar-general 87
of India, chief registrar, registration divisions, district registrar and registrars. Under Deaths Act
this Act it shall be the duty of some persons such as hospital administrator, jailor or
the person incharge of choultry, chattram, hostel, dharmasala, boarding-house,
lodging-house, tavern, barrack, toddy shop or place of public resort etc., required to
register births and deaths. The Registrar shall, as soon as the registration of a birth or
deaths has been completed, give, free of charge, to the person who gives information.
Under this Act also explains the delayed registration and cancellation or correction of
birth and death.

Know about the role of Hospital Administrator in Registering Birth and Death which
are happening in their hospital.
10.20 KEYWORDS
Birth: It means live-birth or still-birth.
Death: It means the permanent disappearance of all evidence of life at any time after
live-birth has taken place.
Focal death: It means absence of all evidence of life prior to the complete expulsion
or extraction from its mother of a product of conception irrespective of the duration of
pregnancy.
Live-birth: It means the complete expulsion or extraction from its mother of a product
of conception, irrespective of the duration of pregnancy, which, after such expulsion
or extraction, breathes or shows any other evidence of life, and each product of such
birth is considered live-born.
Still-birth: It means foetal death where a product of conception has attained at least
the prescribed period of gestation.

1. Who should register birth and death?
2. What is the procedure for delayed registration?

1. Focal Death means absence of all evidence of life prior to the complete
expulsion or extraction from its mother of a product of conception
irrespective of the duration of pregnancy.
2. Still-birth means foetal death where a product of conception has attained
at least the prescribed period of gestation.
3. Live-birth means the complete expulsion or extraction from its mother of
a product of conception, irrespective of the duration of pregnancy, which,
after such expulsion or extraction, breathes or shows any other evidence
of life, and each product of such birth is considered live-born.

88
11
PRE-NATAL DIAGNOSTIC TECHNIQUES
CONTENTS
11.1 Introduction
11.2 Commencement
11.3 Definitions
11.4 Regulation of Genetic Counselling Centers, Laboratories and Clinics
11.5 Regulation of Pre-Natal Diagnostic Techniques
11.6 Determination of Sex Prohibited
11.7 Constitution of Central Supervisory Board
11.8 Term of Office of Members
11.9 Meetings of the Board
11.10 Functions of the Board
11.11 Registration of Genetic Counselling Centers, Laboratories and Clinics
11.12 Certificate of Registration
11.13 Cancellations or Suspension of Registration
11.14 Appeal
11.15 Offences and Penalties
11.16 Resumption in the Case of Conduct of Pre-Natal Diagnostic Techniques
11.17 Penalty for Contravention of the Provisions of the Act
11.19 Let us Sum up
11.21 Keywords

z Understand the regulation of genetic centers and for pre-natal diagnostic
techniques
z Know about the functions of the board under Pre-natal Diagnostic Act
z Know about the offences and penalties under this Act
89
11.1 INTRODUCTION Pre-natal Diagnostic Techniques
An Act to provide for the regulation of the use of pre-natal diagnostic techniques for
the purpose of detecting genetic or metabolic disorders or chromosomal abnormalities
or certain congenital malformations or sex-linked disorders and for the prevention of
the misuse of such techniques for the purpose of pre-natal sex determination leading
to female foeticide; and, for matters connected there with or incidental thereto.
11.2 COMMENCEMENT
z This Act may be called the Prenatal Diagnostic Techniques (Regulation and
Prevention of Misuse) Act, 1994.
z It shall extend to the whole of India except the State of Jammu and Kashmir.
11.3 DEFINITIONS
z “Appropriate Authority” means the Appropriate Authority appointed under
Section 17;
z “Board” means the Central Supervisory Board constituted under Section 7;
z “Genetic Counseling Central” means and institute, hospital, nursing home or any
place, by whatever name called, which provides for genetic counseling to patients;
z “Genetic Clinic” means a clinic, institute, hospital, nursing home or any place, by
whatever name called, which is used for conducting pre-natal diagnostic
procedures;
z “Genetic Laboratory” means a laboratory and includes a place where facilities are
provided for conducting analysis or tests of samples received form Genetic Clinic
for pre-natal diagnostic test;
z “Gynaecologist” means a person who possesses a post-graduate qualification in
gynecology and obstetrics;
z “Medical Geneticist” means a person who possesses a degree or diploma or
certificate in medical genetics in the field of pre-natal diagnostic techniques or has
experience of not less than two years in such field after obtaining any one of the
medical qualifications recognized under the Indian Medical Council Act, 1956; or
A post-graduate degree in biological sciences;
z “Pediatrician” means a person who possesses a post-graduate qualification in
pediatrics;
z “Pre-natal diagnostic procedures” means all gynecological or obstetrical or
medical procedures such as ultrasonography foetoscopy, taking or removing
samples of amniotic fluid, chorionic villi, blood or any tissue of a pregnant
woman for being sent to a Genetic Laboratory or Genetic Clinic for conducting
pre-natal diagnostic test;
z “Pre-natal diagnostic techniques” includes all pre-natal diagnostic procedures and
pre-natal diagnostic tests;
z “Pre-natal diagnostic test” means ultrasonography or any test or analysis of
amniotic fluid, chorionic villi, blood or any tissue of a pregnant woman conducted
to detect genetic or metabolic disorders or chromosomal abnormalities or
congenital anomalies or haemoglobinopathies or sex linked diseases;
90 z “Prescribed” means prescribed by rules made under this Act;
z “Registered medical practitioner” means a medical practitioner who possesses any
recognized medical qualification as defined in clause (h) of Section 2 of the
Indian Medical Council Act, 1956, (102 of 1956.) and whose name has been
entered in a State Medical Register;
z “Regulations” means regulations framed by the Board under this Act.
11.4 REGULATION OF GENETIC COUNSELLING

CENTERS, LABORATORIES AND CLINICS
z No Genetic Counselling Center, Genetic Laboratory or Genetic Clinic unless
registered under this Act, shall conduct or associate with, or help in, conducting
activities relating to pre-natal diagnostic techniques;
z No Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic shall
employed cause to be employed any person who does not possess the prescribed
qualifications;
z No medical geneticist, gynaecologist, pediatrician, registered medical practitioner
or any other person shall conduct or cause to be conducted or aid in conducting by
himself or though any other person, any pre-natal diagnostic techniques at a place
other than a place registered under this Act.
11.5 REGULATION OF PRE-NATAL DIAGNOSTIC

TECHNIQUES
z No place including a registered Genetic Counselling Centre or Genetic Laboratory
or Genetic Clinic shall be used or caused to be used by any person for conducting
pre-natal diagnostic techniques except for the purposes specified in clause (2) and
after satisfying any of the conditions specified in clause (3);
z No Pre-natal diagnostic techniques shall be conducted except for the purposes of
detection of any of the following abnormalities, namely:
Chromosomal abnormalities;
Genetic metabolic diseases
Haemoglobinopathies;
Sex-linked genetic disease;
Congenital anomalies;
Any other abnormalities or disease as may be specified by the Central
Supervisory Board;
z No pre-natal diagnostic techniques shall be used or conducted unless the person
qualified to do so is satisfied that any of the following conditions are fulfilled,
namely:
Age of the pregnant woman is above thirty-five years;
The pregnant woman has undergone of two or more spontaneous abortions or
foetal loss;
The pregnant woman had been exposed to potentially teratogenic agents such
as drugs, radiation, infection or chemicals;
The pregnant woman has a family history of mental retardation or physical 91
deformities such as spasticity or any other genetic disease; Pre-natal Diagnostic Techniques
Any other condition as may be specified by the Central Supervisory Board.

z No person, being relative or the husband of the pregnant woman shall seek or
encourage the conduct of any pre-natal diagnostic techniques on her except for the
purpose specified in clause (2).
z Written consent of pregnant woman and prohibition of communicating the sex of
foetus. No person referred to in clause (2) of Section 3 shall conduct the pre-natal
diagnostic procedures unless:
He has explained all known side and after effects of such procedures to the
pregnant woman concerned;
He has obtained in the prescribed form her written consent to undergo such
procedures in the language which she understands; and
A copy of her written consent obtained under clause (b) is given to the
pregnant woman.
z No person conducting pre-natal diagnostic procedures shall communicate to the
pregnant woman concerned or her relatives the sex of the foetus by words, signs
or in any other manner.
11.6 DETERMINATION OF SEX PROHIBITED

z No Genetic Counselling Centre of Genetic Laboratory or Genetic Clinic shall
conduct or cause to be conducted in its Centre, Laboratory or Clinic, pre-natal
diagnostic techniques including ultrasonography, for the purpose of determining
the sex of a foetus;
z No person shall conduct or cause to be conducted any pre-natal diagnostic
techniques including ultrasonography for the purpose of determining the sex of a
foetus.
11.7 CONSTITUTION OF CENTRAL SUPERVISORY

BOARD
z The Central Government shall constitute a Board to be known as the Central
Supervisory Board to exercise the powers and perform the functions conferred on
the Board under this Act.
z The Board shall consist of:
(a) The Minister in charge of the Ministry of Department of Family Welfare, who
shall be the Chairman, ex officio;
(b) The Secretary to the Government of India in charge of the Department of
Family Welfare, who shall be the Vice-Chairman, ex-officio;
(c) The Director General of Health Services of the Central Government, ex
officio;
(d) The members to be appointed by the Central Government, two each from
amongst:
(i) Eminent medical geneticist;
(ii) Eminent gynaecologists and obstetricians;
(iii) Eminent paediatricians;
92 (iv) Eminent social scientists; and
(v) Representatives of women welfare organizations;
(e) Three women Members of Parliament, of whom two shall be elected by the
House of the People and one by the Council of States;
(f) Our members to be appointed by the Central Government by rotation to
represent the States and the Union territories, two in the alphabetical order
and two in the reverse alphabetical order:
Provided that no appointment under this clause shall be made except on the
recommendation of the State Government or, as the case may be, the Union
territory;
(g) An officer, not below the rank of a Joint Secretary or equivalent of the Central
Government, in charge of Family Welfare, who shall be the Member-
Secretary, ex officio.
11.8 TERM OF OFFICE OF MEMBERS

z The term of office of a member, other than an ex officio member, shall be:
(a) In case of appointment under clause (e) or clause (f) of sub-section (2) of
Section 7, three years; and
(b) In case of appointment under clause (g) of the said subsection, one year.
z If a casual vacancy occurs in the office of any other members, whether by reason
of his death, resignation or inability to discharge his functions owing to illness or
other incapacity, such vacancy shall be filled by the Central Government by
making a fresh appointment and the member so appointed shall hold office for the
remainder of the term of office of the person in whose place he is so appointed.
z The Vice-Chairman shall perform such functions as may be assigned to him by
the Chairman from time to time.
z The procedure to be followed by the members in the discharge of their functions
shall be such as may be prescribed.
11.9 MEETINGS OF THE BOARD

z The Board shall meet at such time and place, and shall observe such rules of
procedure in regard to the transaction of business at its meetings (including the
quorum at such meetings) as may be provided by regulations:
Provided that the Board shall meet at least once in six months:
z The Chairman and in his absence the Vice-Chairman shall preside at the meetings
of the Board.
z If for any reason the Chairman or the Vice-Chairman is unable to attend and
meeting of the Board, any other member chosen by the members present at the
meeting shall preside at the meeting.
z All questions which come up before any meeting of the Board shall be decided by
a majority of the votes of the members present and voting, and in the event of an
equality of votes, the Chairman, or in his absence, the person presiding, shall have
and exercise a second or casting vote.
z Members other than ex officio members shall receive such allowances, if any,
from the Board as may be prescribed.
11.10 FUNCTIONS OF THE BOARD

z The Board shall have the following functions, namely;
z To advice the Government on policy matters relating to use of pre-natal diagnostic 93
techniques; Pre-natal Diagnostic Techniques
z To review implementation of the Act and the Rules made thereunder and
recommend changes in the said Act and rules to the Central Government;
z To create public awareness against the practice of pre-natal determination of sex
and female foeticide;
z To lay down code of conduct to be observed by persons working at Genetic
Counselling Centres, Genetic Laboratories and Genetic Clinics;
z Any other functions as may be specified under the Act.
11.11 REGISTRATION OF GENETIC COUNSELLING

CENTERS, LABORATORIES AND CLINICS
z No person shall open any Genetic Counselling Center, Genetic Laboratory or
Genetic Clinic after the commencement of this Act unless such Centre,
Laboratory or Clinic is duly registered separately or jointly under this Act.
z Every application for registration under sub-section (1) shall be made to the
Appropriate Authority in such form and in such manner and shall be accompanied
by such fees as may be prescribed.
z Every Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic engaged,
either partly or exclusively, in counseling or conducting pre-natal diagnostic
techniques for any of the purposes mentioned in section 4, immediately before the
commencement of this Act, shall apply for registration within sixty days from the
date of such commencement.
z Subject to the provisions of section 6, every Genetic Counselling Centre, Genetic
Laboratory or Genetic Clinic engaged in counseling or conducing pre-natal
diagnostic techniques shall cease to conduct any such counseling or technique on
the expiry of six months from the date of commencement of this Act unless such
Centre, Laboratory or Clinic has applied for registration and is so registered
separately or jointly or till such application is disposed of, whichever is earlier.
z No Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic shall be
registered under this Act unless the Appropriate Authority is satisfied that such
Centre, Laboratory or Clinic is in a position to provide such facilities, maintain
such equipment and standards as may be prescribed.
11.12 CERTIFICATE OF REGISTRATION

z The Appropriate Authority shall, after holding an inquiry and after satisfying itself
that the applicant has complied with all the requirements of this Act and the Rules
made thereunder and having regard to the advice of the Advisory Committee in
this behalf, grant a certificate of registration in the prescribed form jointly or
separately to the Genetic Counselling Centre, Genetic Laboratory or Genetic
Clinic, as the case may be.
z If, after the inquiry and after giving an opportunity of being heard to the applicant
and having regard to the advice of the Advisory Committee, the Appropriate
Authority is satisfied that the applicant has not complied with the requirements of
this Act or the rules, it shall, for reasons to be recorded in writing, reject the
application for registration.
z Every certificate of registration shall be renewed in such manner and after such
period and on payment of such fees as may be prescribed.
94 z The certificate of registration shall be displayed by the registered Genetic
Counselling Centre, Genetic Laboratory or Genetic Clinic in a conspicuous place
at its place of business.
Check Your Progress
1. What do you mean by pre-natal diagnostic technique?
……………………………………………………………………………...
……………………………………………………………………………...
2. What is pre-natal diagnostic procedure?
……………………………………………………………………………...
……………………………………………………………………………...
3. What is genetic laboratory?
……………………………………………………………………………...
……………………………………………………………………………...
11.13 CANCELLATIONS OR SUSPENSION

OF REGISTRATION
z The Appropriate Authority may suo motu, or on complaint, issue a notice to the
Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic to show cause
why its registration should not be suspended or cancelled for the reasons
mentioned in the notice.
z If, after giving a reasonable opportunity of being heard to the Genetic Counselling
Centre, Genetic Laboratory or Genetic Clinic and having regard to the advice of
the Advisory Committee, the Appropriate Authority is satisfied that there has been
a breach of the provisions of this Act or the Rules, it may, without prejudice to
any criminal action that it may take against such Centre, Laboratory or Clinic,
suspend its registration for such period as it any think fit or cancel its registration,
as the case may be.
z Notwithstanding anything contained in sub-sections (1) and (2), if the Appropriate
Authority is, of the opinion that it is necessary or expedient so to do in the public
interest, it may, for reasons to be recorded in writing, suspend the registration of
any Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic without
issuing and such notice referred to in sub-section (1).
11.14 APPEAL
The Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic may, within
thirty days from the date of receipt of the order of suspension or cancellation of
registration passed by the Appropriate Authority under Section 20, prefer and appeal
against such order to:
z The Central Government, where the appeal is against the order of the Central
Appropriate Authority; and
z The State Government, where the appeal is against the order of the State
Appropriate Authority, in the prescribed manner.
11.15 OFFENCES AND PENALTIES

z Prohibition of advertisement relating to pre-natal determination of sex and
punishment for contravention: No person, organization, Genetic Counselling
Centre, Genetic Laboratory or Genetic Clinic shall issue or cause to be issued any 95
advertisement in any manner regarding facilities of pre-natal determination of sex Pre-natal Diagnostic Techniques
available at such Centre, Laboratory, Clinic or any other place.

z No person or organization shall publish or distribute or cause to be published or
distributed any advertisement in any manner regarding facilities of pre-natal
determination of sex available at any Genetic Counselling Centre, Genetic
Laboratory or Genetic Clinic or any other place.
z Any person who contravenes the provisions of sub-section (1) or sub-section
(2) shall be punishable with imprisonment for a term, which may extend to three
years and with fine, which may extend to ten thousand rupees.
z Explanation: For the purposes of this section, “advertisement” includes any
notice, circular, label wrapper or other document and also includes any visible
representation made by means of any light, sound, smoke or gas.
z Offences and penalties: Any medical geneticist, gynecologist, registered medical
practitioner or any person who owns a Genetic Counselling Centre, Genetic
Laboratory or a Genetic Clinic or is employed in such a Centre, Laboratory or
Clinic and renders his professional or technical services to or at such a Centre,
Laboratory or Clinic, whether on a honorary basis or otherwise, and who
contravenes any of the provisions of this Act or rules made thereunder shall be
punishable with imprisonment for a term which may extend to three years and
with fine which may extend to ten thousand rupees and on any subsequent
conviction, with imprisonment with may extend to five years and with fine which
may extend to fifty thousand rupees.
z Any medical geneticist, gynaecologist, registered medical practitioner or any
person who owns a Genetic Counselling Centre, Genetic Laboratory or a Genetic
Clinic or is employed in such a Centre, Laboratory of Clinic and renders his
professional or technical services to or at such a Centre, Laboratory or Clinic,
whether on an honorary basis or otherwise, and who contravenes any of the
provisions of this Act or Rules made thereunder shall be punishable with
imprisonment for a term which may extend to three years and with fine which
may extend to ten thousand rupees and on any subsequent conviction, with
imprisonment which may extend to five years and with fine which may extend to
fifty thousand rupees.
z The name of the registered medical practitioner who has been convicted by the
court under sub-section (1) shall be reported by the Appropriate Authority to the
respective State Medical Council for taking necessary action including the
removal of his name from the register of the Council for a period of two years for
the first offence and permanently for the subsequent offence.
z Any person who seeks the aid of a Genetic Counselling Centre, Genetic
Laboratory or Genetic Clinic or of a medical geneticist, gynecologist or registered
medical practitioner for conducting pre-natal diagnostic techniques on any
pregnant woman (including such woman unless she was compelled to undergo
such diagnostic techniques) for purposes other than those specified in clause (2) of
Section 4, shall, be punishable with imprisonment for a term which may extend to
three years and with fine which may extend to ten thousand rupees and on any
subsequent conviction with imprisonment which may extend to five years and
with fine which may extend to fifty thousand rupees.
96
Health Laws and Policies 11.16 RESUMPTION IN THE CASE OF CONDUCT OF
PRE-NATAL DIAGNOSTIC TECHNIQUES
Notwithstanding anything in the Indian Evidence Act, 1872 (1 of 1872), the court
shall presume unless the contrary is proved that the pregnant woman has been
compelled by her husband or the relative to undergo pre-natal diagnostic technique
and such person shall be liable for abetment of offence under sub-section (3) of
Section 23 and shall be punishable for the offence specified under that section.
11.17 PENALTY FOR CONTRAVENTION OF THE

PROVISIONS OF THE ACT
Whoever contravenes any of the provisions of this Act or any Rules made thereunder,
for which no penalty has been elsewhere provided in this Act, shall be punishable with
imprisonment for a term which may extend to three months or with fine, which may
extend to one thousand rupees or with both and in the case of continuing
contravention with an additional fine which may extend to five hundred rupees for
every day during which such contravention continues after conviction for the first
such contravention.

z Where any offence, punishable under this Act has been committed by a company,
every person who, at the time the offence 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, shall be deemed to be guilty of the offence and shall be
liable to be proceeded against and punished accordingly:
Provided that nothing contained in this sub-section shall render any such person
liable to any punishment, if he proves that the offence was committed without his
knowledge or that he had exercised all due diligence to prevent the commission of
such offence.
z Notwithstanding anything contained in sub-section (1) where any offence
punishable under this Act has been committed by a company and it is proved that
the offence has been committed 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 that offence and shall be liable to be proceeded
against and punished accordingly.
11.19 LET US SUM UP

The Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act was
passed on 1994. Genetic clinic means a clinic, institute, hospital, nursing home or any
place, by whatever name called, which is used for conducting pre-natal diagnostic
procedures. Genetic laboratory means a laboratory and includes a place where
facilities are provided for conducting analysis or tests of samples received form
genetic clinic for pre-natal diagnostic test. Pre-natal diagnostic procedures means all
gynecological or obstetrical or medical procedures such as ultrasonography
foetoscopy, taking or removing samples of amniotic fluid, chorionic villi, blood or any
tissue of a pregnant woman for being sent to a genetic laboratory or genetic clinic for
conducting pre-natal diagnostic test. Pre-natal diagnostic test means ultrasonography
or any test or analysis of amniotic fluid, chorionic villi, blood or any tissue of a
pregnant woman conducted to detect genetic or metabolic disorders or chromosomal
abnormalities or congenital anomalies or haemoglobinopathies or sex linked diseases
regulation of genetic counseling centers, genetic laboratories and genetic clinics. This
Act gives Regulation of genetic counseling centers, genetic laboratories and genetic 97
clinics and Regulation of pre-natal diagnostic techniques, Prohibitions for sex Pre-natal Diagnostic Techniques
determination, and under this act central supervisory board was constituted and it
gives norms for functions of the board, registration of genetic counseling centers,
genetic laboratories and genetic clinics. If any one contravenes the act that offences
are penalized.

Collect more information from a Gynaecologist. How far the female foeticide issues
are reducing with the help of this Act?
11.21 KEYWORDS
Genetic clinic: It means a clinic, institute, hospital, nursing home or any place, by
whatever name called, which is used for conducting pre-natal diagnostic procedures.
Genetic laboratory: It means a laboratory and includes a place where facilities are
provided for conducting analysis or tests of samples received form Genetic Clinic for
pre-natal diagnostic test.
Gynaecologist: It means a person who possesses a post –graduate qualification in
gynecology and obstetrics.
Medical geneticist: means a person who possesses a degree or diploma or certificate
in medical genetics in the field of pre-natal diagnostic techniques or has experience of
not less than two years in such field after obtaining any one of the medical
qualifications recognized under the Indian Medical Council Act, 1956; or A post-
graduate degree in biological sciences.
Pediatrician: means a person who possesses a post-graduate qualification in
pediatrics.

1. Describe the regulation of pre-natal diagnostic techniques.
2. Explain about the central supervisory board, its terms, functions and meetings.
3. How to register genetic counseling centers and genetic laboratory? Explain
Cancellation of registration.

1. Pre-natal diagnostic techniques includes all pre-natal diagnostic
procedures and pre-natal diagnostic tests.
2. Pre-natal diagnostic procedures means all gynecological or obstetrical or
medical procedures such as ultrasonography foetoscopy, taking or
removing samples of amniotic fluid, chorionic villi, blood or any tissue of
a pregnant woman for being sent to a Genetic Laboratory or Genetic
Clinic for conducting pre-natal diagnostic test.
3. Genetic Laboratory means a laboratory and includes a place where
facilities are provided for conducting analysis or tests of samples received
form Genetic Clinic for pre-natal diagnostic test.

98
12
INDIAN MENTAL HEALTH ACT
CONTENTS
12.1 Introduction
12.2 Commencement
12.3 Definitions
12.4 Central Authority for Mental Health Services
12.4 State Authority for Mental Health Services
12.6 Establishment or Maintenance of Psychiatric Hospitals and Nursing Homes
12.7 Application for License
12.8 Duration and Renewal of License
12.9 Revocation of License
12.10 Appeal
12.11 Inspection of Psychiatric Hospitals and Nursing Home
12.12 Admission of Mentally Ill Persons under Certain Special Circumstances
12.13 Order of Discharge by Medical Officer-in-Charge
12.14 Discharge of Person on his Request
12.15 Let us Sum up
12.17 Keywords

z Get an idea about authorities for mental health services
z Know about the establishment and maintenance of mental hospitals
z Understand about the admission and discharge of mentally ill person
12.1 INTRODUCTION
An Act to provide for the regulation of the establishment and working of a psychiatric
hospitals for the purpose of providing proper treatment and care to mentally ill
persons. The Act repeals the Indian Lunacy Act, 1912, and the Lunacy Act, 1977
(Jammu and Kashmir Act 25 of 1977). The provisions of the Indian Lunacy Act, 1912
and the Amending Act which compendiously called Lunacy Act, 1912-1916 were not 99
absolutely exhaustive. Indian Mental Health Act
12.2 COMMENCEMENT
1. This Act may be called the Mental Health Act, 1987.
3. It shall come into force on such dates notification.
The Central Government hereby appoints the 1st day of April, 1993 as the date on
which the said Act shall come into force in all the States and Union Territories.
12.3 DEFINITIONS
1. “Cost of Maintenance” in relation to a mentally ill person admitted in a
psychiatric hospital, or Psychiatric nursing home, shall mean the cost of such
items as the State Government may, by general or special order, specify in this
behalf;
2. “District Court” means, in any area for which there is a city Civil Court that
Court, and in any other area the principal Civil Court of original jurisdiction, and
includes any other Civil Court which the State Government may, by notification,
specify as the court component to deal with all or any of the matters specified in
this Act;
3. “Inspecting Officer” means a person authorized by the State Government or by
the licensing authority to inspect any psychiatric hospital or psychiatric nursing
home;
4. “Medical officer” means a Gazetted Medical Officer in the service of
Government and includes a medical practitioner declared, by a general or special
order of the State Government, to be a medical officer for the purposes of this
Act;
5. “Medical Officer in-Charge” in relation to any psychiatric hospital or
psychiatric nursing home, means the medical officer who, for the time being, is in
charge of that hospital or nursing home;
6. “Medical Practitioner” means a person who possesses a recognized medical
qualification as defined Indian Medical Council Act, 1956, Indian Medicine
Central Council Act, 1970 and Homeopathy Central Council Act, 1973;
7. “Mentally ill person” means a person who is in need of treatment by person of
any mental disorder other than mental retardation;
8. “Mentally ill prisoner” means a mentally ill person for whose detention in, or
removal to, a psychiatric hospital psychiatric nursing home, jail or other place of
safe custody;
9. “Minor” means a person who has not completed the age of eighteen years;
10. “Notification” means a notification published in the Official Gazette;
11. “Prescribed” means prescribed by rules made under this Act;
12. “Psychiatric Hospital” or “Psychiatric Nursing Home” means be, a nursing
home established or maintained by the Government or any other person for such
mentally ill persons and includes a convalescent home established or maintained
by the Government or any other person for such mentally ill persons; but does not
100 include any general hospital or general nursing home established or maintained by
the Government and which provides also for psychiatric services;
13. “Psychiatrist” means a medical practitioner possessing a post-graduate degree or
diploma in psychiatry, recognized by the Medical Council of India, constituted
under Indian Medical Council Act, 1856 (102 of 1956), and includes, in relation
to any State, any medical officer who, having regard to his knowledge and
experience in psychiatry, has been declared by the Government of that State to be
a psychiatrist for the purposes of this Act;
14. “Mental Health Services” include, in addition to psychiatric hospitals and
psychiatric nursing homes, observation wards, day-care centers, in patient
treatment in general hospitals, ambulatory treatment facilities and other facilities,
convalescent homes and half-way –homes for mentally ill persons.
12.4 CENTRAL AUTHORITY FOR MENTAL HEALTH

SERVICES
The Central Government shall establish an authority for mental health with such
designation as it may deem fit.
12.4 STATE AUTHORITY FOR MENTAL HEALTH

SERVICES
1. The State Government shall establish an authority for mental with such
designation as it may deem fit.
2. The Authority established under sub-section (1) shall be subject to the
superintendence, direction and control of the State Government.
3. The Authority established under sub-section (1) shall:
be in charge of regulation, development and co-ordination with respect to
Mental Health Services under the State Government and all other matters
which, under this Act, the concern of the State Government or any other
authority subordination to the State Government;
Supervise the psychiatric hospitals and psychiatric nursing homes and other
Mental Health Services Agencies (including places in which mentally ill
persons may be kept or detained) under the control of the State Government;
Advice the State Government on all matters relating to mental health; and
Discharge such other functions wit respect to matters relating to Mental
Health as the State Government may require.
12.6 ESTABLISHMENT OR MAINTENANCE OF

PSYCHIATRIC HOSPITALS AND NURSING HOMES
z The Central Government may, in any part of India, or the State Government may,
within the limits of its jurisdiction, established or maintain psychiatric hospital or
maintain psychiatric nursing homes for the admission, and care of mentally ill
persons at such places as it thinks fit; and separate psychiatric hospitals and
psychiatric nursing homes may be established or maintained for:
(a) Those who are under the age of sixteen years;
(b) Those who are addicted to alcohol or other drugs which lead to behavioral
changes in a person;
(c) Those who have been convicted of any offence; and
(d) Those belonging to such other or category of persons as may be prescribed.
z On and after the commencement of this Act person shall established or maintain a 101
psychiatric hospital or psychiatric nursing home unless he holds a valid license Indian Mental Health Act
granted to him under this Act:

Provided that a psychiatric hospital or psychiatric nursing home (whether called a
sylum or by any other name) licensed by the Central Government or any State
Government and maintained as such immediately before the commencement of
this Act may continue to be a licensed psychiatric hospital or licensed psychiatric
nursing home, as the case may be, under this Act:
(a) for a period of three months from such commencement.
(b) if an application made in accordance with Sec. 7 for a license is pending on
the expiry of the period specified in Cl. (a) till the disposal of such
application.
z Nothing contained in sub-section (1) shall apply to a psychiatric nursing hospital
or psychiatric nursing home established or maintained by a Central Government
or a State Government.
Check Your Progress
1. What is the previous name of this Act?
……………………………………………………………………………...
……………………………………………………………………………...
2. What is mentally ill person?
……………………………………………………………………………...
……………………………………………………………………………...
3. What is a psychiatrist?
……………………………………………………………………………...
……………………………………………………………………………...
4. What do you mean by psychiatric hospital?
……………………………………………………………………………...
……………………………………………………………………………...
5. What do you mean by mental health services?
……………………………………………………………………………...
……………………………………………………………………………...
12.7 APPLICATION FOR LICENSE

1. Every person, who holds, at the commencement of this Act, a valid license
authorizing that person to establish or maintain any psychiatric hospital or
psychiatric nursing home, shall, if the said person intends to establish or continue
the maintenance of such hospital or nursing home after the expiry of the period.
2. Grant or refusal of license.
On receipt of an application under sec.7, the licensing authority shall make such
inquires as it may deem fit and where it is satisfied that:
(a) The establishment or maintenance of psychiatric hospital or psychiatric
nursing home or the continuance of the maintenance of any such hospital or
nursing home established before the commencement of this Act is necessary;
102 (b) The applicant is in position to provide the minimum facilities prescribed for
the admission, treatment and care of mentally ill persons; and
(c) The psychiatric hospital or psychiatric nursing home, will be under the charge
of medical officer who is a psychiatrist.
It shall grant a license to the applicant in the prescribed form, and where it is not so
satisfied, the licensing authority shall, by order, refuse to grant the license applied for.
12.8 DURATION AND RENEWAL OF LICENSE

1. A license shall not be transferable or heritable.
2. Where a license is unable to function as such for any reason or where a license
dies, the licensee or, as the case may be, legal representative of such licensee shall
forthwith report the matter in the prescribed manner to the licensing authority and
notwithstanding anything contained in sub-section (1), the psychiatric hospital or
psychiatric nursing home concerned may continue to be maintained and shall be
deemed to be maintained and shall to be a licensed psychiatric hospital or
psychiatric nursing home, as the case may be:
a) For a period of three months from the date of such report or in the case of the
death of the licensee from the date of his death, or
b) If an application with sub-section (3) for a license is pending on the expiry of
the period specified in Cl. (a), till the disposal of such application.
c) A license may be renewed from time to time, on an application made in that
behalf to the licensing authority, in such fee, as may be prescribed, and every
such application shall be made not less than one year before the date on which
the period of validity of the license is due to expire.
12.9 REVOCATION OF LICENSE

The licensing authority may, without prejudice to any other penalty that may be
imposed on the licensee, by order in writing, revoke the license if it is satisfied that:
a) The psychiatric hospital or psychiatric nursing home is not being maintained by
the licensee in accordance with the provisions of this Act or the Rules made there-
under; or
b) The maintenance of the psychiatric hospital or psychiatric nursing home is being
carried on in a manner detrimental to the moral, mental or physical well-being of
other in-patients thereof.
12.10 APPEAL
1. Any person aggrieved by an order of the licensing authority refusing to grant or
renew a license, or revoking a license, may, in such manner and with in such
period as may be prescribed, prefer an appeal to the State Government:
Provided that the State Government may entertain an appeal preferred after the
expiry of the prescribed period if it is satisfied that the applicant was prevented by
sufficient cause from preferring the appeal in time.
2. Every appeal under sub-section (1) shall be made in such form and accompanied
by such fee as may be prescribed.
103
12.11 INSPECTION OF PSYCHIATRIC HOSPITALS AND Indian Mental Health Act
NURSING HOMES
1. An inspecting officer may, at any time, enter and inspect any psychiatric hospital
or psychiatric nursing home and require the production of any records, which are
required to be kept in accordance with the rules made in this behalf, for
inspection: provided that any personal records of a patient that any personal
records of a patient so inspected shall be kept confidential except for the purposes
of sub-section (3).
2. Where the Inspecting Officer is satisfied that any in-patient in a psychiatric
hospital or psychiatric nursing home is not receiving proper treatment and care, he
may report the matter to the licensing authority and thereupon the
licensing authority may issue such direction as it may deem fit to the medical
officer-in-charge of the licensee of the psychiatric hospital, or as the case may be,
the psychiatric nursing home and every such medical officer-in-charge or licensee
shall be bound to comply with such directions.
12.12 ADMISSION OF MENTALLY ILL PERSONS UNDER

CERTAIN SPECIAL CIRCUMSTANCES
Any mentally ill person who does not, or is unable to, express his willingness for
admission as a voluntary patient, may be admitted and kept as an in-patient in a
psychiatric nursing hospital or psychiatric nursing home on an application made in
that behalf by a relative or a friend of the mentally ill persons if the medical officer-in-
charge is satisfied that in the interest of the mentally ill persons it is necessary so
to do.
12.13 ORDER OF DISCHARGE BY MEDICAL OFFICER-IN

-CHARGE
Notwithstanding anything contained in Chapter IV, the medical officer-in-charge of a
psychiatric hospital or psychiatric nursing home nay, on the recommendation of two
medical practitioners one of whom shall preferably be a psychiatrist, by order in
writing, direct the discharge of any person other than a voluntary patient detained or
undergoing treatment therein as an in-patient, and such person shall thereupon be
discharged from the psychiatric hospital or psychiatric nursing home.
12.14 DISCHARGE OF PERSON ON HIS REQUEST

Any person (not being a mentally ill prisoner) detained in pursuance of an order made
under this Act who feels that he has recovered from his mental illness, may make an
application to the Magistrate, where necessary under the provisions of this Act, for his
discharge from the psychiatric hospital or psychiatric nursing home.
12.15 LET US SUM UP

Mental Health Act 1987 repeals the Indian Lunacy Act, 1912. Mentally ill person
means a person who is in need of treatment by person of any mental disorder other
than mental retardation. Psychiatric hospital or Psychiatric nursing home means be, a
nursing home established or maintained by the Government or any other person for
such mentally ill persons and includes a convalescent home established or maintained
by the Government or any other person for such mentally ill persons. This Act also
explains the central and state authority for mental health services. In this Act it gives
norms for establishment or maintenance of psychiatric hospitals and psychiatric
nursing homes, establishment or maintenance of psychiatric hospitals or psychiatric
104 nursing homes only with license, and procedure for application for license, duration
and renewal of license, revocation of license, inspection of psychiatric hospitals and
psychiatric nursing home and visiting of patients, admission of mentally ill persons
under certain special circumstances and order of discharge by medical officer in
charge.

Find out the effective service difference in mental health between a general hospital
and a Psychiatric nursing home.
12.17 KEYWORDS
Medical officer: It means a Gazetted Medical Officer in the service of Government
and includes a medical practitioner declared, by a general or special order of the State
Government, to be a medical officer for the purposes of this Act;
Medical Officer-in-Charge: in relation to any psychiatric hospital or psychiatric
nursing home, means the medical officer who, for the time being, is in charge of that
hospital or nursing home;
Medical Practitioner: It means a person who possesses a recognized medical
qualification as defined Indian Medical Council Act, 1956, Indian Medicine Central
Council Act, 1970 and Homeopathy Central Council Act, 1973;
Mentally ill person: It means a person who is in need of treatment by person of any
mental disorder other than mental retardation;
Mentally ill prisoner: It means a mentally ill person for whose detention in, or
removal to, a psychiatric hospital psychiatric nursing home, jail or other place of safe
custody.

1. How to establish and maintain a mental hospital? Explain its licensing procedure.
2. How to admit and discharge a mentally ill person?

1. The Indian Lunacy Act.
2. Mentally ill person means a person who is in need of treatment by person
of any mental disorder other than mental retardation;
3. Psychiatrist means a medical practitioner possessing a post-graduate
degree or diploma in psychiatry, recognized by the Medical Council of
India, constituted under Indian Medical Council Act, 1856 (102 of 1956),
and includes, in relation to any State, any medical officer who, having
regard to his knowledge and experience in psychiatry, has been declared
by the Government of that State to be a psychiatrist for the purposes of
this Act.
4. Psychiatric Hospital or “Psychiatric nursing Home” means be, a nursing
home established or maintained by the Government or any other person
for such mentally ill persons and includes a convalescent home
established or maintained by the Government or any other person for such
mentally ill persons; but does not include any general hospital or general
nursing home established or maintained by the Government and which
provides also for psychiatric services.
Contd….
5. Mental Health Services include, in addition to psychiatric hospitals and 105
psychiatric nursing homes, observation wards, day-care centers, in patient Indian Mental Health Act
treatment in general hospitals, ambulatory treatment facilities and other

facilities, convalescent homes and half-way-homes for mentally ill
persons.

108
LESSON UNIT II 109
Nature of Law
13
NATURE OF LAW
CONTENTS
13.1 Introduction
13.2 Basic Ideas Involved in Law
13.3 Law and Morality
13.4 Ignorance of Law is No Excuse
13.5 Public Law and Private Law
13.6 Primary and Secondary Sources of Indian Law
13.6.1 Primary Sources
13.6.2 Secondary Sources
13.7 Customary Law
13.8 Meaning and Nature of Mercantile (or Business) Law
13.9 Objectives of Business Law
13.10 Some Basic Legal Concepts
13.10.1 Concept of Legal Entity
13.10.2 Concept of Legal Rights
13.11 Different Types of Rights
13.12 Essentials of Law
13.13 Let us Sum up
13.15 Keywords
13.17 Suggested Readings

z Know about the basics of law
z Understand the Business law
13.1 INTRODUCTION
It is paradoxical that the simplest terms are often the most difficult to define and in
this respect, the word ‘law’ is no expectation. The term ‘law’ is used in many senses:
we may speak of the law of physics, mathematics, science, or the laws of the football
or health. In its widest sense, ‘law’ means any rule of conduct, standard or pattern, to
which actions are required to confirm; if not conformed, sanctions are imposed. When
110 we speak of the law of a state, we use the term ‘law’ in a special and strict sense. In
this sense, the term ‘law’ is defined in oxford English dictionary as “the body of rules
whether proceeding from formal enactment or from custom, which a particular state or
community recognizes as binding on its subjects or members”. These are rules which
are recognized and action on by courts of justice. Law may also be defined as rule of
conduct of persons [both natural and artificial] imposed upon and enforced among the
members of a given state.
13.2 BASIC IDEAS INVOLVED IN LAW

The two basic ideas involved in any law are: (i) to maintain some form of social order
in a group and (ii) to compel members of the group to be within that order. These
basic ideas underlie formulation of any rules for the members of a group. A group is
created because first, there is a social instinct in the people to live together and
secondly, it helps them in self-preservation. Rules are made by the members of the
group, so that the group doesn’t whither away. As the members are interested in
continuing the group, penalty is provided for the non-observance of the rules.
Law is made to serve some purpose, which may be social, economic of political.
Some examples of ‘law’ in the widest sense of the term. ‘Law’ in its widest sense may
include: (i) moral rules or etiquettes, the non-observance of which may lead to public
ridicule, (ii) Law of the land – the non-observance of which may lead to arrest,
imprisonment, fines, etc., (iii) rules of international law, the non-observance of which
may lead to social boycott, trade-sanctions, cold war, hot war proxy war, etc.
13.3 LAW AND MORALITY

It was stated earlier that one of the characteristics of law is that it is for the guidance
or conduct of persons. This is so in the case of morality also as there is a close
relationship between the two. In fact law not only has its origin in morality, but also is
easier to enforce when people yield to government for moral reasons. However, a
person may be morally bound but not legally. Thus, if a young person does not show
respect for an elderly person on the street, the law will take no action, although he
stands condemned by the moral judgment of people on the street. On the other hand,
the law occasionally has to decide on a person who is not morally at fault. For
instance, X appoints Y as his agent. Y enters into contact with Z on behalf of X.Y
commits fraud in the transaction and thereby injuries Z. X are bound to compensate Z.
further, there are some actions in which both morality and legality are involved.
Moral
Moral Legal rules
rules
and Legal Examples
Example
Examples Parking
Respect
Murder Offence
the
Stealing Exceeding
Elderly
13.4 IGNORANCE OF LAW IS NO EXCUSE

This is the literal translation of maxim “ignorantia juris non excusat”. Every member
of the society is expected that his actions conform to set pattern or standard as
reflected in legal rules. He cannot take the plea that he did not know them. No doubt, 111
in practice, he cannot learn and understand all the laws of the land, he has access to Nature of Law
books on law and to those persons who are experts in legal matters. Therefore, the
maxim “ignorantia juris non excusat” places a burden on every member of the society
with the knowledge of law. In other words, “ignorance of law is not a good excuse”.
13.5 PUBLIC LAW AND PRIVATE LAW

The public law is that branch of law which determines and regulates the organization
and functioning of states (countries). Also it regulates the relation of the
state (country) with its subjects. Public law includes: (i) constitutional law,
(ii) administrative law, (iii) criminal law, (iv) municipal law, (v) and international law.
Criminal law is enforced on behalf of or in the name of the state.
On the other hand, private law if that branch of the law, which regulates those of the
relation of the citizens with one, another as are not of public importance. In this sense,
the state, through its judicial organs, adjudicates the matter in dispute between them.
In other words, it is primarily concerned with rights and duties of individuals to each
other. Under it, the legal action is begun by the private citizens to establish rights (in
which the state is not primarily concerned) against citizen or a group of citizens.
Private law includes, (i) law of contract, (ii) law of tort, (iii) law of property, (iv) law
of succession, (v) family laws. Private law is, sometimes, referred to as civil law. In
the case of private law, the role of the state is merely to recognize and enforce the
relevant law.
13.6 PRIMARY AND SECONDARY SOURCES OF

INDIAN LAW
The main sources of modern Indian law, as administered by Indian courts, may be
divided into two broad categories:
(i) Primary sources and
(ii) Secondary sources.
13.6.1 Primary Sources

The Primary Sources of Indian Law are:
a) Customs,
b) Judicial precedents (stare decisis),
c) Statutes and
d) Personal law.
13.6.2 Secondary Sources

The Secondary Sources of Indian Law are:
a) English law (common law, equity, law merchant, statute law)
b) Justice, equity and good conscience.
13.7 CUSTOMARY LAW

Customs have played an important role in making the law and therefore is also known
as customary law. ‘Customary law’, in the words of Keeton, may be defined as “those
rules of human action, established by usage and regarded as legally binding by those
to whom the rules are applicable, which are adopted by the courts and applied as
112 sources of law because they are generally followed by the political society as a whole
or by some part of it”. In simple words, “it is the uniformity of conduct of all persons
under like circumstances”. It is a generally observed course of conduct if followed
again and again, it becomes a custom.
Every custom does not become law. A custom, to be valid, must be observed
continuously for a very long time, but also it must be supported by the general public
opinion. Also, a custom must not conflict with any statue law and must not be
opposed to public policy and morality. Another requisite of a valid custom is that it
must be certain and definite and not vague and ambiguous. Last, but not the least, a
custom must be reasonable and not opposed to the principles of justice, equity and
good conscience.
A valid custom is law unless it has been overridden by legislation. For example, the
Hindu marriage act prohibits marriage of persons who are within the “prohibited
degree of relationship”, still the act permits marriage of persons within prohibited
degree of relationship, if there is a proven custom in a certain community. With the
progress of civilization, statutes and judicial precedents are replacing custom as a
source of law. As customary law is unwritten, therefore, it is sometimes called jus
non-scriptum as contrasted with the legislation, which is called jus scriptum.
13.8 MEANING AND NATURE OF MERCANTILE (OR

BUSINESS) LAW
Business law may be defined as that branch of law which prescribes a set of rules for
the governance of certain transactions and relations between: (i) business persons
themselves, (ii) business persons and the state. In the context of Indian business some
of these transactions and relations concern the following:
z Regulation of restrictive and unfair business practices,
z Foreign exchange management and regulation,
z Insolvency of business persons,
z Promotion of conciliation, and arbitration for settlement of business disputes,
z Regulation of companies incorporated under the Companies Act, 1956,
z Negotiable instruments,
z Patents, trademarks and copyrights,
z Actionable claims, factoring and forfeiting,
z Import and export regulation,
z Contracts, sale of goods, guarantee, indemnity, bailment, pledge, charge,
mortgage, partnership, insurance, carriage of goods,
z Prevention of food adulteration, regulation of essential commodities,
z Regulation f stock exchange and financial securities,
z Regulation and development of industries,
z Economic offences,
z Conservation of foreign exchange and prevention of smuggling activities,
z Regulation of foreign contributions, foreign capital,
z Excise, import and export duties, tax on income, wealth, etc.
Nature of Law
1. What are the two basic ideas involved in law?
……………………………………………………………………………...
……………………………………………………………………………...
2. What are the two sources of Indian law?
……………………………………………………………………………...
……………………………………………………………………………...
3. What do you mean by customary law?
……………………………………………………………………………...
……………………………………………………………………………...
4. Define Business law.
……………………………………………………………………………...
……………………………………………………………………………...
13.9 OBJECTIVES OF BUSINESS LAW

From the description of the nature and meaning of business law, it can be inferred that
the subject has many objectives to achieve.
Firstly, law lays down the framework within which business activities shall be carried
out. For example, X Company issues an advertisement disparaging the products of its
rival Y Company. Further X Company are not in conformity with some legal rules
prescribed by some statute or the other. Thus Y Company can enforce its rights, which
have been infringed by the X Company.
Secondly, a business person can resort to various judicial and quasi-judicial
authorities against the government in case his legal rights have been violated.
Thirdly, some laws are made to facilitate the business persons to achieve their goals
smoothly. for example, business has been extended the facility of doing business by
getting a company incorporated, deriving all the advantages of incorporation, such as
separate legal entity, limited liability, etc.
Fourthly, business law has social objectives too. The anti-competition laws, the
pollution control laws, etc., are some of the examples. Further, laws concerning
regulation of essential commodities and prevention of food adulteration in the interest
of the consumers go a long way in serving social objectives.
Lastly, business laws aim to prevent concentration of economic power and help in the
adjustment of claims of individuals against each other.
13.10 SOME BASIC LEGAL CONCEPTS

13.10.1 Concept of Legal Entity
Law applies only to persons. Thus, persons are the subjects of law. A person is an
entity, which is clothed with rights and duties. There are two kinds of persons. A
person may be a natural or an artificial person. All human beings are natural persons.
They are tangible and visible. On the other hand, an artificial person is a metaphysical
body, intangible and invisible. An artificial person is brought into existence by
following a procedure given in some law. For example, a public company is an
artificial person and its brought into existence by following the procedure given in the
Companies Act, 1956. Thus there must be at least seven persons for bringing a public
114 company into existence. In this way, an artificial person comes into existence when
law confers such a status upon a group of persons or any object or institution. An
artificial person is also known as a legal entity when it comes into existence. It has
one ‘corpus’ or ‘body’ in law, distinct from the members who constitute it. In addition
to Companies Act, 1956, there are some other laws under which artificial persons can
be brought into existence. Some such laws are: Societies Registration Act, 1860;
Co-operative Societies Act, 1912.
13.10.2 Concept of Legal Rights

We have mentioned earlier that a person is an entity clothed with certain rights and
duties. The sources of different rights may be customary, statutory, contractual,
tortuous, personal laws, etc. some of the rights, which a person has, are interest in life,
or liberty or property or extending over domestic relations and even to contractual
relations. Some of these interests are not recognized or protected by law. The rights
recognized or protected by law alone are enforceable. These rights have their origin in
some source or the other, such as custom, statutes, personal law, law of tort.
There are a number of distinguishing features of rights. Some of these are: (i) a right is
always vested in a person but not in an inanimate being or animal or even a dead
person. (ii) a right is generally correlative of a duty in relation to the fulfillment of a
right. (iii) The right must relate to a subject matter, namely the objects, which in a
given case may relate to a person or property, place or a thing. (iv) The nature of a
right may be to get something done from another or to refrain him to do something.
Thus, they may be a right to get back the money lent, or to get the house built as per
agreement, or to prevent to trespass upon your property. (v) Every right can be traced
to a source which may be a contract, a custom, a natural law, etc.
13.11 DIFFERENT TYPES OF RIGHTS

Rights may be: (i) personal or proprietary; (ii) in personam or in rem.
z Personal rights: These are rights, which pertain to the realm of status, which
indicated the position of person in the eye of law in the society. Guardianship and
matrimonial rights fall in this category.
z Proprietary rights: These are rights, which are both heritable and transferable. the
ownership of a house is a proprietary right.
z Rights in personam and in rem: The proprietary rights may further be subdivided
in to (i) Those which are available against specified individuals only; (ii) those
which are available against the whole world. If the rights are limited in the sense
of being available against specified individuals only, then they are known as
rights in personam. The rights in personam pertain to the sphere of contractual
obligations only. If the rights available are against the whole world, then they are
known as rights in rem.
13.12 ESSENTIALS OF LAW

There are certain essentials, which must be present in law in order to make it effective.
These are: (i) predictability, (ii) flexibility and (iii) reasonable application and
coverage. Law must be such that one is enabled to predict with some accuracy the
legal consequences of an action. For example, business people enter into contracts on
the premise that if the other party fails to keep its promise, they would have certain
remedies under the law.
Law must be flexible in the sense that it must not n\be so rigid and unchanging as to
be impossible to mould to the present. The world is changing. New inventions are
being made. Law must be flexible enough to meet changing conditions. And, if at a
later stage, it is found that the existing law is incapable of tackling certain changes, 115
and then it must accommodate them by amendments thereto. Nature of Law
Law must be reasonable both in its application and coverage. Wide publicity should
be given to the law enacted so as to give an opportunity to those affected by it to know
its requirements, and consequence for non-compliance of those requirements.
However, the old doctrine of “ignorance of law is no excuse” stands on its own feet.
As regards reasonableness of law’s coverage, the subject matter thereof must be
considered reasonable by the people at large. Therefore, a law that a large number of
persons consider by the people at large. Therefore, a law the large numbers of persons
consider to be unreasonable will soon become ineffective.
13.13 LET US SUM UP

Law means any rule of conduct, standard or pattern, to which actions are required to
confirm; if not conformed, sanctions are imposed. The two basic ideas involved in any
law are: (i) to maintain some form of social order in a group and (ii) to compel
members of the group to be within that order. These basic ideas underlie formulation
of any rules for the members of a group. Ignorance of law is no excuse. Every
member of the society is expected that his actions conform to set pattern or standard
as reflected in legal rules. He cannot take the plea that he did not know them. The
public law is that branch of law which determines and regulates the organization and
functioning of states [countries]. Private law if that branch of the law, which regulates
those of the relation of the citizens with one, another as are not of public importance.
Customs have played an important role in making the law and therefore is also known
as Customary law. Business law may be defined as that branch of law which
prescribes a set of rules for the governance of certain transactions and relations
between: (i) business persons themselves, (ii) business persons and the state essentials
of law. Some basic legal concepts are: concept of legal entity and concept of legal
rights.

Ignorance of law is not excused. Discuss with some example.
13.15 KEYWORDS
Public law: The public law is that branch of law which determines and regulates the
organization and functioning of states (countries).
Private law: Private law if that branch of the law, which regulates those of the relation
of the citizens with one, another as are not of public importance.
Customary law: Customs have played an important role in making the law and
therefore is also known as customary law.
Business law: Business law may be defined as that branch of law which prescribes a
set of rules for the governance of certain transactions and relations between:
(i) business persons themselves, (ii) business persons and the state.

1. Explain about the law and its types.
2. Define business law and its objectives and essentials.
116 Check Your Progress: Model Answers
1. The two basic ideas involved in any law are: (i) to maintain some form of
social order in a group and (ii) to compel members of the group to be
within that order.
2. (i) Primary sources and (ii) Secondary sources.
3. Customary law in the words of Keeton, may be defined as “those rules of
human action, established by usage and regarded as legally binding by
those to whom the rules are applicable, which are adopted by the courts
and applied as sources of law because they are generally followed by the
political society as a whole or by some part of it”.
4. Business law may be defined as that branch of law which prescribes a set
of rules for the governance of certain transactions and relations between:
(i) business persons themselves, (ii) business persons and the state.
13.17 SUGGESTED READINGS

Gulshan, S.S, “Mercantile Law”, Excel Books, New Delhi, 2004.
Kapoor, N.D., “Elements of Mercantile Law”, Sultan Chand & Sons, New Delhi, 2003.
Shukla, M.C., “Mercantile Law”, S. Chand & Company Ltd., New Delhi, 1998.
117
LESSON Law of Contract
14
LAW OF CONTRACT
CONTENTS
14.1 Introduction
14.2 Definition of Contract
14.3 Kinds of Contracts
14.3.1 Formal and Simple Contracts
14.3.2 Express and Implied Contracts
14.3.3 Valid, Voidable, Void and Unenforceable Contracts
14.3.4 Executed and Executory Contracts
14.3.5 Bilateral and Unilateral Contracts
14.4 Essentials of a Valid Contract
14.4.1 Agreement
14.4.2 Consensus Ad Idem or Meeting of Minds
14.4.3 Offer or Proposal
14.4.4 Acceptance
14.4.5 Consideration
14.5 Capacity to Contract-persons who are Competent to Contract
14.6 Consent and Free Consent
14.6.1 Meaning of Consent
14.6.2 Free Consent
14.7 Void and Illegal Contracts
14.8 Wagering Contracts
14.9 Void Agreements
14.10 Quasi-contracts
14.11 Quantum Meruit
14.12 Performance of Contracts
14.12.1 Meaning of Performance of Contract
14.12.2 Meaning of Offer to Perform
14.12.3 Who must Perform the Promise under a Contract?
14.12.4 Contracts which need not be Performed
14.12.5 Rules Regarding the Time and Manner of Performance of Contracts
14.12.6 Reciprocal Promises
14.12.7 Appropriation of Payments
Contd….
118 14.12.8 Assignment of Contracts
14.12.9 Different Modes of Discharge of Contracts
14.12.10 Remedies for Breach of Contracts
14.13 Let us Sum up
14.15 Keywords

z Get a clear idea about different kinds of contract and the essentials of a valid
contract
z Know about offer, acceptance and considerations
z Understand the discharge of contract
14.1 INTRODUCTION
We enter into contracts everyday. Some of these are made consciously, for example,
purchase or sale of a share of a company or a plot of land. Sometimes we do not even
realize that we are making a contract, e.g., hiring a taxi, buying a book, etc. in any
case, contracts, however made, confer legal rights on the party and subjects the other
party of some legal obligation.
In business transactions, where promises are very often made at one time and the
performance is to follow later, the parties have two alternatives open to them. They
may either rely upon one another’s honour to ensure performance, or else there should
be a legally enforceable obligation to perform the agreement. Reliance upon honour
alone is insufficient protection. Legal means of enforcing promises has, therefore,
been developed in civilized societies. Legally enforceable promises are termed
contracts. Promises that do not meet the requirement of a contract is the most common
means of rendering a promise enforceable. The object and function of the law of
contract is to see that, as far as it is possible, expectations created by promises of the
parties are fulfilled and obligations prescribed by the agreement of the parties are
enforced. The contract is, indeed, a cement that holds our economic system together.
For this reason the sanctity of contract has always been made an objective of social
control and individual liberty.
14.2 DEFINITION OF CONTRACT

In the broadest sense, a contract is an exchange of promises by two or more persons,
resulting in an obligation to do and refrain from doing a particular act, which
obligation is recognized and enforced by law. In creating a legal obligation contract
gives a right to one person and casts a corresponding duty on another person. On
account of the presence if rights and obligations, the law gives a remedy for breach of
promise and recognize its due performance as a duty. Hence a contract is sometimes
defined as “an agreement creating an obligation,” which means a binding agreement.
Our Contract Act [S.2(h)] defines a contract as “as agreement enforceable by law.”
This definition naturally resolves itself into two distinct parts. First, there must be an
agreement. Secondly, such as agreement must be enforceable by law. It will be so
enforceable if it is coupled with obligation. There fore, a contract is a combination of 119
the two ideas of agreement and obligation. An agreement is necessary the outcome of Law of Contract
consenting minds, or there is consensus ad idem – consent to the matter. An obligation

is the legal duty to do or abstain from doing what one has promised to do or abstain
from doing. A contractual obligation arises from a bargain between the parties to the
agreement, who are called the promisor and the promisee.
For example, A agrees with B to sell his car for Rs. 20,000 to B. In this example, the
following rights and obligations have been created:
i) A is under an obligation to deliver the car to B. B has a correlative right to receive
the car.
ii) B is under an obligation to pay Rs. 20,000 A. A has a correlative right to receive
the Rs. 20,000.
All obligations, however, are not contractual in nature. For instance the obligations
resulting from the following are not contractual, namely:
1. Torts or civil wrong;
2. Quasi-contracts;
3. Judgments of courts – contracts of record;
4. Relationship between husband and wife, trustee and beneficiary – status
obligations.
14.3 KINDS OF CONTRACTS

Contracts may be classified in terms of their form, or in terms of their enforceability,
or the way they are created.
14.3.1 Formal and Simple Contracts

Contracts are classified in terms of their form as (1) contracts under seal, (2) contracts
of record, and (3) simple or parol contracts. The first two classes are known as formal
contracts, their validity or legal force being based upon form alone. When the terms of
an obligation are written or printed upon paper or parchment and are signed, sealed,
and delivered, the obligation constitutes a contract under seal. An instrument of this
nature is technically known as a deed or a common-law speciality.
An obligation imposed by the judgments of a court and entered upon its records is
often called a contract of record.
It cannot accurately be described as a contract, however, because it is really not based
upon an agreement of the parties. One form of contract of record is in fact a contract.
This kind exists when one acknowledges before a competent court that he is bound or
obligated to pay a certain sum unless specified thing is done or not done. For example,
a party who has been arrested may be released on his promise to appear in court and
may bind himself to pay a certain sum in the event that he fails to do so. An obligation
of this kind is known as a recognizance.
All contracts other than contracts of record and contracts under seal a re-called simple
or parol contracts, whether they are in writing or merely oral. A parol or simple
contract, whether oral or in writing, must be supported by ‘consideration’.
Formal contracts or contracts under seal, recognized under the English law, do to find
any place in the Indian law. The simple or parol contract supported by consideration is
the type of contract largely recognized under the Indian Contract Act. Form alone
does not allow to dispense with consideration under the Indian Act. But S. 25(1) of the
Act makes provision for a kind of contract which to some extent resembles the formal
contract or specialty of English law, and is enforceable, if it satisfies four conditions,
120 namely: (1) the contract must be in writing, (2) it must be registered according to the
law of registration of documents, (3) it must be between parties standing in near
relation to each other, and (4) it should proceed out of natural love and affection
between the parties.
14.3.2 Express and Implied Contracts

Simple contracts may be classified in terms of the way in which they are created as:
(1) express contracts, and (2) implied contracts.
An express contract is one in which the parties have made an oral or written
declaration of their intensions and of the terms of the transaction. In other words, an
express contract is one, the terms of which are stated in words, spoken or written.
An implied contract is one in which the evidence of agreement is not shown by words,
written or spoken, but by acts and conducts of the parties. Such a contract arise when
one person, without being requested to do so, renders services under circumstances
indicating that he expects to be paid for them, and the other person, knowing such
circumstances, accepts the benefit of those services. An implied contract cannot arise
when there is an existing express contract on the same subject. Thus, contract in
which the manifestation of assent is purely acts rather than words are termed implied
contracts.
Under certain conditions the law creates and enforces legal rights and obligations
when no real contract, express or implied, exists. These obligations are known as
quasi-contracts. A quasi or constructive contract rests upon the equitable principle that
a person shall not be allowed to enrich himself unjustly at the expense of another. In
truth, however, it is not a contract at all. Duty, and not a promise or agreement or
intension of the person sought to be charged, defines it. We shall have more to say
about it at a later state.
14.3.3 Valid, Voidable, Void and Unenforceable Contracts

Contracts may be classified also in terms of their enforceability or validity as:
(1) valid contracts, (2) voidable contracts, (3) void contracts or void agreement, and
(4) unenforceable contracts.
A valid contract is an agreement, which is binding and enforceable. It has all the
essential elements to be stated and discussed later.
A voidable contract is an agreement that is binding and enforceable but, because of
the lack of one or more of the essentials of a valid contract, it may be repudiated by
the aggrieved party at his option. If the party having the right to avoid his obligation
does not exercise the right to avoid his obligation does not exercise the right within a
reasonable time, the agreement is binding and enforceable.
A void contract is really not a contract at all. The term means an agreement, which is
without any legal effect. Thus an agreement by a minor is void under the Indian law.
An unenforceable contract is one, which, though perfectly valid in all other respects,
lacks some technical requirement needed to make it enforceable, e.g., some necessary
written evidence. Such a contract will not be enforced by the courts unless and until
the defect is rectified. Thus contracts for the sale of land or any interest therein must
be evidence in writing, signed by the defendant, before they can be the subjects of a
successful action at law. But such unenforceable contracts are not void, and therefore
if they have been performed and property has been transferred the court will not
intervene to set the agreement aside. Thus, if A really agrees to buy B’s house and
pays a deposit to B, then later changes his mind and refuses to sign a written contract
to purchase the house, B will be unable to sue A for damages or performance of
the contract but will be able to keep A’s deposit and the court will not assist A to
recover it.
14.3.4 Executed and Executory Contracts 121
Law of Contract
Contracts may be classified in terms of the extent to which they have been performed
carried out as (1) executed contracts, and (2) executory contracts.
An executed contract is one that has been completely performed. In other words, an
executed contract is one under the terms of which nothing remains to be done by
either party. A contract may be executed at once, (i.e., at the time the contract is
made), as in the case of a cash sale; or it may become executed in the future by its
terms being carried out in due time.
An executory contract is composed of undertaking in which one or one both parties
are under an obligation to do or not to do certain things. In order words, under the
terms of the contract something remains to be done. For example, if an electric supply
company agrees to furnish electricity to another party for a specified period of time at
a stipulated price, the contract is executory. If the entire prices are paid in advance, the
contract is still deemed executory; although, strictly speaking, it is executed on one
side and executory on the other.
14.3.5 Bilateral and Unilateral Contracts

An agreement may originate in one of the several ways. First, there may be an offer of
a promise and a simple assent. This is possible only when the promise is under seal or
of record, in which case it is binding because of its form alone. This way or mode of
making contract is applicable in English law and not in Indian law. Second way in
which there may be an offer of an act for a promise, as when a public omnibus by
running on its route makes an offer of its services for the promise of the one entering
to pay his fare. Third, there may be an offer of a promise for an act, as one promises to
pay a specified sum for the performance of an act, such as the returning of lost goods.
Fourth, an agreement may originate in an offer of a promise for a promise, as when
one person offers to pay Rs. 100 in return for the promise of another to paint his car.
The first three methods result in unilateral contracts, because in each instance there is
an obligation to perform on the part of only one party. The fourth or last method
creates a bilateral contract, in that there is an obligation on the part of both to do or to
refrain from doing a particular thing. In case of a unilateral or one-sided contract, one
party to the contract has performed his part even at the time of its formation and an
obligation is outstanding only against the other. In the bilateral or two-sided contract,
at the time of its formation there are two outstanding obligations, one on either party
to the contract, e.g., A promises to paint a picture in one month in return for which B
promises to pay Rs. 100. Here, there are two promises and each party is a promisor in
respect of one promise and a promisee in respect of the other, and as such each can
hold the other liable for the breach of his promise.
If follows from the above distinction between executed and executory contracts and
between unilateral and bilateral contracts that a contract is a contract from the time it
is made and not from the time its performance is due. Thus, the fact that in an
executory contract, both the parties have to perform their parts of the contract does not
affect the validity of the contract. It was stated in Sahab Ram vs. Ram Niwas [1953]
1 All 494 [F.B] that the fact the agreement has not entered into. Similarly, there may
be cases in which performance of a contract is postponed or deferred. Thus, where A
agrees to supply 100 quintals of wheat three months after the date of contract, the
performance will become due three months after the date of the contract but the
contract will be a contract on the date when the offer is accepted and other conditions
of a valid contract are complied with.
14.4 ESSENTIALS OF A VALID CONTRACT

In order to be an enforceable contract, there must be (1) an agreement, (2) based upon
the genuine assent of the parties, (3) supported by consideration, (4) made for a lawful
122 object, (5) between complement parties. These requirements of valid contract may be
analysed into the following elements, all of which must be present:
1. Proposal of offer by one party and acceptance of the proposal of offer by another
party, resulting in an agreement – consensus ad-idem;
2. An intention to create legal relationship or an intent to have legal consequences;
3. Genuine; (i.e. free and real) consent between the parties (i.e., not marred by
mistake, undue influence, coercion, fraud or misrepresentation);
4. The parties to the contract are capable of contracting;
5. The object contracted for is legal and is not opposed to public policy;
6. There are at least two persons to make the contract;
7. The agreement is supported by lawful consideration (or, under English law,
proper form is used);
8. The agreement is capable of being performed;
9. The terms of the contract are certain.
14.4.1 Agreement
A contract is a legally binding agreement. This agreement result when one person, the
offeror or promisor, makes a proposal or offer and the person, to whom the offer is
made, the offeree or promisee, accepts it. For an agreement to arise, there must be two
or more parties to the transaction. As it is imperative that there be a concurrence of at
least two minds, it is impossible for one person to make an agreement with himself.
To illustrate, when a person in his official capacity, a managing director of a
company, makes a promise to himself, as an individual, no agreement is formed by an
acceptance in the later capacity. Plurality of persons is an essential characteristic of an
agreement.
14.4.2 Consensus Ad Idem or Meeting of Minds

To constitute an agreement or a contract there must be a meeting of the minds of the
parties and both must agree to the same thing in the same sense. This means the will
of the parties must meet, or there must be consensus ad idem. For example, A, a
painter, agrees to paint the house of B and B agrees to pay A the sum of Rs. 2,000
upon the satisfactory completion of the work. In this case, there is a meeting of the
minds of A and B on the subject of what is to be done and at what price.
14.4.3 Offer or Proposal

Contract act defines an offer or proposal as follows: “when one person signifies to
another his willingness to do or to abstain from doing anything, he is said to make a
proposal.” In simple words, an offer is a proposal by one person, whereby the
expresses his willingness to enter into a contractual obligation in return for a promise,
or act, or forbearance. Note the offer consists of two parts: (1) a promise by the
offeror, coupled with (2) a request addressed to the offeree for something in return.
The promise that the offeror makes in not binding upon him until the offeree
unconditionally assents to the terms contained in the offer. For example, A offer Rs. 5
to B if he would mow his lawn. The promise to pay Rs. 5 is binding as soon as B
promises to mow the lawn. Until then A is free to withdraw his offer.
Requirements of an Offer
A valid offer must meet the tests of: (1) contractual intension, (2) definiteness, and
(3) communication to the offeree.
z Contractual Intention: To constitute an offer, the offeror must intend to create a 123
legal obligation. When there is a lack of such intention on his part, it makes no Law of Contract
difference whether the offeree takes any action concerning the offer. Parties are
free to make their own agreement, and if they agree that the breach of either party
will not give rise to legal rights, there is no contract, even though the offer and
acceptance have been reduced to writing. Hence, an offer must contemplate to
give rise to legal consequences and be capable if creating legal relations. The
following are the examples of a lack of contractual intention on the part of the
offeror.
a) Social invitations: Ordinary invitations to social affairs are not offers in the
eyes of the law, because the idea of bargain is absent in such cases and there
is no intention to create a legal relationship. An agreement between two
persons to go together to pictures, or for a walk does not create a legal
obligation on their part to abide by it, as it relates to social matters.
A invited B to dinner at his house on a specified date, A forgot all about the
dinner and his invitation to B. when B arrived at A’s residence A was not
there and no dinner was ready. This agreement did not give rise to a legally
binding agreement, and B could not enforce it or claim compensation for
expense and inconvenience.
Agreement between a husband and wife who are living in friendly intercourse
are not contracts but only domestic arrangements.
b) Offers made in jest or excitement: A person may a proposal or statement in a
jest without any thought or intention of creating a binding obligation. A
proposal made in jest, cannot be expected by the offeree as a reasonable man,
to have been made with the intention of making a contract. Also, a person,
labouring under the stress of great emotion or excitement, may make a
statement that cannot be treated as an offer on account of the fact that it would
be obvious to a reasonable man that a legal relation is not contemplated.
Promises held out over loudspeakers are often claptrap of politics.
c) Invitation to negotiable: The first statement made by one of the two persons is
not necessarily an offer. In many cases there may be preliminary discussion or
an invitation by one party to the other to negotiate or talk business. If A asks
B, “ do you want to buy this car of mine?” he is not making an offer but is
inviting an offer that A can accept or reject. On the other hand, after A’s
invitation, B may continue the preliminary negotiations by saying, “what do
you want for it?” If A then replies, “I will sell it to you for Rs. 8,000,” A
makes an offer.
d) Invitation to offer: Ordinarily, marked prices of goods do not constitute an
offer so as to compel the tradesman to sell those goods at the marked prices.
Similarly, advertising is not held as offers. Advertisements are generally
assumed to constitute “invitations to trade” rather than offers. The trader
merely indicates that he is willing to consider an offer made by a buyer on
these terms. In other words, he is inviting an offer and not making one. Also,
an announcement that a person will sell his property at public auction to the
highest bidder is mere declaration of intention to hold an auction at which
bids will be received. A bid is an offer, which is accepted when the hammer
falls, and until the acceptance of the bid is signified in some manner neither
party assumes any legal obligation to the other. At any time before the highest
bid is accepted, the bidder may withdraw his offer to purchase or the
auctioneer his offer to sell. The owner’s offer to sell is made at the time
through the auctioneer, and not when he advertises the auction sale.
z Definite Offer: An offer must be definite and certain. If it is indefinite, loose or
vague if an essential provision is lacking, it cannot be accepted. The reason is that
124 it cannot be accepted. The reason is that the courts cannot tell what the parties are
to do. Thus an offer to conduct a business for such time as should be profitable is
too vague to be considered a valid offer, as it does not consists of a definite
promise to be bound. Where A, who has bought a horse from B, promises to buy
another if the first one proves lucky, and refuses to buy the second horse, cannot
enforce the promise, it being loose and vague.
z Communication of the Offer: An offer must be communicated to the offeree.
Until an offer is made known to the offeree, he does not know what he has to
accept. An offer becomes effective only when it has been communicated to the
offeree. The mere desire to enter into an agreement, which remains hidden in the
recesses of one’s mind, can never constitute an offer. Lord Lindlay says: ‘a state
of mind not communicated cannot be regarded in dealings between man and man.
The writing of a letter embodying a definite proposition will also prove futile
unless the letter is posted and reaches the offeree. Again, an offer must be
communicated by the offeror or his duly authorized agent. If the offeree learns of
the offeror’s intention from some outside source, no offer results. An offer to the
public may be made through the newspaper, but it is not effective so far as a
particular individual is concerned until he learns that the offer has been made. To
the existence of a contract there must be mutual assent – offer and consent to the
offer. Without that there is no contract. How can there be consent or assent to that
of which the party has never heard. Where A, without knowing that a reward if
offered for the arrest of a particular criminal, apprehends the criminal, he cannot
recover the reward if he learns of the reward after apprehending the criminal. He
had not knowledge of the offer and could not be taken to have accepted it.
Duration of Offer
An offer that has been communicated properly continues as such until it lapses, or
until it is revoked, rejected, or accepted. The offeror is considered to be continually
renewing the offer until one of the above takes place.
1. Offer lapses after stipulated or reasonable time: An offer does not remain open
indefinitely, although the offeror fails to withdraw it. If the offer stipules the
period during which it is to continue, it automatically lapses at the end of that
period. An attempted acceptance after that date could only amount to a new offer
being made by the offeree of the original offer. An offer, which provides for no
time limit remains open for a reasonable time - a reasonable time being such
period as a reasonable person might conclude was intended.
2. An Offer lapses by the death or insanity of the offeror or the offeree before
acceptance: If the offeror dies before acceptance, there is no offer to accept, and
if the acceptance is made it becomes infructuous. A dead man can no more
continue to offer than he could begin to offer. In the same manner, the offeree’s
death without accepting the offer puts an end to the offer, and his heirs or
executors cannot accept for him. But if the acceptance is made in ignorance of the
death or insanity of the offeror, there would be a valid contract. In English law,
the death or insanity of the offeror or offeree causes an offer to lapse even though
the other party has no notice of the death.
S owned certain debentures of a company. K offered to buy them. S died without
accepting the offer. His administrator accepted the offer and sued K for damages
when he refused to perform the contract. Held, the death of terminated the offer to
buy, and his administrator after S’s death could not accept.
3. An Offer lapses by subsequent illegality: If the performance of the contract
becomes illegal after the offer is made, it lapses. Thus if an offer is made to sell
alcoholic liquors but a law prohibiting the sale of liquors is enacted before the
offer is accepted, the offer is terminated.
4. An Offer lapses by not being accepted in the mode prescribed, or if no modes 125
prescribed, in some usual and reasonable manner: According to English law, Law of Contract
once the offer has lapsed on this account, there cannot be a further acceptance,
unless the offeror aggress thereto. In Indian law, if the offer prescribes the manner
in which it is to be accepted and the acceptance is not made in such a manner, the
proposer or offeror may, within a reasonable time after the acceptance is
communicated to him, insist that his offer shall be accepted in the prescribed
manner and not otherwise. If the fails to do so, he accepts the acceptance as made.
5. A condition offer lapses when the condition is not accepted by the offeree.
6. An offer lapses by when the condition is not accepted by the offeree: If the
offeree rejects the offer by distinct refusal, he cannot receive the offer by
attempting to accept it, unless the offeror renews the proposal.
7. An offer lapses by counter-offer by the offeree: As it amounts to rejection of the
order. If A makes an offer to B to sell his car for Rs. 5,000 and B, instead of
accepting the offer, makes an offer to buy it for Rs. 4,000, the original offer by A
is terminated, Bin effect saying, “I refuse your offer, but in its place, I make a
different offer.” Such an offer by the offeree is known as a counter-offer. In
substance, the counter-offer presupposes a rejection of the original offer. If the
original offeror, who is now the offeree, accepts the counter-offer, a binding
contract results.
8. Revocation of the offer by the offeror: Ordinarily, the offeror can revoke his offer
before it is before it is accepted. If he does so, the offeree cannot create a contract
by accepting the revoked offer. Thus, the bidder at an auction sale may withdraw
[revoke] his bid [offer] before it is accepted by the auctioneer by using any of the
customary methods, e.g., fall of hammer. The auctioneer thereafter accepts the
revoked offer [withdrawn bid]. An offer may be revoked by the offeror before its
acceptance, even though he had originally agreed to hold it open for a definite
period of time. So long as it is a mere offer, it can be withdrawn whenever the
offeror desires. The rule applies even though the offer expressly stipulates that it
may not be withdrawn without the consent of the other party. Thus, if the offeror
aggress to keep his offer open for a specified time, he may nerveless revoke it
before the expiration of that time, unless (i) the offer has in the meantime been
accepted before notice of revocation has reached the offeree, or (ii) there is
consideration for keeping the offer open, e.g., option contract.
Communication of Revocation
A revocation of an offer must be communicator or made known to the person to
whom the offer was made. Until it is communicated to the offeree, he has reason to
believe that there is still an offer, which he may accept, and he may rely on this belief
and accept the offer. A letter or telegram revoking an offer made to a particular
offeree is effective and a revocation against the person who makes it when it is put
into course of transmission, (i.e., when the telegram is handed in at the telegraph
office or the letter is posted) and as against the offeree when the revocation comes to
his knowledge, (i.e., he receives the telegram of letter).
Essentials of a Valid Offer

1. The terms of the offer must be definite, unambiguous and certain or capable of
being made certain. If the terms of the offer are loose, vague, ambiguous or
uncertain, it is not a valid offer.
2. An offer must have knowledge of the offer before he can accept it. The offer must
be communicated to the other party. The communication of offer is complete only
when it comes to the knowledge of the offeree. In the offer is lost on the way in
transit it is no offer. This is true of specific as well as general offers.
126 3. An offer cannot contain a term the non-compliance of which may be assumed to
amount to acceptance. An offeror cannot say that if the offeree does not accept the
offer within two days the offer would be deemed to have been accepted. Such a
burden cannot be imposed on the offeree. It is for the offeree to accept the offer or
not; and therefore, he may communicate his acceptance accordingly.
4. If a person makes a statement without any intention of creating a binding
obligation this odes not amount to an offer. It is only mere declaration of intention
to offer.
5. Where two parties make identical offers to each other in ignorance of each other’s
offer this does not result in a contract. Such offers are known as cross offers and
neither of the two can be called and acceptance of the other.
6. The offer must be made with a view to obtain acceptance thereto.
7. The offer must be made with the intention of creating legal relationship. An offer
of a purely social or domestic nature is not a valid offer.
8. The offer must be communicated to the offeree before it can be accepted. This is
true of both specific and general offers.
9. If no time is fixed by the offeror within which the offer is to be accepted, the offer
does not remain open for an indefinite period. Where no time is specified, then the
offer is to be accepted within a reasonable time. Thus, if no time is specified then
the offer lapses after a reasonable time. What is a reasonable time is a question of
fact and would depend upon the circumstances of each case.
10. An offer must be distinguished from a mere invitation to offer.
Irrevocable Offers
Generally, a proposer specifies a period within which the offeree must accept. Thus, if
A makes an offer to B on 1st June, valid up to June, but revokes it on 5th June, before
its acceptance by B the revocation is effective, and the offeree has no remedy.
However, the courts will bind an offeror to his promise to hold an offer open in
exchange for a consideration given by the offeree. For instance, in the above case, if B
had given some consideration to A to keep the offer open, then A could not revoke the
same before the specifies time. Sometimes such contracts are called “option contracts”
Revocation of Offer
There are many reasons due to which the offer lapses or is revoked such as:
1. an offer is revoked by the death or insanity of the proposer, if the fact of his death
or insanity comes to the knowledge of the acceptor before acceptance. Therefore,
if the acceptance is made in ignorance of the death, or insanity of the offeror,
there would be a valid contract,
2. an offer lapses by the death or insanity of the offeree before acceptance,
3. an offer terminates when rejected by the offeror,
4. an offer terminates when revoked by the offeror before acceptance by the offeree,
5. an offer terminates by not being accepted in the mode prescribed, or if no mode is
prescribed, some usual and reasonable mode (or manner),
6. a conditional offer terminates when the condition is not accepted by the offeree,
7. an offer terminates by counter by the offeree.
Meaning of a Counter-Offer
When in place of acceptance the terms of an offer as they are, the offeree accepts the
same subject to certain conditions or qualifications, he is said to make a counter-offer.
Example. An offer to sell rice was accepted by the offeree with an endorsement on the 127
sold and bought notes that yellow and wet grain will not be accepted. Held, there was Law of Contract
no contract.
14.4.4 Acceptance
An agreement consists of an offer by one party and its acceptance by the person or
persons to whom it is made. Acceptance is the manifestation by the offeree of his
assent to the terms of the offer. Mathematically stated, offer and Acceptance =
Contract. The acceptance must be absolute and unconditional. It must accept just what
is offered. No particular form of words or mode of expression is required for an
acceptance. Any expression of an intention to agree is sufficient. An acceptance may
be indicated, for example, by saying “yes”, or by an informal “O.K.” by a mere
affirmative nod of the head, or in the case of an offer of a unilateral contract, by
performing the act called for.
Who can accept – an offer may be accepted only by the person to whom it is made. If
any else attempts to accept, no contract with that person arises. Thus, if a person
intends to contract with B, A cannot give himself any right under the offer to B.
A sold his business to his manager without disclosing the fact to his customers. On the
afternoon of the day on which the sale was carried through a customer [Jones], who
had a running account, sent an order for some goods addressed to the vendor of the
business by name. The new owner of the business executed the order without
disclosing that the business had changed hands. It was held that he could not recover
the price, as there was no contract.
If the offer is directed not to a specified individual but to the public at large, it may be
accepted by any member of the public at large who has knowledge of the existence of
the offer.
Mode of Acceptance
To make a concluded contract, the acceptance must be unequivocal, unconditional and
without any variance of any sort between it and the proposal. A binding contract can
only occur when the offer made is met by an acceptance does not conform to the
terms of the offer in all respects, or contains any new terms or conditions, it becomes
a counter-offer and thus rejects the original offer. For example, where an offer was to
buy fully paid up shares and partly paid shares were allotted, there was no acceptance
and so no binding agreement.
Acceptance of an Offer
When the person to whom the offer is made signifies his assent thereto, the offer is
said to be accepted [S 2(b)]. Thus, acceptance is the act of giving consent to the
proposal. The offeree is deemed to have given his acceptance when he gives his assent
to the proposal. The acceptance of an offer may be express or implied. It is express
when the acceptance has been signified either in writing or by words of mouth or by
performance of some required act of the offeree.
Examples: (i) A shopkeeper received an order from a customer – a household lady. He
executed the order by sending the goods. The customer’s order for goods constitutes
the offer, which was accepted by the shopkeeper by sending the goods. It is a case of
acceptance by conduct. Here the shopkeeper is accepting the offer by the performance
of the act (i.e., sending the goods).
(ii) A loses his dog and announces a reward of Rs. 500 to anyone who brings his dog
to him. B need not convey his acceptance of the offer, which is a general one. If the
finds the dog and gives it to A, he is entitled to the reward as he accepted the offer
doing the required act.
128 Implied Acceptance
Acceptance is implied when it is said to be gathered form the surrounding
circumstances or the conduct of the parties.
Examples (i) A enters into a bus for going to his destination and takes a seat. From the
very nature of the circumstance the law will imply acceptance on the part of A.
(ii) A’s scooter goes out of the order and he is stranded on a lonely road. B, mechanic
who observes this starts correcting the fault. A allows B to do the same. From the
nature of the circumstances A has given his acceptance to the offer of B.
Who Can Accept an Offer

We have mentioned earlier that a specific offer can be accepted only by the person to
whom it is made. The rule of law id that if A wants to enter into a contract with B then
C cannot substitute himself for B without A’s consent. However in the case of a
general offer it can be accepted by anyone by complying with the terms of the offer.
Examples: (i) A purchased B’s business. Prior to the purchase, A was working as the
manager of B. C, to whom B owned a debt, placed an order with the latter for the
supply to certain goods. A supplied the goods even though the order was not
addressed to him. C refused to pay A for the goods because he, by entering into
contract with B, intended to set-off his debt against B. Held, the offer could be
accepted by B only and not by anyone else. (Boulton vs. Jones 157 ER 232).
(ii) The case of Carlill vs. Carbolic Smoke Ball Co. (supra) illustrates that a general
offer can be accepted by anyone by complying with the requirements of the offer.
Essentials of Valid Acceptance

The following are the essential of a valid acceptance:
1. Must be absolute and unqualified and according to the exact terms of the offer,
2. It must be communicated to the offeror,
3. It must be according to the mode, if any, prescribed by the offeror,
4. It must be given within the time specified, if any, otherwise it must be given
within a reasonable time,
5. It must/be made before the offer lapses or is terminated, revoked or withdrawn. If
the offer has already lapsed then there is nothing to accept,
6. It must be given by the person to whom the offer is made. However, in the case of
a general offer, acceptance can be given by any member of the public.
14.4.5 Consideration
Need for Consideration
Contracts result only when one promise is made in exchange for something in return.
The something in return is what we mean by consideration. The requirement of
consideration stems from the policy of extending the arm of he law to the enforcement
of mutual promises of parties. We know from our study of offer and acceptance that a
mere promise is not enforceable. There must be an offer, which is a promise
conditional upon the making of a certain promise by the other party, and the offer
must be accepted by a return promise. For example, a mere promise to make a gift,
although presumably creating a moral obligation, is not enforceable at law, as the
person to whom the promise of a gift is given does not give anything in return. To be
enforceable a promise must be purchased, or the consideration be bargained for or
given in exchange for the promise.
The requirement of consideration limits the enforcement of promises to those in which 129
each of the parties has bargained to give or surrender something. The fact that each Law of Contract
party has agreed to give or surrender something suggests that the parties have devoted
some reflection to the matter and that they seriously desire the promises to have legal
consequences. That it is said that the justification for the doctrine, a certain protection
against hasty and ill-considered contracts. Consideration is an aid in determining that
promises are worthy of enforcement. Some degree of reciprocity and mutuality of
undertaking is requisite before promises will be enforced; and the doctrine of
consideration is the most important test of the enforceability of executory promises.
Definition of Consideration
Sir Frederick Pollock has defined consideration as “the price for which a promise is
bought (i.e., as quid pro quo)”. In Currie vs. Misa (1857) 10 Ex. 153, Lush J., defined
consideration as “some right, interest, profit, or benefit accruing to one party for some
forbearance, detriment, loss or responsibility given, suffered, or undertaken by the
other.”
Section 2(d) of the Indian Contract Act, 1872, defines consideration thus: “when at the
desire of the promisor, the promisee or any other person has done or abstained from
dong, or does or abstains from doing or promises to do or to abstain from doing
something, such act or abstinence or promise is called a consideration for the
promise”.
Kinds of Consideration
A consideration may be: (a) executory or future, (b) executed or present, or (c) past
consideration:
a) Executory consideration means that it takes the form of a promise to be performed
in the future. It is the price promised by one party in return for the other party’s
promise, e.g., an agreement to marry someone, or a promise to deliver goods or to
render services at a future date.
b) Executed or present consideration means consideration, which takes place
simultaneously with the promise. The act constituting the consideration is wholly
or completely performed. If A buys a book from a book-seller and pays the price
and the book-seller delivers the book to A there an then, the consideration in this
case is executed or present, since it is performed simultaneously by both the
parties.
c) Past consideration means a past act or forbearance, that is, one, which took, place
and is complete before the promise is made. If A does B a good turn in 1974, and
in1975 B makes a promise to A to supply him with certain goods in consideration
of this act, A will be able to enforce B’s promise, as in Indian law, past
consideration is also good consideration. But in English law, past consideration is
no consideration, and in the above example, A will be unable in English law
enforce B’s promise.
But even in English law, there are exceptions to the rule that past consideration is no
consideration, namely:
(i) When services are rented at the express or implied request of the promisor in
circumstances, which raise an implication of a promise to pay.
(ii) When a time-barred debt is know ledged in writing.
(iii) Under S 27 of Bill of Exchange Act, 1882, past consideration will support a bill of
exchange.
Rules Governing Consideration

a) A simple contract, whether oral or in writing, must be supported by consideration,
otherwise it will be normally void. A contrast without consideration is a gratuity,
130 or, in the words of Salmond, “a promise without consideration is a gift; one made
for a consideration is a bargain”. Hence, “bargain without consideration is a
contradiction in terms and cannot exist.”
b) In Indian law, consideration must move at the desire of the Promisor. The
Promisor must desire the act or forbearance. The act performed at the desire of
third party cannot be consideration. But the promisor need not necessarily derive
any benefit from the contract. The benefit may be intended for a third party.
Under Sec 2(d) all that is necessary if that the desire promisor and the action of
the promise should have a connection (Gopal vs. Firm Hazarilal, 1963 M.P. 37).
Again, for consideration to be present, it is essential that what is done must have
been done a t the rushes voluntarily to B’s help, there is no consideration. If,
however, A goes to B’s help at B’s desire, there is good consideration.
c) In Indian law, consideration may move from the promisee or any other person.
Thus, in Indian law, a stranger to consideration may maintain a suit. In Chinnaya
Rau vs. Ramayya (1881) 4 Mad.137, A, an old lady, by a deed of gift, made over
certain property to her daughter with a direction with a direction that the daughter
should pay an annuity to A’s brother as had been done by A. By an agreement of
even date between the daughter of A and the brother of A, the daughter promised
to pay the annuity. The daughter, however, did not pay the annuity as promised.
A’s brother sued the daughter. It was held that the consideration moved from A,
the donor of the estate, thought nor from her brother. That was sufficient
consideration for the daughter’s promise to A’s brother, because the consideration
in India need not move from the promisee, but can move from any other person.
Similarly, in Samuel v. Ananthanatha (1883) 6 Mad. 351, the administatrix of an
estate agreed to pay S his share of the estate, if S would give a promissory note for
portion of barred debt claimed by A from her. S executed a promissory note in
favour of A, give it to be administatrix, and received his share of the estate. A
sued S on the promissory note and it was held that there was consideration for the
same. Hence, in Indian law, a stranger to the consideration can sue to enforce the
contract, though a stranger to the contract cannot use.
d) Though, in Indian law, a stranger to the consideration can sue, yet both in English
law and Indian law, a stranger to a contract cannot, as a rule, sue on it, even
though it is made for his benefit. The bases of this rule is that a contract is a
private relationship between the parties who make it, and no other person can
acquire rights or incur liabilities under it. This rule is usually designated as the
doctrine of privity of contract.
Privity of contract – in general third parties cannot sue for the carrying out of
promises made by the parties to a contract.
i) Dunlop Tyre Co vs. Selfridges Ltd. (1915) A.C. 847, is the leading case on
this point. Dunlops supplied tyres to a wholesaler. D, on condition that any
retailer to whom D ressupplied the tyres should promise D not to sell them to
the public below Dunlop’s list price. D supplied tyres to Selfridges upon this
condition, but nevertheless Selfridges sold them below the list price. Held,
there was a contract between Selfridges and D, and a between Dunlops and D,
but no contract between Dunlops and Selfridges. Therefore, Dunlops could
not obtain damages from Selfridges.
ii) In Shankar vs. Umbabhai (1915) 37 Bom. 471, effected a policy of insurance
on his own life, and the policy was expressed to be for benefit of his wife. The
wife was held not entitled to sue the insurance company, as she was not a
party to the contract of assurance. She could have sued if the policy had been
assigned in writing to her by the assured, or a trust had been created by the
assured.
Exceptions to the Doctrine of Privity 131
Law of Contract
There are, however, exceptions to the rule of privity of contract recognized both
by the English law and the Indian law, under which a person who is not a party to
a contract can sue on it. The expectations to the rule are:
i) Constructive trust: If the right of the third party does not arise out of contract
but out of a trust, the cestui que trust or the beneficiary has a right of action.
The stranger should, however, be clearly designated as a beneficiary. Thus, if
A and B agree to confer a benefit on C. B would be regarded as a constructive
trustee for C of the benefit of the contract. C would then be entitled to sue B
(and join A as co-defendant).
ii) It was pointed out that the addressee of an insured article is the beneficiary
under the contract between the sender and the Central Government who is
liable for compensation under Sec. 33, Post Offices Act, for non-delivery. A
trust of movable property is deemed to be declared by the sender from the fact
that he addressed the insured cover as deliverable to the addressee. A
constructive trust having been created in favour of the addressee, he is entitled
to have the benefit as against the trustee, the Central Government through the
post office, and sue it.
iii) Agency: A principal, even if concealed, may sue on a contract made by an
agent. Thus, where A is secretly acting as agent for P, P can intervene to
enforce the contract between T and A.
iv) Charge in favour of a person: When a charge in favour of a person has been
created on the specific immovable property, such charge is enforceable at the
instance of the person beneficially interested, though he may not be a party to
the document creating the charge.
v) Family settlements: The fourth exception arises in cases of family
arrangements or marriage settlement or otherwise when a charge is created (as
above) on specific immovable property intended to benefit a third person or
where provision is made for the marriage expenses of female members
vi) Fund in hand of a party: Where a fund is created in the hands of one of the
contracting parties in favour of a third party, it may be possible to give the
latter a remedy in quasi-contract on the grounds that to allow the contracting
party to keep the fund would be allow unjust enrichment. Thus, if A admits to
C that he had received money from B for payment to C, then C can
successfully recover the amount from A.
vii) Assignment: The assignee of a debt or an actionable claim may, if the
assignment is legal assignment, sue the original debtor.
e) The fifth rule governing consideration is that there must be mutuality, i.e., each
party must do or agree to do something. A gratuitous promise, as in the case of a
subscription for charity, in not enforceable.
f) Consideration need not be adequate, but must have some value, however slight. It
is up to the parties to fix their own prices. For example, where a voluntarily
agreed to sell his motor car for Rs. 500 to B, it became a valid contract despite
thee inadequacy of the consideration. The parties are presumed to be capable of
appreciating their own interests and reaching of their own equilibrium, and the
law, as a general rule, leaves people to make their own bargains, and does not
concern itself with the adequacy of consideration. If a person, voluntarily chooses
to make an extravagant promise for an inadequate consideration it is his own
affair. That the courts do not exist to repair bad bargains, and though
consideration must be present, the parties themselves must attend to its value. But
the value must be of an economic character, and mere natural affection of itself is
132 not enough. Nevertheless, acts or omissions even of a trivial nature may be
sufficient to support a contract.
However, where the consideration embodies in a deal is woefully inadequate, it
may raise a suspicion or fraud, coercion and undue influence on the part of the
person gaining the advantage. Because of the rule of the inadequacy of
consideration being no bar to a valid contract, it has been said that “in many cases,
the doctrine of consideration is a mere technically irreconcilable either with
business expediency or common sense.”
g) Consideration must be competent: Though the consideration need not be
adequate to the promise, it must be competent, real and not illusory, impossible,
uncertain, vague or ambiguous. Consideration must be real, though it may be
nominal. A son’s vague promise to “stop being a nuisance” to is father is no
consideration.
h) Consideration must be lawful: E.g. not some illegal act, such as paying someone
to commit a crime. If the Consideration is unlawful, the contract is void and
unenforceable.
i) Consideration must be something more than the promise is already bound to do
for the Promisor. Thus, an agreement to perform an existing obligation made with
the person to whom the obligation is already owed is not made for Consideration.
For instance, discharge of a public duty already imposed by law is not
Consideration; nor is the performance of a contractual duty owed to B will suffice
to support a promise by V to A. Thus, A was engaged to marry B, and C promised
A an annuity of 150 in consideration of his marrying B. on his marriage with B, it
was held that the fulfillment of A’s contract with B was consideration to support
C’s promise to pay the annuity.
1. Define contract.
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2. What is the another name for simple contract?
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3. What do you mean by void?
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4. What do you mean by voidable?
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14.5 CAPACITY TO CONTRACT-PERSONS WHO ARE

COMPETENT TO CONTRACT
Any one cannot enter into a contract; he must be competent to contract according to
the law. Every person is competent to contract if he: (i) is of the age of majority, (ii) is
of sound mind, and (iii) is not disqualified from contracting by any law to which he is
subject (S.11). Thus, there may be a flaw in the capacity of parties of the contract. The
flaw in capacity may be due to minority, lunacy, idiocy, drunkenness, drug addiction
or status. If a party to a contract suffers from any of these flaws the contract may not
be a valid one. If the contract would have been allowed to be a valid one then it would 133
result in one party being at a disadvantage in the bargaining process. Law of Contract
14.6 CONSENT AND FREE CONSENT

14.6.1 Meaning of Consent
We have seen earlier that an offer by one party is accepted by the other party. The
consent of the offeree to the offer by the offeror is necessary. It is essential to the
creation of a contract that both parties agree to the same thing in the same sense.
When two or more persons agree upon the same thing in the same sense they are said
to consent.
Examples
i) A agrees to sell his Maruti Car deluxe model for Rs1.20 lakhs. B agrees to buy the
same. There is a valid contract since A and B have consented to contract on the
same subject matter.
ii) A who owns two Maruti Cars, offers to sell one, say, yellow-coloured, to B for
Rs. 1.20 lakhs. B agrees to buy the car for the price thinking that A is selling the
other car red coloured. There is no consent and hence no contract. A and B have
agreed not to the same thing but are thinking for different cars.
iii) A signed a promissory note, which he was told was a letter of guarantee. He was
held not liable on the promissory note, as there was no consent and consequently
no agreement entered into by him.
14.6.2 Free Consent

For a contract to be valid it is not only necessary that the parties consent but also that
they consent freely. Where there is a consent but no free consent the contract is
voidable at the option of the party whose consent was not free. Thus, free consent is
one of the essentials of valid contract. A consent is said to be free when it is not
caused by: (i) coercion, (ii) undue influence, (iii) fraud, (iv) misrepresentation or
(v) mistake.
14.7 VOID AND ILLEGAL CONTRACTS

A void contract is one, which has no legal effect. An illegal contract like the void
contract has no legal effect as between the immediate parties, but has this further
effect the transactions collateral to such a contract become tainted with illegality and
are, therefore, not enforceable. A borrowed Rs.100 from B in order to bet with as to
the result of a horse race. A contract of betting in represent of horseracing is void
under Section 30 of the Act, and if A loses, C cannot recover, because from A. But B
can recover the sum of Rs. 100 from A since his transactions with A is only collateral
to a void contract and is enforceable. On the other hand, if B has borrowed Rs. 1,000
from A to buy a revolver to shoot C, the question whether A can recover, because his
loan was an aid to an illegal object of B, and illegal object taints collateral transactions
also. If, on the other hand, A did not know the purpose of the loan, even though B had
bought the revolver and shot C, A can recover. All illegal agreement are void, but all
void, but all void agreements are not illegal. A minor’s contract is void but not illegal.
14.8 WAGERING CONTRACTS

Meaning of a wager: A wager is a promise to pay money or transfer property upon
the determination or ascertainment of an uncertain event, e.g., a horse race, or a
football match.
134 A wagering contract is one by which two persons, professing to hold opposite views
touching them issue of an uncertain event, mutually agree that, dependent upon the
determination of that event, one shall win from the other, and that other shall pay or
hand over to him, a sum of money or other stake; neither of the contracting parties
having any other interest in that contract than the sum or stake he will so win or lose,
there being no other real consideration for the making of such contract by either of the
parties.
There are several aspects of this definition, which must be emphasized. Thus, the
following points are essential to make a contract a wagering contract:
In the first place, there must be a promise to pay money or money’s worth.
1. Secondly, the promise must be conditional on an even happening.
2. Thirdly, the event must be uncertain, either because it has to happen in the future
or no one knows whether or not it will happen, or though it has happened, the
contracting parties do not know of the result.
3. Fourthly, one party has to win and the other to lose on the conclusion of the event.
Each party must stand either to win or lose under the terms of the contract. But if
one party may win but cannot lose, or if he may lose but cannot win, or if he can
neither lose nor win, it is not a wagering contract.
4. The last essential feature of a wager is that the stake or best must be the only
interest, which the parties have in the contract; and there must not be any other
consideration for the making of the contract by either of the parties. For example,
if A lays B ten to one in rupees against a particular horse, B stands to win Rs. 10,
A stands to win Re. 1, but neither of them has nay other interest whatsoever in the
contract.
Wagering contracts are void and not illegal except in Bombay, were they have been
declared illegal under the avoiding Wagers [Amendment] Act, 1861. Therefore, in
Bombay, a wagering contract, being illegal, is void not only between the immediate
parties, but taints and renders void a contract collateral to it. In the rest of India,
wagering contracts are only void, so that a contract collateral to a wagering contract is
not void. The winner of a wager cannot sue the loser for his winnings, even though the
loser makes a fresh promise to pay. Thus, where A bets with B and loses; applies to C
for a loan in order to pay B. C gives the loan to A to enable him to pay B. in Bombay,
C cannot recover his money from A, because this is money paid “under” or “in respect
of” a wagering transaction which is illegal there. But in the rest of India such a
transaction would be void and not illegal and C could recover from A. money paid to
a stakeholder to retain pending the result of a wager can be recovered from the
stakeholder by the payer any time before he has handed it over to the winner of the
wager, but winner cannot use the stakeholder for the money.
14.9 VOID AGREEMENTS

All the agreements, which are declared by the Contract Act to be void, are summed up
here for the convenience of the reader:
1. Contracts by a minor or a person of unsound mind.
2. Contract made under a mistake of fact material to the agreement on the part of
both the parties.
3. An agreement of which the consideration or object is unlawful.
4. If any part of a single consideration for one or more objects, or any one or any
part of any one of several considerations for a single object is unlawful, the
agreement is void.
5. An agreement made without consideration.
6. An agreement in restraint of marriage. 135
Law of Contract
7. An agreement in restraint of trade.
8. An agreement in restraint of legal proceedings.
9. Agreements, the meaning of which is not certain, or capable of being made
certain.
10. Agreement by way of wager.
11. An agreement to enter into agreement in the future.
12. An agreement to do an act impossible in itself.
14.10 QUASI-CONTRACTS
A contract to be enforceable must have certain essential elements, namely, offer and
acceptance, genuine consent, lawful consideration, lawful object, and capacity to
contract. But under certain conditions the law creates and enforces legal rights
and obligations when no real contract exists. These obligations are known as
quasi-contracts. Our Contract Act describes them as certain relations resembling;
those of contracts.
A quasi or constructive contract rests upon the equitable principle that a person shall
not be allowed to enrich himself unjustly at the expense of another. The maxim is
Nemo debet locuplatari ex liena Justua – “No man must grow rich out of another
person’s loss”. In truth, it is not a contract at all. It is an obligation which the law
creates, in the absence of any agreement, when and because the acts of the parties or
others have placed in the possession of one person money, or its equivalent, under
such circumstances that in equity and good conscience he ought not to retain it, and
which ex aequo bono (in justice and fairness) belongs to another. Duty, and not a
promise or agreement or intention of the person sought to be charged, defines it. It is
fictitiously deemed contractual, in order to fit the cause of the action to the contractual
remedy”.
The following types of quasi-contracts have been dealt with in the Contract Act, Secs.
68-72:
1. Necessaries supplied to a person incapable of contracting or on his behalf.
2. Suits for money had and received.
3. Quantum Meruit.
4. Obligations of a finder of goods.
5. Obligations of a person enjoying benefit of a Non-gratuitous Act.
14.11 QUANTUM MERUIT

The expression “Quantum Meruit” literally means, “as much as earned.” It is used
where a person claims reasonable remuneration for the services rendered by him when
there was no express promise to pay the definite remuneration. The general rule is that
where a party to a contract has not fully performed what the contract demands as a
condition of payment, he can bring no action for payment for that which he has done.
A mate was engaged on the terms that he would be paid a lump sum for a complete
voyage. He died before the voyage was completed. It was help his representatives
could no recover the lump sum, neither could they sue for payment for the services
rendered by the deceased. The first claim failed because the deceased had not
completed his part, the second could not be made because the existing contract was
the only basis for action and it was indivisible and so made full performance a
136 condition precedent to the ship owner’s liability. Moreover, the ship owner’s did not
prevent the completion of the work.
But where one party who has performed part of his contract is prevented b the act of
the other form completing his side of the contract, he may sue on a quantum meruit,
for the value of what he has done. This is not a claim on the contract but is a claim on
the quasi-contractual obligation, which the law implies in these circumstances.
14.12 PERFORMANCE OF CONTRACTS

14.12.1 Meaning of Performance of Contract
A contract creates obligations, ‘Performance’ of contract means the carrying out of
obligations under it. The parties to contract must either perform or offer to perform
their promises unless such performance is dispensed with or excused under the
provisions of the Indian Contract Act.
14.12.2 Meaning of Offer to Perform

It may happen that the Promisor offers performance of his obligation under the
contract at the proper time and place but promisee refuses to accept the performance.
This is called as ‘Tender’ or ‘Attempted performance’. If a valid tender is made and id
not accepted by the promisee, the Promisor shall not be responsible for non-
performance nor shall he lose his rights under the contract. However, since the tender
is an offer to deliver anything to the promisee, the promisee must have a reasonable
opportunity to see that the thing offered is the thing contracted for.
14.12.3 Who must Perform the Promise under a Contract?

The promise may be performed by promisor himself or his agent or by his legal
representative.
i) In case, there was an intention of the parties that the promise must be performed
by the Promisor himself, such promise is to be performed by him only. Thus,
where A promises to paint a picture for B, then A must perform this promise
personally.
ii) If here is no such intention of the parties, then the Promisor may employ a
competent person to perform the promise. If A has promised to deliver some items
of grocery to B, A may perform this promise either personally delivering the items
to B or causing it to be delivered to B through someone.
iii) In case of death of the Promisor, the legal representative must perform the
promise unless a contrary intention appears from the contract. A promise to
deliver goods to B on a certain day on payment of Rs. 1,000. A dies before that
day. A’s legal representatives are bound to deliver the goods to B, and B is bound
to pay Rs. 1,000 to A’s representatives.
iv) Where, however, a contract involves personal skill, then it comes to an end with
the death of the promisor. Thus, where A promises to paint a picture for B by a
certain day but dies before that day, the contract cannot be enforced by A’s
representatives or by B.
z Performance of Joint Promises: The act provides rules for devolution of joint
liabilities and rights.
z Devolution of Joint Liabilities: When two or more persons have made a joint
promise, then, unless a contrary intention appears from the contract, all such
persons jointly must fulfil the promise. In the event of death of nay of them, his
representative jointly with the survivor or survivors and in case of the death of all
promisors, the representatives of all them jointly must fulfil the promise.
z Liabilities of Joint Promisors: When two or more persons make a joint promise, 137
the promisee may, in the absence of an express agreement to the contrary, compel Law of Contract
anyone or more of such joint promisors to perform whole of the promise. Thus,
the liability of joint promisors is joint as well as several (S. 43). Thus, S. 42 makes
all the joint promisors liable on the promise jointly, whereas S. 43 provided that
any one of the joint promisors may be compelled to perform.
Example: A, B and C jointly promise to pay D Rs. 3,000. D may compel either A,
or B or C or any two of them to pay him Rs. 3,000.
z Right of Contribution Amongst Joint Promisors: Where, a joint promisor has
been compelled to perform the whole promise, he may compel every other joint
promisor to contribute equally with himself to the performance of the promise,
unless a contrary intention appears from the contract. If nay one of the joint
promisors makes default in such contribution, the remaining joint promisors must
bear the loss arising from such default in equal shares.
Examples:
(i) A, b and C are under a joint promise to pay D Rs. 3,000. A is compelled to
pay the whole amount of Rs. 3,000. A can recover Rs. 1,000 each from B and
C.
(ii) A, B and C jointly promise to pay D a sum of Rs. 3,000. C is compelled to
pay the whole amount of Rs. 3,000. A is insolvent, but his assets are sufficient
to pay ½ of his debts. C is entitled to receive Rs. 500 from A’s estate and
Rs. 1,250 from B.
(iii) A, B and C are under a joint promise to pay D Rs. 3,000. C is unable to pay
anything and A is compelled to pay the whole amount of Rs. 3,000. A is
entitled to receive Rs. 1,5000 from B.
z Release of Joint Promisor: Where two or more persons have made a joint
promise, a release of one of such joint promisors by the promisee does not
discharge the other joint promisor or promisors, neither does it free him from the
responsibility to the other joint promisor to promisors.
z Devolution of Joint Rights: When a person has made a promise to two or more
persons jointly, then unless a contrary intention appears from the contract, the
right to claim performance rests with all the joint promisors and after the death of
any of them, with the representatives of such deceased promisee jointly with the
survivor or survivors; and after the death of the survivors also, with the
representatives of all jointly. Thus, unlike the case of joint promisors whose
liability is joint as well as several, the right of the promisees is only joint and thus
any one of them cannot enforce performance unless so agreed.
Example: A, is consideration of Rs. 5,000 lent to him by B and C, promises B and
C jointly to repay them that sum with interest on a day specifies. B dies. The right
to claim performance rests with B’s representative jointly with C during C’s life,
and after C’s death with the representative of B and C jointly.
14.12.4 Contracts which need not be Performed

There are certain situations where contracts need not be performed. These are (i) The
parties may mutually agree to substitute the original contract by am new one or to
rescind it or alter it. A owes money to B under a contract. It is agreed between A, B
and C that B shall henceforth accept C as his debtor, instead of A. the old debt of A
and B is at an end and a new debt from C to B has been contracted. (ii) The promisee
may dispense with or remit wholly or in part the performance of the promise made to
him or extend the time for such performance or accept any satisfaction for it. For
instance, A promises to paint a picture for B. Later, B forbids A to do so. A is no
138 longer bound to perform the promise. Or C owes D Rs.5, 000. C pays D Rs. 2,000 and
D accepts it in satisfaction of his claim on C. This payment is a discharge of the whole
claim. (iii) The person at whose option the contract is voidable because of undue
influence, coercion, fraud or misrepresentation can rescind it. (iv) The promise
neglects or refuses to afford the promisor reasonable facilities for the performance of
his promise. For instance, A contracts with B to repair B’s house. B neglects or
refuses to point out to A the places in which his house requires repair. A need not
perform.
14.12.5 Rules Regarding the Time and Manner of

Performance of Contracts
These rules are: (i) Where the time for performance has been specified and the
promisor has undertaken to perform it without application by the promise, the
promisor must perform on the day fixed during the usual business hours and at the
place at which the promise ought to be performed. A promises to deliver goods to B at
his warehouse on 15th July. A offers the goods at B’s warehouse but after the usual
hours for closing it. The performance of A is not valid. (ii) Where the time of
performance is not specified and the promisor agrees to perform without a demand
from the promisee, the performance must be made within a reasonable time. What is a
reasonable time is, in each particular case, a question of fact. (iii) Where a promise is
to be performed of a certain day, and the promisor has not undertaken to perform it
without application by the promisee, the promisee must apply for performance at a
proper place and within the usual business hours. What a proper time and place is, in
each particular case, a question fact. (iv) When a promise is to be performed without
application by the promisee and no place is fixed for its performance, the promisor
must apply to the promisee to appoint a reasonable place for the performance of the
promise, and perform it at such place. A undertaken to deliver 1,000 kilos of Jute to B
on a fixed day. A must apply appoint a reasonable place for the purpose of receiving it
and must deliver it to him at such place. (v) where the performance of any promise
may be made in any manner or at any time which the promisee prescribes or
sanctions.
Examples:
i) A owes B Rs. 2,000, B accepts some A’s goods in deduction of the debt. The
delivery of the goods operates as a part payment.
ii) B owes A Rs. 2,000, A desires B to pay the amount to A’s account with C, a
banker. B, who also banks with C orders the amount to be transferred from his
account to A’s credit and this is done by C, afterwards and before A knows of the
transfer, C fails. There has been a good payment by B.
iii) A, a shopkeeper desires B, a customer who owes him Rs. 1, 000 to send him a
cheque for Rs. 1,000 by post. The debt is discharged as soon as B puts into the
post a letter, containing the cheque addressed to A.
14.12.6 Reciprocal Promises

Reciprocal promises means a promise in return for a promise. Thus, where a contract
consists of a promise by one party (to do or not to do something in future) in
consideration of a similar promise by other party, it is a case of reciprocal promises.
Reciprocal promises may be divided into three groups: (i) mutual and dependent,
(ii) mutual and independent; and (iii) mutual and concurrent.
Rules Concerning Performance of Different Kinds of Reciprocal Promises

These are:
1. In the case of mutual and dependent promises, the performance of the one party
depends upon the prior performance of the other party. If the promisor, who must
perform, fails to perform it, he cannot claim the performance of the reciprocal 139
promise. On the other hand, he must compensate the other party to the contract for Law of Contract
any loss, which such other party may sustain by the non-performance of the
contract.
Examples:
i) A contract with B to execute certain builder’s work for a fixed price, B
supplying the necessary timber for the work. B refuses to furnish any timer
and the work cannot be executed. A need not perform the contract. B is bound
to compensate for any loss caused to A by the non-performance of the
contract.
ii) X promise Y to sell him 100 units of a commodity, to be delivered next day
and Y promises X to pay for them within a month. X does not deliver
according to his promise, Y’s promise to pay need not be performed. Also X
must compensate Y.
2. In the case of mutual and independent promises, each party must perform his
promise without waiting for the performance or readiness to perform o the part of
the other. A promises B deliver him goods on 10th July and B in turn promises to
pay the price on 6th July. B’s paying the price is independent of A’s delivering the
goods and even if B does not pay the price on 6th July, A must offer the delivery
of the goods on 10th July. A can, of course, sue B for price and damages.
3. In the case of mutual and concurrent promises, the performance is to be
simultaneous. Thus, no promisor need perform need perform his promise unless
the promisee is ready and willing to perform his reciprocal promise.
Examples:
i) L and M contract that L shall deliver goods to M to be paid by instalments,
the first to be paid on delivery. L need not deliver, unless M is ready and
willing to pay for the goods on delivery. And M need not pay for the goods
unless L is ready and willing to deliver them on payment.
ii) R and S contract that R shall deliver goods to S at a price to be paid by
instalment, the first instalment to be paid on delivery. R need or deliver,
unless S is ready and willing to pay the first instalment on delivery. And S
need not pay the first instalment, unless R is ready and willing to deliver the
goods on payment of the first instalment.
Reciprocal Promise to do Things Legal and also other Things Illegal: Where
persons reciprocally promise, firstly, to do certain things, which are legal, and
secondly, under specified circumstances, to do certain things, which are illegal, the
first set of promises is a contract but the second set is a void agreement.
Examples: X and Y agree that shall sell Y a house for Rs. 1,00,000 but that if Y uses it
as a gambling house, he shall pay X Rs. 5,00,000 for it. The first set of reciprocal
promises, namely, to sell the house and pay Rs.1, 00,000 for it is a contract. The
second set is for unlawful object, that Y may use the house as a gambling house and is
a void agreement.
14.12.7 Appropriation of Payments

Appropriation of payments means application of payments. When a debtor owes
several debts in respect of which the payment must be made [to the same creditor], the
question may arise as to which of the debts, payment is to be appropriated. In
England, the law on the subject was laid down in Clayton’s case. The rule in
Clayton’s case was stated as: “if a man owes another two debts upon distinct cause,
and pays him a sum of money, the payer has a right to say to which account the
money so paid is to be appropriated”.
140 14.12.8 Assignment of Contracts
Assignment means transfer. When a party to a contract transfers his right, title and
interest in the contract to another person or persons, he is said to assign the contract.
Assignment of a contract can take place by (i) operation of law or (i) an act of parties.
The example of assignment by operation of law is by insolvency or death of the party
to the contract. In the case of insolvency the official receiver (or official assignee)
acquires the interest in the contract. In the case of death, the legal representative of the
deceased, who was a party to the contract are not active; it is the law which operates.
In the case of assignment by act of parties, the parties themselves make the
assignment.
14.12.9 Different Modes of Discharge of Contracts

A contract may be discharged by: (i) performance, (ii) tender; (iii) mutual consent;
(iv) subsequent impossibility (v) breach.
1. Discharge of Contracts by Performance or Tender: The obvious mode of
discharge of a contract is by performances that is where the parties have done
whatever was contemplated under the contract, the contract comes to an end.
Thus, where a contract to sell his to B for Rs 1,85,000, as soon as the car is
delivered to B and B pays the agreed price for it, the contract comes to an end by
performance. The tender or offer of performance has the same effect as
performance .If a promisor tenders performance of his promise but the other party
refuses to accept, the promisor stands discharged of his obligations.
2. Meaning of Mutual Consent: If the parties to a contract agree to substitute a new
contract for it, or to rescind it or alter it the original contract is discharged. A
contract may terminate by mutual consent in any of the six ways viz. Novation,
rescission, alteration and remission, waiver and merger.
(a) Novation: It means substituted of a new contract for the original one The
new contract may be substituted either between the same parties or between
different parties A owes money to B under a contract. It is agreed between
A, B and C that B shall henceforth accept C as his debtor instead of A. The
old debt of A to B is at an end a new debt from C to B has been contracted.
In order that the new contract is valid, it is essential to have the consent of
all the parties, including the new one (s), if any. Also the contract which is
substituted must be one capable of enforcement in law. Thus, where the
subsequent agreement is insufficiently stamped, and therefore, cannot be
sued upon, novation does not become effective, that is the original party
shall continue to be liable.
(b) Rescission: It means cancellation of all or some of the terms of the contract.
Where parties mutually decide to cancel all or some of the contract, the
obligation of the parties thereunder terminates.
(c) Alteration: If the parties mutually are to change certain terms of the
contract, it has the effect of terminating the original contract. There is,
however, no change in the parties.
(d) Remission: It is the acceptance of a lesser sum than what was contracted for
or a lesser fulfilment of the promise made. A owes B Rs 5,000. A pays to B
Rs 1,000 and B accepts them in satisfaction of his claim on A. This payment
is a discharge of the whole claim. It may be noted that the promisee may
remit or give up a part of his claim and the promise to do so is binding even
though there is no consideration for doing so.
Example: A owes B Rs 5,000. A pays to B accepts, in satisfaction of the 141
whole debt, Rs 2,000 paid at the time and place at which Rs 5,000 were Law of Contract
payable. The whole debt is discharged.

(e) Waiver: It means relinquishment or abandonment of a right. Where a party
waives his right under the contract, the other party is released of his
obligations. A promises to paint a picture for B. B afterwards forbids him to
do so. A is no longer bound to law of contract.
(f) Merger: A contract is said to have been discharged by way of merger where
an inferior right possessed by a person coincides with a superior right of the
same person. A, who is holding a certain property under a lease, buys it. His
rights as a lessee vanish; they right associated later by the change of certain
circumstances material to the ownership.
3. Discharge of Contracts by Impossibility of Performance: A contract may be
discharged because of impossibility of performance. There are two types of
impossibility: (i) impossibility may be inherent in the transaction. (i.e, the
contract), (ii) impossibility may emerge later by the change of certain
circumstances material to the contract.
Example of inherent impossibility: (i) A promises to pay B Rs. 50,000 if B rides
on a horse to the moon the contract is void ab initio.
(ii) a agrees with B to discover treasure by magic. The agreement is void ab initio,
as there is an impossibility inherent therein.
“Subsequent or Supervening Impossibility” as a Mode Discharge of Contract:
Where a contract originates as one capable of performance but later due to change
of circumstances its performance becomes impossible, it is known to have become
void by subsequent or supervening impossibility. The subsequent impossibility is
known as ‘doctrine of frustration’ under the English law.
A contract is deemed to have become impossible of performance and thus void
under the following circumstances:
(a) Destruction of the Subject Matter of the Contract: Where the performance of
the subject matter of contracts is destroyed for no fault of the promisor, the
contract becomes void by impossibility of performance. Thus, where a music
hall was agreed to be let out on certain dates, but before those dates it was
destroyed by fire the owner was absolved from liability to let the building as
promised [Taylor v. Caldwell (1863) 122 E R 299].
(b) By the Death or Disablement of the Parties: Where the performance of the
contract must be executed personally by the promise, his death or physical
disability to perform shall render the contract void and thus exonerate him
from the obligation.
Examples. (i) A, a singer, agrees with B, to give performance at some
particular theatre on a specified date. While on her way to theatre, A meets
with an accident and is rendered unconscious. The agreement becomes void.
(ii) A contracts to act at a theatre for six months in consideration of a sum
paid in advance by B. On several occasions A is too ill to act. The contract to
act on those occasions becomes void.
However, in a case where the contract is not to be executed personally by the
promisor, then death or physical disability does not render the contract void.
Example. X borrowed Rs 10,000 from Y to be repaid by a certain date. X dies
before the debt course, the legal representative’s liability is limited to the
extent of the value of the assets inherited by him.
142 (c) Subsequent Illegality: Where by subsequent legislation, the performance of a
contract is forbidden by law, the parties are absolved from liability to perform
it. A contracts to supply B 100 bottles of whisky. Before the contract is
executed, i.e., bottles supplied, dealings in all sorts of liquor are declared
forbidden, the contract becomes void.
(d) Declaration of War: If war is declared between two countries subsequent to
the making of the contract, the parties would be exonerated from its
performance. A contract to take indigo for B to a foreign port. A’s
government afterwards declares war against the country in which the port is
situated. The contract becomes void when war is declared.
(e) Non-Existence or Non-Occurrence of a Particular State of Things: When
certain things necessary for performance cease to exist, the contract becomes
void. A contracted to have a flat for viewing the coronation procession of the
king. The procession had to be cancelled on account of king’s illness. In a suit
for recovery of the rent it was held that the contract became impossible of
performance, and that the hirer need not pay the rent.
Circumstances in which a Contract is not Discharged on the Ground of
Subsequent Impossibility: Except for the five cases mentioned above,
subsequent impossibility does not discharge contracts. He who agrees to do an
act must do it, unless absolutely impossible under the five cases mentioned
above. There are at least five cases, where the performance is not excused on
account of subsequent impossibility. These are:
(i) Difficulty of Performance: The mere fact that performance is more
difficult or expensive or less profitable than the parties anticipated, does
not discharge the contract. A promised to send certain goods from
Mumbai to Antiwerp is September. In August war broke out and shipping
was not available except at very high rates. Held, the increase of freight
rates did not excuse performance.
(ii) Commercial impossibility: It means that if the contract is performed, it
will result in a loss to the promisor. Commercial impossibility to perform
a contract does not discharge the contract. A contract to lay gas mains is
not discharged because the outbreak of war makes it expensive to procure
the necessary materials.
(iii) The promisor is not exonerated from his liability if the third person, on
whose work the promisor relied, fails to perform. Thus, a wholesaler’s
contract to deliver goods is not discharged because a manufacturer has not
produced the goods concerned.
(iv) Strikes, lockouts and civil disturbances: Events like these do not terminate
contracts unless there is a clause in the contract to that effect. A agreed to
supply B certain goods to be produced in Algeria. The goods could not be
produced because of riots and civil disturbances in that country. Held,
there was no excuse for non-performance of the contract.
(v) Failure of one of the object: If the contract is made for several purposes,
the failure of one of them does not terminate the contract. A agreed to let
a boat to H to: (a) view the naval review at the coronation and (b) to
cruise around fleet. Owing to the king’s illness the naval review was
cancelled but the fleet was assembled and the boat could have been used
to cruise round the fleet. Held, the contract was not discharged.
4. Discharge of a Contract by Operation of Law: Discharge by operation of law 143
may take place in four ways: Law of Contract
(a) By death. Death of the promisor results in termination of the contract in

cases involving personal skill or ability.
(b) By insolvency. The insolvency law provides for discharge of contracts
under certain circumstances so where an order of discharge is passed by
an insolvency court the insolvent stands discharged of all debits incurred
previous to his adjudication.
(c) By merger. When between the same parties, a new contract is entered
into, and a security of a higher degree or a higher kind is taken, the
previous contract merges in the higher security. Thus a right of action on
an ordinary debt would be merged in the right of suing on a mortgage for
the same debt.
(d) By the unauthorized alteration of terms of a written document. Where any
of the parties alters any of the terms of the contract without seeking the
consent of the other party to it, the contract terminates.
5. Discharge of Contracts by Breach: A breach of contract is one party’s failure,
without a legal excuse, to live up to any of its promises under a contract. A
contract terminates by breach of contract. If the promisor has not performed his
promise in accordance with the terms of the contract or where the performance is
not excused by tender, mutual consent or impossibility or operation of law, then
this amounts to a breach of contract on the part of the promisor. The consequence
of this is that the promise becomes entitled to certain remedies. The breach of
contract may arise in two ways: (1) anticipatory (2) actual.
14.12.10 Remedies for Breach of Contracts

When someone breaches a contract, the other party is no longer obligated to keep its
end of the bargain. From there, that party may proceed in several ways:
(i) the other party may urge the breaching party to reconsider the breach.
(ii) if it is a contract with a merchant, the other party may get help from consumer’s
associations.
(iii) the other party may bring the breaching party to an agency for alternative dispute
resolution.
(iv) the other party may sue for damages.
(v) the other party may sue for other remedies.
As soon as either party commits a breach of the contract, the other party becomes
entitled to certain reliefs. These remedies are available under the Indian Contract Act,
1872, as also under the Specific Relief Act, 1963. There are some remedies:
(i) A decree for specific performance
(ii) An injunction
(iii) A suit on quantum meruit
(iv) Rescission of the contract
(v) Damages for the loss sustained or suffered.
144 Check Your Progress 2
1. What do you mean by consent?
…………………………………….………………………………………..
…………………………………….………………………………………..
2. What do you mean by wager?
…………………………………….………………………………………..
…………………………………….………………………………………..
3. What is quantum meruit?
…………………………………….………………………………………..
…………………………………….………………………………………..
4. What do you mean by novation?
…………………………………….………………………………………..
…………………………………….………………………………………..
5. What do you mean by recession?
…………………………………….………………………………………..
…………………………………….………………………………………..
6. What do you mean by alteration?
…………………………………….………………………………………..
…………………………………….………………………………………..
7. What do you mean by remission?
…………………………………….………………………………………..
…………………………………….………………………………………..
8. What do you mean by waiver?
…………………………………….………………………………………..
…………………………………….………………………………………..
9. What do you mean by merger?
…………………………………….………………………………………..
…………………………………….………………………………………..
14.13 LET US SUM UP

A contract is sometimes defined as “an agreement creating an obligation,” which
means a binding agreement. This definition naturally resolves itself into two distinct
parts. First, there must be an agreement. Secondly, such as agreement must be
enforceable by law. Different kinds of contracts are: formal and simple contracts,
express and implied contracts, valid, voidable, void and unenforceable contracts,
Executed and executory contracts, Bilateral and unilateral contracts.
Essentials of a valid contract are, there must be: (1) an agreement, (2) based upon the
genuine assent of the parties, (3) supported by consideration, (4) made for a lawful
object, (5) between complement parties. This lesson highlighted the requirements
of an offer. A valid offer must meet the tests of (1) contractual intension,
(2) definiteness, and (3) communication to the offeree. And also it emphasized the
essentials of a valid offer, irrevocable offers. When in place of acceptance the terms of
an offer as they are, the offeree accepts the same subject to certain conditions or 145
qualifications, he is said to make a counter offer. A consideration may be: Law of Contract
(a) executory or future, (b) executed or present, or (c) past consideration. This lesson
highlighted rules governing consideration. A void contract is one, which has no legal
effect. An illegal contract like the void contract has no legal effect as between the
immediate parties. A wager is a promise to pay money or transfer property upon the
determination or ascertainment of an uncertain event, the law creates and enforces
legal rights and obligations when no real contract exists. These obligations are known
as quasi-contracts. The expression “Quantum Meruit” literally means, “as much as
earned.” It is used where a person claims reasonable remuneration for the services
rendered by him when there was no express promise to pay the definite remuneration.
‘Performance’ of contract means the carrying out of obligations under it. The parties
to contract must either perform or offer to perform their promises unless such
performance is dispensed with or excused under the provisions of the Indian contract
act. A contract may be discharged by: (i) performance, (ii) tender, (iii) mutual consent,
(iv) subsequent impossibility, (v) breach.

Find out the differences between void and voidable contract with examples.
14.15 KEYWORDS
Contract: In the broadest sense, a contract is an exchange of promises by two or more
persons, resulting in an obligation to do and refrain from doing a particular act, which
obligation is recognized and enforced by law.
Parol contracts: All contracts other than contracts of record and contracts under seal a
re called simple or parol contracts, whether they are in writing or merely oral.
Valid contract: A valid contract is an agreement, which is binding and enforceable. It
has all the essential elements to be stated and discussed later.
Voidable contract: A voidable contract is an agreement that is binding and
enforceable but, because of the lack of one or more of the essentials of a valid
contract, it may be repudiated by the aggrieved party at his option.
Void contract: A void contract is really not a contract at all. The term means an
agreement, which is without any legal effect.

1. Define contract. Explain the different kinds of contract.
2. Explain the essentials of a valid contract.
3. Explain the requirement and duration of an offer.
4. What are the essentials of a valid offer?
5. What are the rules governing consideration?
6. Explain the expectations to the doctrine of privity.
7. What do you mean by performance of a contract? Who must perform the promise
under a contract?
8. Explain the different modes of discharge of contract.
9. What do you mean by breach of contract? What are the remedies for breach of
contracts?
CYP 1
1. A contract is defined as “an agreement creating an obligation,”
2. Parol contracts
3. Void contract is really not a contract at all. The term means an agreement,
which is without any legal effect. Thus an agreement by a minor is void
under the Indian law.
4. A voidable contract is an agreement that is binding and enforceable but,
because of the lack of one or more of the essentials of a valid contract, it
may be repudiated by the aggrieved party at his option. If the party having
the right to avoid his obligation does not exercise the right to avoid his
obligation does not exercise the right within a reasonable time, the
agreement is binding and enforceable.
CYP 2
1. When two or more persons agree upon the same thing in the same sense
they are said to consent.
2. A wager is a promise to pay money or transfer property upon the
determination or ascertainment of an uncertain event, e.g., a horse race, or
a football march.
3. “Quantum Meruit” literally means, “as much as earned.”
4. Novation means substituted of a new contract for the original one The
new contract may be substituted either between the same parties or
between different parties.
5. Rescission means cancellation of all or some of the terms of the contract.
6. If the parties mutually are to change certain terms of the contract.
7. It is the acceptance of a lesser sum than what was contracted for or a
lesser fulfilment of the promise made.
8. It means relinquishment or abandonment of a right. Where a party waives
his right under the contract.
9. A contract is said to have been discharged by way of merger where an
inferior right possessed by a person coincides with a superior right of the
same person.

Gulshan, S.S, “Mercantile law”, Excel Books, New Delhi, 2004.
Kapoor, N.D., “Elements of Mercantile Law”, Sultan Chand & Sons, New Delhi, 2003.
Shukla, M.C., “Mercantile Law”, S. Chand & Company Ltd., New Delhi, 1998.
147
LESSON The Patient and the Consumer
Protection Act, 1986
15
THE PATIENT AND THE CONSUMER PROTECTION
ACT, 1986
CONTENTS
15.1 Introduction
15.2 Reasons for Attitudinal Change
15.3 Definitions
15.4 Consumer
15.5 Hire
15.6 Consideration
15.7 Contract of Personal Service
15.8 Objects and Reasons for the Act
15.9 Consumer Disputes Redressal Agencies
15.10 Powers of Consumer Disputes Redressal Agencies
15.11 Let us Sum up
15.13 Keywords

z Get an idea about the patient and consumer protection Act
z Know about the objects and the reasons for this Act
z Understand the consumer disputes redressal agencies
15.1 INTRODUCTION
Till recently, of any dispute regarding negligence on the part of the doctors or
hospitals was raised in a court of law, it was either filed under the Law of Torts to
claim damages or under Sections 304A, 336, 337 and 338 of the Indian Penal Code to
get the negligent punished. However, after the introduction of the Consumer
Protection Act, 1986, a drastic change has taken place, and we find a number of
complaints being filed by patients and their heirs in the District Forum, and State /
National Commission created under the Consumer Protection Act, 1986, against
individual doctors and hospitals for negligence.
148
Health Laws and Policies 15.2 REASONS FOR ATTITUDINAL CHANGE
There can be number of reasons for this change, but the main reasons are:
z Increasing knowledge of one’s rights as a patients.
z doctors and hospitals are no more held in high esteem as they were held before;
z no cost is involved if a complaint is filed in the District Forum of State / National
Commission under the Consumer Protection Act, since a patient can make out his
case and argue it himself.
z A complaint is decided within a short span of three to four months under the
Consumer Protection Act while it usually takes ears in the civil / criminal courts.
z Thus the Act has opened up possibilities of easy, cheap and quick redressal of
grievances.
z The lowest tribunal under the Act is the District Forum.
z Higher valuation matters have been given to the State Commission and the
National Commission.
z The State Commission will hear and decide appeals against the orders of the
District Forum.
z The National Commission in turn will have and decide appeals against the orders
of the State Commission.
z A Special leave Petition raising questions of Law against the orders of the
National Commission may be made to the Supreme Court.
15.3 DEFINITIONS
z ‘Consumer’, means any person who;
(a) Buys any goods for a consideration which has been paid or promised or partly
paid and partly promised, or under any system of deferred payment and
includes any use of such goods other than the person who buys such goods for
consideration paid or promised or partly paid or partly promised or under any
system of deferred payment when such use is made with the approval of such
person, but does not include a person who obtains such goods for resale or for
any commercial purpose; or
(b) Hires and services for a consideration which has been paid or promised or
party paid and partly promised or under any system of deferred payment and
includes and beneficiary of such services other than the person who hires the
services for consideration paid or promised or partly paid and partly
promised, or under any system of deferred payment, when such services are
availed of with the approval of the first mentioned person.
z ‘Consumer dispute’ means a dispute where the person against whom a complaint
has been made denies or disputes the allegations contained in the complaint.
z ‘Service’ means service of any description which is made available to potential
users and includes the provision of facilities in connection with banking,
financing, insurance, transport, processing, supply of electrical or other energy,
boarding or lodging or both, entertainment, amusement or the provision of news
or other information, but does not include the rendering of any service free of
charge or under a contract of personal service.
z ‘Complaint’ means any allegation in writing made by a complainant such that:
(a) As a result of any unfair trade practice adopted by any trader, the complainant
has suffered loss or damage;
(b) The goods mentioned in the complaint suffer from one or more defects; 149
The Patient and the Consumer
(c) The services mentioned in the complaint suffer from deficiency in some Protection Act, 1986
respect;
(d) A trader has charged for the goods mentioned in the complaint a price in
excess of the price fixed by or under any law for the time being in force or
displayed on the goods or any package containing such goods,
With a view to obtaining any relief provided by or under this Act;
z ‘Complainer’ means:
(i) A consumer; or
(ii) Any voluntary consumer association registered under the Companies Act,
1956 (1 of 1956), or under any other law for the time being in force, or
(iii) The Central Government or any State Government, which makes a complaint.
z ‘Deficiency’ means fault, imperfection, shortcoming or inadequacy in the quality,
nature and manner of performance which is required to be maintained by or under
any law for the time being in force or has been undertaken to be performed by a
person in pursuance of a contract or otherwise in relation to any service.
Now the question arises whether a patient getting treatment for an ailment either.
(a) in a government hospital, or (b) in a charitable hospital, or (c) in a nursing home,
or (d) from a medical practitioner, is a consumer or not.
According to the above definitions, a consumer is one who hires any service for a
consideration. A person is not a consumer if he receives any service free of charge or
under a contract of personal service.
We shall now explain the words ‘consumer’, ‘hire’ and consideration in the literal
sense and contract of personal service in the legal sense.
15.4 CONSUMER
A consumer is one who consumes. It may be the goods which he buys to consume or
the services he hires. Thus all human beings are consumers so long as they liver and
all consumers’ problems are human problems.
15.5 HIRE
The dictionary meaning of ‘hire’ is quite limited’ payment for use of an object or
service. It generally refers to hiring a taxi or house or anything temporarily.
15.6 CONSIDERATION
In the words of Pollock, ‘consideration’ is the price for which the promise of the other
is bought and the promise thus given for value is enforceable. When a transaction
takes place each party gets something. This ‘something’ is called the consideration.
15.7 CONTRACT OF PERSONAL SERVICE

A contract of personal service should have: (a) the element of payment of wages,
salary, fee or charges for a technical or professional service; and (b) the hirer or
consumer should be in a position to supervise or control the person who is rendering
the service. In the case of a doctor’s services, the patient is in no position to supervise
or control the doctor. Therefore, the doctor cannot be said to be under a contract of
personal service to the patient. On the other hand, a clerk employed by a firm is under
a ‘contract of personal service.’
1. What is a consumer?
………………………………..…………………………………………….
………………………………..…………………………………………….
2. What is consumer dispute?
…………………………………….………………………………………..
…………………………………….………………………………………..
3. What do you mean by deficiency?
…………………………………….………………………………………..
…………………………………….………………………………………..
15.8 OBJECTS AND REASONS FOR THE ACT

The Consumer Protection Act, 1986, seeks to provide better protection of the interests
of consumers and, for that purpose, to make provision for the establishment of
consumer councils and other authorities for the settlement of Consumer disputes and
for matters connected therewith, in order to provide speedy and cheap remedy to the
consumers.
It seeks to promote and protect the rights of consumers such as:
z The right to be protected against marketing of goods which are hazardous to life
and property;
z The right to be informed about the quality, quantity, potency, purity, standard and
price of goods to protect the consumer against unfair trade practices;
z The right to be assured, wherever possible, access to a variety of goods at
competitive prices;
z The right to be heard and to be assured that the consumer’s interests will receive
due consideration at appropriate forums;
z The right to seek redressal against unfair trade practice or unscrupulous
exploitation of consumers; and
z The right to consumer education.
15.9 CONSUMER DISPUTES REDRESSAL AGENCIES

There are three sets of redressal agencies:
z District Forums,
z State Consumer Disputes Redressal Commission,
z National Consumer Disputes Redressal Commission.
1. The District Forum shall consist of one president and two members:
(a) A person who is or has been or is qualified to be a District Judge will be its
President;
(b) A person of eminence in the field of education, trade or commerce;
(c) A lady social worker.
The District Forum shall have jurisdiction to entertain complaints where the value
of the goods or services and the compensation, if any, claimed does not exceed Rs
20 lakhs.
2. The State Commission shall consist of one president and two members: 151
The Patient and the Consumer
(a) A person who is or has been a judge of a High Court shall be its President; Protection Act, 1986
(b) Two other members who shall be persons of ability, integrity and standing
and have adequate knowledge or experience of, or have shown capacity in
dealing with, problems relating to economics, law, commerce, accountancy,
industry, public affairs or administration, one of whom shall be a woman.
The State Commission shall have the jurisdiction to entertain complaints of above
Rs. 20 lakhs but not exceeding Rs 1 crore as well as appeals against the orders of
any District Forum within the State.
(a) The National Commission shall consist of one president and four members;
(b) A person who or has been a judge of the Supreme Court shall be its President;
(c) Four other members who shall be persons of ability, integrity and standing
and have adequate knowledge or experience of, and have shown capacity in
dealing with problems relating to economics, law commerce, accountancy
industry, public affairs or administration, one of whom shall be a woman.
3. The National Commission shall have jurisdiction to attend to complaints where
the value of the goods of services and compensation, if any, claimed exceeds Rs 1
crore as well as appeal s against the orders of any State Commission.
15.10 POWERS OF CONSUMER DISPUTES REDRESSAL

AGENCIES
The agencies such as District Forum / State Commission / National Commission
under the Act, though act as quasi-judicial bodies, yet enjoy wide powers of both civil
and criminal courts to adjudicate the disputes in a proper legal manner. They have
been vested with the same powers as are vested in a civil court of competent
jurisdiction under the Code of Civil Procedure while trying a regular suit in:
z Summoning and enforcing the attendance of any opposite party of witness and
examining the witness on oath;
z The discovery and production of any document or other material object
producible as evidence;
z The reception of evidence of Affidavits;
z The requisitioning of an expert or report from any other relevant source; and
z Issuing a commission for examination of any witness and other matter, which may
be prescribed.
On a careful reading of the provisions of the Consumer Protection Act, 1986, as a
whole it would be seen that in enacting the statute, the intention of parliament was to
provide protection and relief to four categories of consumers, namely (a) persons who
have suffered loss or damages as a result of any unfair trade practice adopted by any
trader; (b) persons who have purchased goods for consideration which are found to
suffer from one or more defects; (c) persons who have purchased goods for which the
trader has charged a price in excess of the price fixed by or under any law for the time
being in force, or displayed on the goods or any package containing such goods; and
(d) persons who have hired any services for consideration when the services provided
are found to suffer from deficiency in any respect.
These categories of persons have been conferred the right to approach the redressal
agencies constituted under the Act and provisions have been made enabling those
agencies to grant them speedy and efficacious remedies to set right their grievances.
152 Under the Act, the District Forum / State Commission / National Commission may
direct the opposite party to do one or more of the following things to provide relief to
the aggrieved party:
1. Remove the defect of the goods;
2. Replace the goods with new goods of similar description which shall be free from
any defect;
3. Return the price to the complainant;
4. Pay such amount as may be awarded;
5. Discontinue the unfair trade practice;
6. Remove the deficiencies in the service;
7. Not to offer hazardous goods for sale, and
8. Withdraw the hazardous goods form the market.
15.11 LET US SUM UP

A consumer is one who consumes. It may be the goods which he buys to consume or
the services he hires. Thus all human beings are consumers so long as they liver and
all consumers’ problems are human problems. Consumer dispute means a dispute
where the person against whom a complaint has been made denies or disputes the
allegations contained in the complaint The main objects and reasons for The
Consumer Protection Act, 1986, seeks to provide better protection of the interests of
consumers and, for that purpose, to make provision for the establishment of Consumer
councils and other authorities for the settlement of Consumer disputes and for matters
connected therewith, in order to provide speedy and cheap remedy to the Consumers
It seeks to promote and protect the rights of consumers. There are three sets of
redressal agencies: District Forums, State Consumer Disputes Redressal Commission,
National Consumer Disputes Redressal Commission. Under the Act, the District
Forum / State Commission / National Commission may direct the opposite party to do
one or more of the actions to provide relief to the aggrieved party.

Discuss about a consumer issue araised in a hospital situated at your city.
15.13 KEYWORDS
Consumer dispute: It means a dispute where the person against whom a complaint
has been made denies or disputes the allegations contained in the complaint.
Service: It means service of any description which is made available to potential users
and includes the provision of facilities in connection with banking, financing,
insurance, transport, processing, supply of electrical or other energy, boarding or
lodging or both, entertainment, amusement or the provision of news or other
information, but does not include the rendering of any service free of charge or under
a contract of personal service.
Complaint: It means any allegation in writing made by a complainant.
Deficiency: It means fault, imperfection, shortcoming or inadequacy in the quality,
nature and manner of performance which is required to be maintained by or under any
law for the time being in force or has been undertaken to be performed by a person in
pursuance of a contract or otherwise in relation to any service.
153
15.14 QUESTIONS FOR DISCUSSION The Patient and the Consumer
Protection Act, 1986
1. Explain about the Patient and Consumer Protection Act.
2. Explain consumer disputes redressal agencies and its power.

1. Consumer means any person who: (i) Buys any goods for a consideration
which has been paid or promised or partly paid and partly promised.
(ii) Hires and services for a consideration which has been paid or
promised or party paid and partly promised.
2. Consumer dispute means a dispute where the person against whom a
complaint has been made denies or disputes the allegations contained in
the complaint.
3. Deficiency means fault, imperfection, shortcoming or inadequacy in the
quality, nature and manner of performance which is required to be
maintained by or under any law for the time being in force or has been
undertaken to be performed by a person in pursuance of a contract or
otherwise in relation to any service.

154
16
BIO-MEDICAL WASTE (MANAGEMENT AND
HANDLING) RULES
CONTENTS
16.1 Introduction
16.3 Application
16.4 Definitions
16.5 Duty of Occupier
16.6 Treatment and Disposal
16.7 Segregation, Packaging, Transportation and Storage
16.8 Prescribed Authority
16.9 Authorisation
16.10 Advisory Committee
16.11 Annual Report
16.12 Maintenance of Records
16.13 Appeal
16.14 Schedules
16.14.1 Schedule I – Categories of Bio-Medical Waste
16.14.2 Schedule II – Colour Coding and Type of Container
16.14.3 Schedule V – Standards for Treatment and Disposal of Wastes
16.14.4 Schedule VI – Schedule for Waste Treatment Facilities
16.15 Let us Sum up
16.17 Keywords

z Understand the Bio-medical Waste Management Act and its application
z Get a clear idea about the treatment, disposal, segregation, packaging, transporting
and storage of bio-medical waste
z Know about the different schedules of this Act
155
16.1 INTRODUCTION Bio-medical Waste (Management
and Handling) Rules
Bio-medical waste is the waste generated by health care establishments, research
facilities and laboratories. Safe disposal of biomedical waste is now a legal
requirement in our country. In this connection, the Government of India first enacted
the Environment (Protection) Act in 1986 and then notified the Rules for the
Management and Handling of Biomedical waste on 20th July, 1998.

1. These rules may be called the Bio-Medical Waste (Management and Handling)
Rules, 1998.
2. They shall come into force on the date of their publication in Official Gazette.
16.3 APPLICATION
These rules apply to all persons who generate, collect, receive, store, transport, treat,
dispose or handle bio-medical waste in any form.
16.4 DEFINITIONS
In these rules unless the context otherwise requires:
z “Act” means the Environment (protection) Act, 1986
z “Animal House” means a place where animals are reared/kept for experiments or
testing purposes.
z “Authorization” means permission granted by the prescribed authority for the
generation, collection, reception, storage, transportation, treatment, disposal
and/or any other form of handling bio-medical waste in accordance with these
rules and any guidelines issued by the Central Government.
z “Authorized Person” means an occupier or operator authorized by the prescribed
authority to generate, collect, receive, store, transport, treat, dispose and/or handle
bio-medical waste in accordance with these rules and any guidelines issued by the
Central Government.
z “Bio-medical waste” means any waste, which is generated during the diagnosis,
treatment or immunization of human beings or animals or in research activities
pertaining thereto or in the production or testing of biological, and including
categories mentioned in Schedule I.
z “Biologicals” means any preparation made from organisms or micro-organisms or
product of metabolism and biochemical reactions intended for use in the
diagnosis, immunization or the treatment of human beings or animals or in
research activities pertaining thereto.
z “Bio-Medical waste treatment facility” means any facility wherein treatment,
disposal of bio-medical waste or processes incidential to such treatment or
disposal is carried out.
z “Schedule” means schedule appended to these rules.
16.5 DUTY OF OCCUPIER

It shall be the duty of every occupier of an institution generating bio-medical waste
which includes a hospital, nursing home, clinic, dispensary, veterinary institution,
animal house, pathological laboratory, blood bank by whatever name called to take all
steps to ensure that such waste in handled without any adverse effect to human health
and the environment.
156
Health Laws and Policies 16.6 TREATMENT AND DISPOSAL
z Bio-medical waste shall be treated and disposed of in accordance with Schedule I,
and in compliance with the standards prescribed in Schedule V.
z Every occupier, where required, shall set up in accordance with the time–
Schedule VI, requisite bio-medical waste treatment facilities like incinerator,
autoclave, microwave system for the treatment of waste or ensure requisite
treatment of waste at a common waste treatment facility or any other waste
treatment facility.
16.7 SEGREGATION, PACKAGING, TRANSPORTATION

AND STORAGE
z Bio-medical waste shall not be mixed with other wastes.
z Bio-medical waste shall be segregated into containers/bags at the point of
generation in accordance with Schedule II prior to its storage, transportation.
z If a container is transported from the premises where bio-medical waste is
generated to any waste treatment facility outside the premises, the container shall,
apart from the label prescribed in Schedule III, also carry information prescribed
in Schedule IV.
z Notwithstanding anything contained in the Motor Vehicle Act, 1998 or Rules
thereunder, untreated bio-medical waste shall be transported only in such vehicle
as may be authorized for the purpose by the competent authority as specified by
the government.
z No untreated bio-medical waste shall be kept stored beyond a period of 48 hours:
Provided that if for any reason it becomes necessary to store the waste beyond
such period, the authorized person must take permission of the prescribed
authority and take measures to ensure that the waste does not adversely affect
human health and the environment.
16.8 PRESCRIBED AUTHORITY

z The Government of every State and Union territory shall establish a prescribed
authority with such members as may be specified for granting authorization and
implementing these rules. If the prescribed authority comprises of more than one
member, a chairperson for the authority shall be designated.
z The prescribed authority for the State or Union Territory shall be appointed within
one month of the coming into force of these rules.
16.9 AUTHORISATION
z Every occupier and Every operator of an institution generating, collecting,
receiving, storing, transporting, treating, disposing and/or handling bio-medical
waste in any other manner, except such occupier of clinics, dispensaries,
pathological laboratories, blood banks providing treatment/service to less than
1000 patients per month, shall make an application.
z Every application for grant of authorization shall be accompanied by a fee as may
be prescribed by the Government of the state or Union Territory.
16.10 ADVISORY COMMITTEE

The Government of every State/Union territory shall constitute an advisory
committee. The committee will include experts in the field of medical and health,
animal husbandry and veterinary sciences, environmental management, municipal 157
Bio-medical Waste (Management
administration and any other related department or organization including non- and Handling) Rules
governmental organizations. The state pollution control board/ pollution control
committee shall be represented. As and when required, the committee shall advise the
Government of the State/Union Territory and the prescribed authority about matters
related to the implementation of these rules.
16.11 ANNUAL REPORT

Every occupier/operator shall submit an annual report to the prescribed authority,
include information about the categories and quantities of bio-medical wastes handled
during the preceding year. The prescribed authority shall send this information in a
compiled form to the central pollution control board by 31st March every year.
16.12 MAINTENANCE OF RECORDS

z Every authorized person shall maintain records related to the generation,
collection, reception, storage, transportation, treatment, disposal and/or form of
handling of bio-medical waste in accordance with these rules and any guidelines
issued.
z All records shall be subject to inspection and verification by the prescribed
authority at any time.
16.13 APPEAL
Any person aggrieved by an order made by the prescribed authority under these rules
may, within thirty days from the date on which the order is communicated to him,
prefer an appeal to such authority as the Government of State/Union Territory may
think fit to constitute; Provided that the authority may entertain the appeal after expiry
of the said period of thirty days if is satisfied that the appellant was prevented by
sufficient cause from filling the appeal in time.
16.14 SCHEDULES
The Biomedical Waste (Management and Handling) Rules, have six schedules. A
brief summary of the contents of each schedule is presented below.
Schedule Contents
Schedule I Classification of biomedical waste in various categories
Colour coding and type of containers to be used for each

Schedule II
category of biomedical waste
Schedule III Pro forma of the label to be used on container/bag
Schedule IV Pro forma of label for transport of waste container/bag
Schedule V Standards for treatment and disposal of waste
Schedule VI Deadlines for creation of waste treatment facilities
Form I Format of application for authorization
Form II Format of annual report
Form III Format of accident reporting

158 16.14.1 Schedule I – Categories of Bio-Medical Waste
Category No. 1 Human anatomical waste (human tissues, organs, body parts)
Animal waste (Animal tissues, organs, body parts, bleeding
Category No. 2
parts, fluid, blood)
Microbiology and biotechnology waste (waste from laboratory
Category No. 3 cultures, stocks or specimens of micro-organisms live or
attenuated vaccine, human and animal cell culture)
Category No. 4 Waste sharpe (needles, syringes, scalpes, blades, glass etc)
Discarded medicine and cytotoxic drugs (outdated and
Category No. 5
contaminated medicine)
Solid waste (dressings, soiled plaster caste, linens other
Category No. 6
contaminated with blood)
Solid waste (waste generated from disposable items other than
Category No. 7 the waste sharpe such as tubings, catheters, intravenous sets
etc)
Liquid waste (waste generated from laboratory and washing,
Category No. 8
cleaning, housekeeping and disinfecting activities)
Incineration ash (ash from incineration of any bio-medical
Category No. 9
waste)
Chemical waste (chemicals used in production of biologicals,
Category No. 10
chemicals used in disinfection, as insecticides etc.)
Check Your Progress

1. What do you mean by bio-medical waste?
…………………………………….………………………………………..
…………………………………….………………………………………..
2. What is bio-medical waste treatment facility?
…………………………………….………………………………………..
…………………………………….………………………………………..
3. How many schedules are followed in this Act? What are those?
…………………………………….………………………………………..
…………………………………….………………………………………..
16.14.2 Schedule II – Colour Coding and Type of Container

Colour coding Type of container Waste category
Yellow Plastic bag Category 1, 2 , 3 and 6
Red Disinfected container/plastic bag Category 3, 6 and 7
Blue/white Plastic bag / puncture proof container Category 4 and 7
Black Plastic bag Category 5, 9 and 10
16.14.3 Schedule V - Standards for Treatment and Disposal of Wastes

z Standards for Incinerators: All incinerators shall meet the following operating
and emission standards:
Operating Standards
1. Combustion efficiency (CE) shall be at least 99.00%
2. The combustion efficiency is computed as follows:
%CO 2 159
CE u 100 Bio-medical Waste (Management
%CO 2 %CO and Handling) Rules
3. The temperature of the primary chamber shall be 800 = 50 C.

4. The secondary chamber gas residence time shall be at least 1 (one) second at
1050 +/- 50 C, with minimum 3 percent oxygen in the stack gas.
Emission Standards Concentration mg/NM3 at
Parameters (12% CO2 correction)
1. Particulate matter 150
2. Nitrogen oxides 450
3. HCI 50
4. Minimum stack height shall be 30 meters above ground.
5. Volatile organic compounds in ash shall not be more than 0.01%.
Note:
Suitably designed pollution control devices should be installed / retrofitted
with the incinerator to achieve the above emission limits, if necessary.
Wastes to be incinerated shall not be chemically treated with any chlorinated
disinfectants.
Chlorinated plastics shall not be incinerated.
Toxic metals in incineration ash shall be limited within the regulatory
quantities as defined under the Hazardous Waste (Management and Handling)
Rules, 1989.
Only low sulphur fuel like LDO/LSHS/Diesel shall be used as fuel in the
incinerator.
z Standards for Waste Autoclaving: The autoclave should be dedicated for the
purposes of disinfecting and treating bio-medical waste.
1. When operating a gravity flow autoclave, medical waste shall be subjected to:
(i) A temperature of not less than 121C and pressure of 15 pounds per square
inch (psi) for an autoclave residence time of not less than 60 minutes; or
(ii) A temperature of not less than 135C and a pressure of 31 psi for an autoclave
residence time of not less than 45 minutes; or
(iii) A temperature of not less than 149C and a pressure of 52 psi for an autoclave
residence time of not less than 30 minutes.
2. When operating a vacuum autoclave, medical waste shall be subjected to a
minimum of one pre-vacuum pulse to purge the autoclave of all air. The waste
shall be subjected to the following:
(i) A temperature of not less than 121C and pressure of 15 psi for an autoclave
residence time of not less than 45 minutes; or
(ii) A temperature of not less than 135C and a pressure of 31 psi for an autoclave
residence time of not less than 30 minutes.
3. Medical waste shall not be considered properly treated unless the time,
temperature and pressure indicators indicate that the required time temperature
and pressure were reached during the autoclave process. If for any reasons, time,
temperature or pressure indicator indicates that the required temperature, pressure
or residence time was not reached, the entire load of medical waste must be
160 autoclaved again until the proper temperature, pressure and residence time were
achieved.
4. Recording of Operational Parameters: Each autoclave shall have graphic or
computer recording devices which will automatically and continuously monitor
and record dates, time of day, load identification number and operating
parameters throughout the entire length of the autoclave cycle.
5. Validation Test Spore Testing: The autoclave should completely and consistently
kill the approved biological indicator at the maximum design capacity of each
autoclave until. Biological indicator for autoclave shall be Bacillus
atearothermophilus spores using vials or spore strips, with at least 1 × 10 spores
per milliliter. Under no circumstances will an autoclave have minimum operating
parameters less than a residence time of 30 minutes, regardless of temperature and
pressure, a temperature less than 121C or a pressure less than 15 psi.
6. Routine Test: A chemical indicator strip/tape that changes colour when a certain
temperature is reached can be used to verify that a specific temperature has been
achieved. It may be necessary to use more than one strip over the waste package
at different location to ensure that the inner content of the package has been
adequately autoclaved.
z Standards for Liquid Waste: The effluent generated from the hospital should
confirm to the following limits:
Parameters Permissible Limits
pH 6.6-9.0
Suspended solids 100 mg/l
Oil and grease 10 mg/l
BOD 30 mg/l
Bio-assay test 90% survival of fish after 96 hours in 100 percent effluent.
These limits are applicable to those hospitals, which are either connected with sewers
without terminal sewage treatment plant or not connected to public sewers. For
discharge into public sewers with terminal facilities, the general standards as notified
under the Environment (Protection) Act, 1986 should be applicable.
z Standards of Microwaving:
1. Microwave treatment shall not be used for cytotoxic, hazardous or radioactive
wastes, contaminated animal carcasses, body parts and large mental items.
2. The microwave system shall completely with the efficacy test/routine tests
and a performance guarantee may be provided by the supplier before
operation of the unit.
3. The microwave should completely and consistently kill the bacteria and other
pathogenic organisms that is ensured by approved bio-logical indicator at the
maximum design capacity of each microwave unit, biological indicators for
microwave shall be Bacillus Subtitles spores using vials or spore strips with at
least 1 × 10 spores per milliliter.
z Standards of deep burial:
1. A pit or trench should be dug about 2 meters deep. It should be half filled with
waste, then covered with lime within 50 cm of the surface, before filling the rest
of the pit with soil.
2. It must be ensured that animals do not have any access to burial sites. Covers of
galvanized iron/wire meshes may be used.
3. On each occasion, when wastes are added to the pit, a layer of 10 cm of soil shall 161
Bio-medical Waste (Management
be added to cover the wastes. and Handling) Rules
4. Burial must be performed under close and dedicated supervision.
5. The deep burial site should be relatively impermeable and no shallow well should
be close to the site.
6. The pits should be distant from habitation, and sited so as to ensure that no
contamination occurs of any surface water or ground water. The area should not
be prone to flooding or erosion.
7. The location of the deep burial site will be authorized by the prescribed authority.
8. The institution shall maintain a record of all pits for deep burial.
16.14.4 Schedule VI – Schedule for Waste Treatment

z Hospitals and nursing homes in towns with population of 30 lakhs and above - by
31st December, 1999 or earlier.
z Hospitals and nursing homes in towns with population of below 30 lakhs,
a. with 500 beds and above by 31st December 1999 or earlier
b. with 200 beds and above
less than 500 beds by 31st December 2000 or earlier
c. with 50 beds and above
but less than 200 beds by 31st December 2001 or earlier
d. with less than 50 beds by 31st December 2002 or earlier
z All other institutions generating biomedical waste.
16.15 LET US SUM UP

Bio-Medical Waste (Management and Handling) Rules was passed on 1998. These
rules apply to all persons who generate, collect, receive, store, transport, treat, dispose
or handle bio-medical waste in any form. Bio-medical waste means any waste, which
is generated during the diagnosis, treatment or immunization of human beings or
animals or in research activities pertaining thereto or in the production or testing of
biological. The Government of every state/union territory shall constitute an advisory
committee. The committee will include experts in the field of medical and health,
animal husbandry and veterinary sciences, environmental management, municipal
administration and any other related department or organization including
non-governmental organizations. The Biomedical Waste (Management and Handling)
Rules, have six schedules. Schedule I - Classification of biomedical waste in various
categories, Schedule II - Colour coding and type of containers to be used for each
category of biomedical waste, Schedule III - Pro forma of the label to be used on
container/bag, Schedule IV - Pro forma of label for transport of waste container/bag,
Schedule V - Standards for treatment and disposal of waste and Schedule
VI - Deadlines for creation of waste treatment facilities.

How many health care workers aware and following about the colour coding of bio-
medical waste in your city?
162
Health Laws and Policies 16.17 KEYWORDS
Authorization: It means permission granted by the prescribed authority for the
generation, collection, reception, storage, transportation, treatment, disposal and/or
any other form of handling bio-medical waste in accordance with these rules and any
guidelines issued by the Central Government.
Authorized person: It means an occupier or operator authorized by the prescribed
authority to generate, collect, receive, store, transport, treat, dispose and/or handle bio-
medical waste in accordance with these rules and any guidelines issued by the Central
Government.
Bio-medical waste: It means any waste, which is generated during the diagnosis,
treatment or immunization of human beings or animals or in research activities
pertaining thereto or in the production or testing of biological, and including
categories mentioned in Schedule I.
Biologicals: It means any preparation made from organisms or micro-organisms or
product of metabolism and biochemical reactions intended for use in the diagnosis,
immunization or the treatment of human beings or animals or in research activities
pertaining thereto.
Bio-medical waste treatment facility: It means any facility wherein treatment,
disposal of bio-medical waste or processes incidental to such treatment or disposal is
carried out.

1. Explain in detail about the Bio-medical Waste Management Act.
2. How the bio-medical waste are treated and disposed?
3. How the bio-medical waste are segregated, packed and transported?
4. What are the different schedules followed in this Act?
5. Explain the different standards for treatment and disposal of bio-medical wastes.

1. Bio-medical means any waste, which is generated during the diagnosis,
treatment or immunization of human beings or animals or in research
activities.
2. Bio-Medical waste treatment facility means any facility wherein
treatment, disposal of bio-medical waste or processes incidental to such
treatment or disposal is carried out.
3. Schedule I: Classification of biomedical waste in various categories.
Schedule II: Colour coding and type of containers to be used for each
category of biomedical waste. Schedule III: Pro forma of the label to be
used on container/bag. Schedule IV: Pro forma of label for transport of
waste container/bag. Schedule V: Standards for treatment and disposal of
waste. Schedule VI: Deadlines for creation of waste treatment facilities.

163
LESSON Atomic Energy Act
17
ATOMIC ENERGY ACT
CONTENTS
17.1 Introduction
17.3 Definitions
17.4 General Powers of the Central Government
17.5 Notification of Discovery of Uranium or Thorium
17.6 Control Over Training or Concentration of Substances Containing Uranium
17.7 Disposal of Uranium
17.8 Power of Entry and Inspection
17.9 Notation of Certain Contracts
17.10 Control over Production and Use of Atomic Energy
17.11 Control over Radioactive Substances
17.12 Special Provisions as to Safety
17.13 Offences and Penalties
17.15 Repeal of Act (29 of 1948)
17.16 Let us Sum up
17.18 Keywords

z Understand this Act and its applicability
z Know about the procedure for notification, disposal of uranium
z Understand the control over production and use of atomic energy and radioactive
substances
17.1 INTRODUCTION
An Act to provide for the development, control and use of atomic energy for the
welfare of the people of India and for other peaceful and for matters connected
therewith.
164
Health Laws and Policies 17.2 SHORT TITLE, EXTENT AND COMMENCEMENT
1. This Act may be called the Atomic Energy Act, 1962.
3. It shall come into force on such date as the Central Government may, by
17.3 DEFINITIONS
a) “Atomic energy” means energy released from atomic nuclei as a result of any
process , including the fission and fusion processes;
b) “fissile material” means uranium 233, uranium 235, plutonium or any material
containing these substances or any other material that may be declared as such by
notification by the Central Government;
c) “Minerals” include all substances obtained or obtained or obtainable from the soil
(including alluvium or rocks) by underground or surface working;
d) “Notification” means notification published in the Official Gazette;
e) “Plant” includes machinery, equipment or appliance whether affixed to land or
not;
f) “prescribed equipment” means any property which the Central Government may,
by notification , prescribe, being a property which in its a opinion is specially
designed or adapted or which used or intended to be used for the production or
utilisation of any prescribed substances or for the utilisation of atomic energy,
radioactive substances, or incorporated in equipment used or intended to be used
for any of the purposes aforesaid;
g) “prescribed substance” means any substance including any mineral which the
Central Government may, by notification , prescribe, being a substance which in
its opinion is or may be used for the production or use of atomic energy or
research into matters connected therewith and includes uranium, plutonium,
thorium, deuterium or any of their respective derivatives or compounds or any
other materials containing any of the aforesaid substances;
h) “radiation” means gamma rays, X-ray, and rays consisting of alpha particles, beta
particles, neutrons, protons and other nuclear and sub-atomic particles; but not
sound or radio waves, or visible, infrared or ultraviolet light;
i) “radioactive substance” or “radioactive material” means any substance or
materials which spontaneously emits radiation in excess of the levels prescribed
by notification by the Central Government.
Any reference in this Act to the working of minerals shall be construed as
including a reference to the mining, getting, carrying away, and transporting,
sorting, extracting or otherwise treating of minerals.
Any reference in this Act to the production or use of atomic energy shall be
construed as including a reference to the carrying out of any process
preparatory or ancillary to such production or use.
17.4 GENERAL POWERS OF THE CENTRAL

GOVERNMENT
Subject to the provisions of this Act, Central Government shall have power:
z To produce, use and dispose of atomic energy and carry out research into any
matters connected therewith;
z To manufacture or otherwise produce any prescribed or radioactive substance and 165
any articles which in its opinion are, or are likely to be, required for, or in Atomic Energy Act
connection with, the production, development or use of atomic energy or such

research as aforesaid and to dispose of such prescribed or radioactive substance or
any articles manufactured or otherwise produced:
to by or otherwise acquire store and transport any prescribed or radioactive
substance and any articles which in its opinion are or are likely to be required
for or in connection with the production development or use of atomic energy
and
to dispose for such prescribed or radioactive substance or any articles bought
or otherwise acquired by it either by itself or through any authority or
corporation established by it or a government company
z To declare as restricted information any information not so far published or
otherwise made public relating to:
The location quality and quantity of prescribed substances and transactions
for their acquisition whether by purchase or otherwise, or disposal whether by
sale or otherwise
The processing of prescribed substances and the extraction or production of
fissile materials from them
The theory design construction and operation of plants for the treatment and
production of nay of the prescribed substances and for the separation of
isotopes
The theory design construction and operation of nuclear reactors
Research and technological work on materials and processes involved in or
derived from items I to IV.
z To declare as prohibited area any area or premises where work including research
design or development is carried on in respect of the production treatment use
application or disposal of atomic energy or of any prescribed substance;
z To provide for control over radioactive substances or radiation generating plant in
order to:
Prevent radiation hazards,
Secure public safety and safety of persons handling radioactive substances or
radiation generating plant, and
Ensure safe disposal of radioactive wastes.
z To provide for the production and supply of electricity from atomic energy and
for taking measures conducive to such production and supply and for all matters
incidental thereto either by it self of through any authority or corporation
established by it or a Government company and
z To do all such things including the erection of buildings and execution of works
and the working of minerals as the Central Government considers necessary or
expedient for the exercise of the foregoing powers.
17.5 NOTIFICATION OF DISCOVERY OF URANIUM OR

THORIUM
z Every person who whether before or after the commencement of this Act has
discovered or discovers that uranium or thorium occurs at any place in India shall
within three months after the date of commencement of this act or after the
166 discovery whichever is later report the discovery in writing to the Central
Government or to any person or authorized by the Central Government in this
behalf.
z Every person who has reason to believe that uranium occurs at any place in India
shall without delay send intimation of such beliefs and the reasons there for
Central Government or to any such person or authority as aforesaid.
17.6 CONTROL OVER TRAINING OR CONCENTRATION

OF SUBSTANCES CONTAINING URANIUM
z If the Central Government is satisfied that any person is mining or is about to
mine any substance from which in the opinion of the Central Government
uranium can be or may reasonably be expected to be isolated or extracted or is
engaged or is about to be engaged in treating or concentrating by any physical,
chemical or metallurgical process any substance from which in the opinion of the
Central Government uranium can be or may reasonably be expected to be isolated
or extracted the Central Government may by notice in writing given to person
either.
z Require him in conducting the mining operations or in treating or concentration
the substance aforesaid to comply with such terms and conditions and adopt such
processes as the Central Government may in the notice or from time to time
thereafter think fit to specify or
z To tally prohibit him from conducting the mining operations or trading or
concentrating the substances aforesaid.
z Where the Central Government decides to pay compensation under sub section
the amount thereof shall be determined in accordance with Section 21 but in
calculating the compensation payable no account shall be taken of the value of
any uranium contained in the substance referred to in sub-section.
Check Your Progress
1. What do you mean by Atomic energy?
…………………………………..………………………………………….
…………………………………..………………………………………….
2. What is fissile material?
…………………………………..………………………………………….
…………………………………..………………………………………….
3. What is radiation?
…………………………………..………………………………………….
…………………………………..………………………………………….
4. What is radioactive substance?
…………………………………..………………………………………….
…………………………………..………………………………………….
17.7 DISPOSAL OF URANIUM

z No minerals concentrates and other materials which contain uranium in its natural
state in excess of such proportion as may be prescribed by notification by Central
Government shall by disposed of except with the previous permission in writing
of the Central Government and in accordance with such terms and conditions as it 167
may impose. Atomic Energy Act
z The Central Government may serve notice on any person who has produced any
mineral concentrate or other material referred to in sub-section.
17.8 POWER OF ENTRY AND INSPECTION

z Any person authorized by the Central Government may on producing if so
required a duly authenticated document showing his authority enter any mine
premises or land.
z Where he has reason to believe that work is being carried out for the purpose of or
in connection with production and processing of any processing of any prescribed
substances or substances from which a prescribed substance can be obtained or
production development or use of atomic energy or research into matters connect
therewith.
z The person carrying out the inspection may make copies of or extracts from any
drawing plan or other document found in the mine premises or land and for the
purpose of making such copies or extracts may remove any such drawing plan or
other document after giving a duly signed receipt for the same and retain
possession thereof for a period not exceeding seven days.
17.9 NOTATION OF CERTAIN CONTRACTS

z The Central Government may serve on the parties to a contract relating to
prospecting or mining of any substance from which any of the prescribed
substances can be obtained or to production or use of atomic energy or to research
into matters connected therewith not being a contract for the rendering of personal
services a notice in writing stating that on such date as may be specified in the
notice the rights and liabilities of any of the parties to the contract specified in the
contract specified in the notice. Hereinafter referred to as the specified party will
be transferred to the Central Government and thereupon subject to any withdrawal
of the notice under the following provisions of this section the contract shall as
regards any rights exercisable or liabilities incurred on or after the said date have
effect as if the central government were a party to the contract instead of the
specified party and as if for any reference in the contract to the specified party
there were substituted a reference to the Central Government.
z A notice served under sub-section shall contain a statement to the effect that an
objection may be made thereto within such time and in such manner as may be
specified and if any such objection is duly made and not withdrawn the Central
Government shall afford an opportunity to the person making the objection of
appearing before and being heard by a person appointed by the Central
Government for the purpose.
z After considering any such objection and the report of the person appointed by it
under sub-section the Central Government may make such order as it may deem
proper.
z Where the rights and liabilities of a party to a contract are transferred to the
Central Government under this section there shall be paid to that party such
compensation in respect of any loss suffered by that party as may be agreed
between him and the Central Government and in default of such agreement as
may be determined by arbitration.
168
Health Laws and Policies 17.10 CONTROL OVER PRODUCTION AND USE OF
ATOMIC ENERGY
z The Central Government may subject to such rules as may be made this behalf by
order prohibit except under a license granted by it:
The working of any mine or minerals specified in the order being a mine or
minerals from which in the option of the Central Government any of the
prescribed substances can be obtained.
The acquisition production possession use disposal export or import:
Of any of the prescribed substances, or
Of any minerals or other substances specified in the rules from which in
the opinion of the Central Government any of the prescribed substances
can be obtained, or
Of any plant designed or adopted or manufactured for the production,
development and use of atomic energy or for research into matters
connected therewith, or
Of any prescribed equipment.
z Nothing in this section shall affect the authority of the Central Government to
refuse a license for the purpose of this section or to include in a license such
conditions as the Central Government thinks fit or to revoke a license and the
Central Government may take any action as aforesaid.
z Without prejudice to the generality of the foregoing provisions the rules referred
to in this section may provide for:
The extent to which information in the possession of or which has been made
available to the person granted a license for purposes of this section should be
regarded as restricted information;
The extent to which the area or premises under the control of the person to
whom a license has been made available to the person granted a license for
purposes of this section should be regarded as a prohibited area;
The conditions and criteria for location of any installation or operation of any
plant in respect of which a license has been granted or is intended to be
granted for the purposes of this section including those necessary for
protection against radiation and safe disposal of harmful by-products or
wastes;
The extent of the licenses liability in respect of any hurt to any person or any
damage to property caused by ionizing radiators or any radioactive
contamination either at the plant under license in the surrounding area;
Provision by licensee either by insurance or by such other means as the
Central Government may approve of sufficient funds to be available at all
time to ensure settlement of any claims in connection with the use of the site
or the plant or any damage to any property caused by ionizing radiations
emitted at the plant under license or radioactive contamination either at the
plant under license or in surrounding areas;
Obligatory qualifications security clearances, hours of employment minimum
leave and periodical medical examination of the persons employed and any
other requirement or restriction or prohibition on the employer, employed
persons and other persons and;
Such other incidental and supplementary provisions including provisions for
inspection and also for the sealing of premises and seizure retention and
disposal of any article in respect of which there are reasonable grounds for
suspecting that a contravention of the rules has been committed as the Central 169
Government considers necessary. Atomic Energy Act
z The Central Government may also prescribe the fees payable for payable for issue
of licenses under sub-section (1).
17.11 CONTROL OVER RADIOACTIVE SUBSTANCES

The Central Government may prohibit the manufacture possession use transfer by sale
or otherwise export and import and in an emergency transport and disposal of any
radioactive substances without its written consent.
17.12 SPECIAL PROVISIONS AS TO SAFETY

z The Central Government may as regards any class or description of premises or
places being premises or places in which radioactive substances are manufactured
produced mined treated stored or used or any radiation generating plant
equipment or appliance is used make such provision by rules as appear to the
Central Government to be necessary:
To prevent injury being caused to the health of persons employed at such
premises or places or other persons either by radiations or by the ingestion of
any radioactive substance.
To secure that any radioactive waste products resulting from such
manufacture production mining treatment storage or use as aforesaid are
disposed of safely.
To prescribe qualifications of the persons for employment at such premises or
places and the regulation of their hours of employment minimum leave and
periodical medical examination.
And the rules may in particular and without prejudice to the generality of this
subsection provide for imposing requirements as to the erection or structural
alterations of buildings or the carrying out of works.
z The Central Government may as respects the transport of any radioactive
substance or any prescribed substance specified by an order issued under this Act
as being dangerous to health make such rules as appear to be necessary to prevent
injury being caused by such transport to the health of persons engaged therein and
other persons.
z Rules made under this section may provide for imposing requirements
prohibitions on employers employed persons and other persons.
z Any person authorized by the Central Government under this section may on
producing if so required a duly authenticated document showing his authority
enter at all reasonable hours any premises or any vehicle vessel or aircraft for the
purpose of ascertaining whether has been committed or is being committed in or
in connection with the premises vehicle vessel or aircraft any contravention of the
rules made under this section.
z In the event of any contravention of the rules made under this section the Central
Government shall have the right to take such measures as it may deem necessary
to prevent further injury to persons or damage to property arising from radiation
or contamination by radioactive substances including without prejudice to the
generality of the foregoing provisions and to the right to take further action for the
enforcement of penalties under sec the sealing of premises vehicle vessel or
aircraft and the seizure of radioactive substances and contaminated equipment.
170
Health Laws and Policies 17.13 OFFENCES AND PENALTIES
Whoever:
z Contravenes any order under Section 14 or any condition subject to which a
license is granted under that section; or
z Contravenes any rule made under Section 17 or any requirement prohibition or
restriction imposed under any such rule;
z Obstructs any person authorized by the Central Government under sub-section (4)
of Section 17 in the exercise of powers under that sub-section; or
z Contravenes sub-section (2) of Section 18 shall be punished with imprisonment
for a term which may extend to five years or with fine or with both.
z Fails to comply with any notice served on him under Section 5 or with any terms
and conditions that may be imposed on him under that section; or
z Fails to comply with any notice served on him under Section 7 or knowingly
makes any untrue statement in any return or statement made in pursuance of any
such notice; or
z Obstructs any person or authority in the exercise or powers under Section 8 or 9;
or
z Contravenes any other provisions of this Act or any order made thereunder.

z Where an offence under this Act has been committed by a company every person
who at the time the offence 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 shall be deemed to be guilty of the offence and shall be liable to be
proceeded against and punished accordingly.
Provided that nothing contained in this sub-section shall render any such person
liable to any punishment if he proves that the offence was committed with out his
knowledge or that he exercised all due diligence to prevent the commission of
such offence.
z Notwithstanding anything contained in sub-section (1), where any offence this
Act has been committed by a company and it proved that the offences has been
committed or connivance of or is attributable to any neglect on the part of any
director manager secretary of other officer of the company such director manager
secretary or other officer shall be deemed to be guilty of that offence and shall be
liable to be proceeded against and punished accordingly.
For the purposes of this section:
“company” means any body corporate and includes a firm and other association of
individuals and
“director” in relation to firm means a partner in the firm.
17.15 REPEAL OF ACT (29 OF 1948)

The Atomic Energy Act, 1948 is hereby repealed.
17.16 LET US SUM UP

Atomic Energy Act was passed on 1962. Atomic energy means energy released from
atomic nuclei as a result of any process, including the fission and fusion processes.
fissile material means uranium 233, uranium 235, plutonium or any material
notification by the central government. Radiation means gamma rays, x-ray, and rays 171
consisting of alpha particles, beta particles, neutrons, protons and other nuclear and Atomic Energy Act
sub-atomic particles; but not sound or radio waves, or visible, infrared or ultraviolet
light notification of discovery of uranium or thorium. This act emphasized disposal of
uranium, control over production and use of atomic energy control over radioactive
substances, special provisions as to safety, etc., any person or a company who
contravenes the act are rigorously penalized.

How atomic energy is useful in hospitals?
17.18 KEYWORDS
Atomic energy: It means energy released from atomic nuclei as a result of any
process, including the fission and fusion processes.
Fissile material: It means uranium 233, uranium 235, plutonium or any material
notification by the Central Government.
Minerals: It include all substances obtained or obtained or obtainable from the soil
(including alluvium or rocks) by underground or surface working.
Notification: It means notification published in the Official Gazette.
Plant: It includes machinery, equipment or appliance whether affixed to land or not.

1. Explain about the Atomic Energy Act.
2. Explain the general powers of the Central Government subject to this act.
3. How to control over production and use of atomic energy?
4. How to control over radioactive substances?
5. Explain some special provisions as to safety under this Act.
6. Explain the offences and penalties under Atomic Energy Act.

1. Atomic energy means energy released from atomic nuclei as a result of
any process, including the fission and fusion processes.
2. Fissile material means uranium 233, uranium 235, plutonium or any
material containing these substances or any other material that may be
declared as such by notification by the Central Government.
3. Radiation means gamma rays, X-ray, and rays consisting of alpha
particles, beta particles, neutrons, protons and other nuclear and sub-
atomic particles; but not sound or radio waves, or visible, infrared or
ultraviolet light.
4. Radioactive substance or radioactive material means any substance or
materials which spontaneously emits radiation in excess of the levels
prescribed by notification by the Central Government:
Any reference in this Act to the working of minerals shall be
construed as including a reference to the mining, getting, carrying
away, and transporting, sorting, extracting or otherwise treating of
minerals.
Any reference in this Act to the production or use of atomic energy
shall be construed as including a reference to the carrying out of any
process preparatory or ancillary to such production or use.
172
Health Laws and Policies 17.20 SUGGESTED READING
173
LESSON The Electricity Act, 2003
18
THE ELECTRICITY ACT, 2003
CONTENTS
18.1 Introduction
18.2 Indian Electricity Act, 1910
18.3 Electricity (Supply) Act, 1948
18.4 Main Amendments to the Existing Acts
18.5 Electricity Regulatory Commission Act, 1998
18.6 Common Features of State Acts
18.7 Need for the New Legislation
18.8 Salient Features of the Electricity Act, 2003
18.8.1 Role of Government
18.8.2 Rural Electrification
18.8.3 Generation
18.8.4 Transmission
18.8.5 Consumer Protection
18.8.6 Trading/Market Development
18.8.7 Regulatory Commissions/Appellate Tribunal
18.8.8 CEA-Central Electricity Authority
18.8.9 Tariff Principles
18.8.10 Measures against Theft of Electricity
18.8.11 Restructuring of SEBs
18.9 Let us Sum up
18.11 Keywords

z Understand the different acts regulated the electricity sector
z Know about the common features of state acts
z Understand the salient features of the Electricity Act, 2003
174
18.1 INTRODUCTION
The erstwhile Acts that regulated the electricity sector:
z The Indian Electricity Act, 1910.
z The Electricity (Supply) Act, 1948.
z The Electricity Regulatory Commission Act, 1998.
18.2 INDIAN ELECTRICITY ACT, 1910

z Provided basic framework for electric supply industry in India.
z Growth of the sector through private licensees. License by State Govt.
z Provision for license for supply of electricity in a specified area.
z Legal frame work for laying down of wires and other works.
z Provisions laying down relationship between licensee and consumer.
18.3 ELECTRICITY (SUPPLY) ACT, 1948

z Mandated creation of SEBs.
z Need for the State to step in (through SEBs) to extend electrification (so far
limited to cities) all across the country.
18.4 MAIN AMENDMENTS TO THE EXISTING ACTS

z Amendment in 1975 to enable generation in Central sector.
z Amendment to bring in commercial viability in the functioning of SEBs.
z Section 59 amended to make the earning of a maximum return of 3% on fixed
assets a statutory requirement (w.e.f. 1.4.1985).
z Amendment in 1991 to open generation to provide for private sector participation
in transmission, and also provision relating to Transmission Utilities.
z Amendment in 1991 to open generation to private sector and establishment of
RLDCs.
18.5 ELECTRICITY REGULATORY COMMISSION

ACT, 1998
z Provision for setting up of Central/State Electricity Regulatory Commission to
with powers to determine tariffs.
z Constitution of SERC optional for States.
z Distancing of Govt. from tariff determination.
18.6 COMMON FEATURES OF STATE ACTS

z Independent Regulatory mechanism:
Constitution of SERC
Powers of tariff fixation, Licensing, regulation of working of Licensees,
performance standards etc., to SERC
z Reorganization of SEB: 175
The Electricity Act, 2003
TRANSCO as successor of entity.
Single buyer model.
Separation of generation, transmission & distribution.
18.7 NEED FOR THE NEW LEGISLATION

z Requirement of harmonizing and rationalizing the provisions in the existing laws
to:
Create competitive environment for bench work competition which will result
in enhancing quality and reliability of service to consumer.
Distancing regulatory responsibilities of Govt.
z Reform legislation by several states separately.
z Obviating need for individual states to enact their own reform laws
z Requirement of introducing newer concepts like power trading open access
Appellate Tribunal etc.
z Special provision for the rural areas.
18.8 SALIENT FEATURES OF THE ELECTRICITY

ACT, 2003
z Role of Government
z Rural Electrification
z Generation
z Transmission
z Distribution
z Consumer Protection
z Trading / Market Development
z Regulatory Commission / Appellate Tribunal
z Tariff Principles
z CEA
z Measures against Theft of Electricity
z Restructuring of SEBs
18.8.1 Role of Government

z Central Government to prepare National Electricity Policy and Tariff Policy
(Section 3)
z Central Govt. to notify a National Policy for rural areas permitting stand alone
systems based on renewal and Non-Conventional energy sources in consultation
with states (Section 4)
z Central Govt., to formulate a National Policy in consultation with the concerned
state Govts., for bulk purchase of power and management for local distribution
through User’s Association, Co-operatives, Franchisees and Panchayat
Institutions etc.
176 18.8.2 Rural Electrification
z Appropriate Govt. to endeavor to extend supply of electricity to all
villages/hamlets (Section 6)
z No requirement of license if a person intends to generate and distribute power in
rural area. (Section 14).
18.8.3 Generation
z Generation free from Licensing (Section 7)
z Requirements of TEC for non – hydro generation done away with (Section 7)
z Captive Generation is free from controls. Open access to Captive generating
plants subjects to availability of transmission facility (Section 9)
z Clearance of CEA for hydro projects required. Necessary due to concern of dam
safety and inter-state issues (Section 8)
z Generation from Non-Conventional sources / Co-generation to be promoted.
Minimum percentage of purchase of power from renewable may be prescribed by
regulatory Commissions [Sections 61(h), 86(1)(e)]
18.8.4 Transmission
z There would be Transmission Utility at the Center and in the States to undertake
planning & development of transmission system.
z Load dispatch to be in the hands of a govt. company /organization. Flexibility
regarding keeping Transmission Utility and load dispatch together or separating
them. Load Dispatch generator and distributors. Instructions to be binding on both
(Sections 26, 27, 31, 38, 39)
z Transmission companies to be licensed by the Appropriate Commission after
giving due consideration to the views of the Transmission Utility [Section 15(5)
(b)].
z The Load Dispatch Center / Transmission Utility /Transmission Licensee not to
trade in power. Facilitating genuine competition generators (Sections 27, 31, 38,
39, 41)
z Open access to the transmission lines to be provided to distribution licenses,
generating companies (Sections 38-40)
This would generate competitive pressures and lead to gradual cost reduction.
Check Your Progress
1. Name the acts which regulated the electricity sector.
……………………………………………………………………………...
……………………………………………………………………………...
2. List out the salient features of the Electricity Act, 2003.
……………………………………………………………………………...
……………………………………………………………………………...
18.8.5 Consumer Protection

z Consumer to be given connection within stipulated time [Section 43(1)]
z Penalty in the event of failure to give connection [Section 43(3)]
z Payment of interest on security deposit [Section 47(4)]
z Regulatory commissions to be specify electricity supply code to be followed by 177
licensees (Section 50) The Electricity Act, 2003
z No sum due from consumers recoverable after a period of two years unless the
same was shown recoverable continuously [Section 56(2)]
z Redressel forum for redressal for grievances of consumers to be appointed by
every distribution licensee with in 6month Ombudsman scheme (Section 42)
Standards of Performance
z Licensees required to meet standard of performance specified by regulatory
commission failure to meet standards makes them liable to pay compensation to
affected persons with in ninety days.
z Licensee is furnished to the commissions periodical information on standard of
performance (Section 57)
z District level committee – (a) to coordinate and review extension of electrification
in each district (b) to review quality of power supply and consumer satisfaction,
etc. [Section 166(5)]
18.8.6 Trading/ Market Development

z Trading distinct activity permitted with licensing (Section 12)
z Regulatory commission may fix ceiling on trading margin to avoid artificial price
volatility [Sections 79 (2)(b) & 86 (2)(b)]
z The regulatory commission to promote development of market including trading.
(Section 66)
18.8.7 Regulatory Commissions/Appellate Tribunal

z State Electricity Regulatory Commission to be constituted within six months.
z Provision for joint commission by more than one State/UT.
z Provision for constitution of Appellate Tribunal consisting of chairman and three
members.
z Appellate Tribunal to hear appeals against the orders of CERC/SERC and also to
exercise general supervision and control over the Central/State Commissions.
z Appeal against the orders of Appellate Tribunal to lie before the Supreme Court.
z Appellate Tribunal considered necessary to:
Reduce litigation and delay in decision through High Court.
Provide technical expertise in decision appeals.
18.8.8 CEA - Central Electricity Authority

z CEA to continue as the main technical advisor of the Govt.of India/state
government with the responsibility of the overall planning (Section 70)
z CEA to specify the technical standards for electrical plants and electrical lines
(Section 73)
z CEA to be technical advisers to CERC as well as SERCs (Section 73)
z CEA to specify the safety standards (Section 53)
18.8.9 Tariff Principles

z Regulatory commissions to determine tariff for supply of electricity by generating
co. on long / medium-term contracts (Section 62)
178 z No tariff fixation by regulatory commission if tariff is determined through
competitive bidding or where consumers, on being allowed open access enter into
agreement with generators /traders.
z Consumer tariff should progressively reduce cross subsidies and move towards
actual cost of supply [Sections 61(g), (h)]
z Sate government may provide subsidy in advance through the budget for specified
target groups if it requires the tariff to be lower than that determined by the
regulatory commission (Section 65)
z Regulatory commissions may undertake regulation including determination of
multi-year tariff principles ,which rewards efficiency and is based on commercial
principles [Section 61(e)(f)]
z Regulatory commission to look at the costs of generation, transmission and
distribution separately [Section 62(2)]
18.8.10 Measures against Theft of Electricity

z focus on revenue realisation rather than criminal proceedings (Sections 126, 135)
z penalties linked to the connected load and quantum of energy and financial gain
involved in theft (Section 135)
z provisions for compounding of offences (Section 152)
z assessment of electricity charges for unauthorized use of electricity by the
assessing officer designated by the state government. (Section 126)
z theft punishable with imprisonment (Section 135)
z punishment provision for abetment of theft (Section 150)
z special courts (Sections 153-158)
18.8.11 Restructuring of SEBs

z provision for transfer scheme to create or more companies from SEB.
(Section 131)
z provision for continuance of SEBs (Section 172)
z States given flexibility to adopt reform model/path
18.9 LET US SUM UP

Acts that regulated the electricity sector are: The Indian Electricity Act, 1910; The
Electricity (Supply) Act, 1948; The Electricity Regulatory Commission Act, 1998.
Some common features of state acts are Independent Regulatory mechanism,
Reorganization of SEB. Salient features of the Electricity Act, 2003 are highlighted in
this act:
z Role of Government
z Rural Electrification
z Generation
z Transmission
z Distribution
z Consumer Protection
z Trading / Market Development
z Regulatory Commission / Appellate Tribunal
z Tariff Principles 179
The Electricity Act, 2003
z CEA
z Measures against Theft of Electricity
z Restructuring of SEBs.

Is there any privilege in consuming the electricity in health care sectors? Find out.
18.11 KEYWORDS
Rural electrification: Appropriate Govt. to endeavor to extend supply of electricity to
all villages/hamlets (Section 6);
Transmission: There would be Transmission Utility at the Center and in the States to
undertake planning & development of transmission system.
Appellate tribunal: Appellate Tribunal considered necessary to:
z Reduce litigation and delay in decision through High Court.
z Provide technical expertise in decision appeals.

1. Explain about the salient features of Electricity Act, 2003.
2. Describe the different acts regulated the electricity sector.

1. The acts which regulated the electricity sector are:
The Indian Electricity Act, 1910
The Electricity (Supply) Act, 1948
The Electricity Regulatory Commission Act, 1998
2. Salient features of Electricity Act, 2003 are:
Role of Government
Rural Electrification
Generation
Transmission
Distribution
Consumer Protection
Trading / Market Development
Regulatory Commission / Appellate Tribunal
Tariff Principles
CEA
Measures against Theft of Electricity
Restructuring of SEBs

180
19
INDIAN BOILERS ACT
CONTENTS
19.1 Introduction
19.2 Commencement
19.3 Definitions
19.4 Use of Boiler Pending Grant of Certificate
19.5 Revocation of Certificate or Provisional Order
19.6 Production of Certificates, etc.
19.7 Penalties for Tempering with Register Mark
19.8 Trial of Offences
19.9 Let us Sum up
19.11 Keywords

z Understand the Indian Boilers Act
z Know about the certification procedures and its revocation
19.1 INTRODUCTION
An act to consolidate and amend the law relating to steam boilers.
19.2 COMMENCEMENT
z This Act may be called the Indian Boilers Act,1923.
z Is extends to the whole of India except the State of Jammu and Kashmir.
19.3 DEFINITIONS
z Accident means an explosion of a boiler of steam pipe or any damage to a boiler
or steam pipe which is calculated to weaken the strength thereof so as to render to
liable to explode;
z Board means the Central Boilers Board constituted under Section 27A; 181
Indian Boilers Act
z Boiler means any closed vessel exceeding 622.75 liters in capacity which is used
expressly for generating steam under pressure and includes any mounting or other
fitting attached to such vessel which is wholly or partly under pressure when
steam is shut off;
z Chief Inspector, Deputy Chief Inspector and Inspector means, respectively, a
person appointed to be a Chief Inspector, a Deputy Chief Inspector and Inspector
under this act;
z Economizer means any part of a feed-pipe that is wholly or partially exposed to
the action of flue gases for the purpose or recovery of waste heat;
z Feed-pipe means any pipe or connected fittings which feed water passes directly
to a boiler and which does not form a integral part thereof;
z Owner includes any person using a boiler as agent of the owner thereof and any
person using a boiler which he has hired or obtained on loan from the owner
thereof;
z Prescribed means prescribed by regulations or rules made under this Act.
z Steam pipe means any pipe through which steam passes from a boiler to a prime
mover or other user or both if:
The pressure at which steam passes through such pipe exceeds 3.5 kilograms
per square centimeter above atmospheric pressure; or
Such pipe exceeds 254 millimeters in internal diameter: and includes in 3ither
case any connected fitting or a steam pipe;
z Structural alteration addition or renewal shall not be deemed to include any
renewal or replacement of a petty nature when the part or fitting used for
replacement is not inferior in strength efficiency or otherwise to the replaced part
or fitting.
19.4 USE OF BOILER PENDING GRANT OF

CERTIFICATE
Notwithstanding anything herein before contained, when the period of a certificate
relating to a boiler has expird, the owner shall, provided that he has applied before the
expiry of tha period for a renewal of the certificate by entitled to use the boiler at the
maximum pressure entered in the former certificate pending the issue or orders on the
application.
19.5 REVOCATION OF CERTIFICATE OR PROVISIONAL

ORDER
The chief inspector may be any time with draw or revoke any certificate or
provisional order on the report of an inspector or otherwise;
z If there is reason to believe that the certificate or provisional order has been
fraudulenly obtained or has been grated erroneously or without sufficient
examination; or
z If the boiler in respect of which it has been granted has sustained injury or has
ceased to be in good condition; or
z Where the State Government has made rules requiring that boilers shall be in
charge of persons holding in certificate of proficiency or competency if the boiler
is incharge of a person not holding the certificate required by such rules; or
182 z Where no such rules have been made, if the boiler is in charge of a person who is
not having regard to the condition of the boiler, in the opinion of the chief
inspector competent to have charge thereof.
Check Your Progress
1. What do you mean by boiler?
……………………………………………………………………………...
……………………………………………………………………………...
2. What is economizer?
……………………………………………………………………………...
……………………………………………………………………………...
3. What is feed-pipe?
……………………………………………………………………………...
……………………………………………………………………………...
4. What is steam pipe?
……………………………………………………………………………...
……………………………………………………………………………...
19.6 PRODUCTION OF CERTIFICATES, ETC.

The owner of any boiler who holds a certificate or provisional order relating thereto
shall, at all reasonable times during the period for which the certificate or order is in
force, be bound to produce the same when called upon to do so by a District
Magistrate, Commissioner of Police or Magistrate of the first class having jurisdiction
in the area in which the boiler is for the time being, or by the Chief Inspector or by an
Inspector appointed under the Indian Factories Act, 1911, or by any person specially
authorized in writing by a District Magistrate or Commissioner of Police.
19.7 PENALTIES FOR TEMPERING WITH REGISTER

MARK
z Whoever removes, alters, defaces, renders invisible or otherwise tampers with the
register number marked on a bolier in accordance with provisions of this Act or
any act repealed herby, shall be punishable with fine which may extend to five
hundred rupees.
z Whoever fraudulently marks upon a boiler a register number which has not been
allotted to in under this Act or any Act repealed hereby, shall be punishable with
imprisonment which may extend to two years, or with fine or with both.
z No prosecution for an offence made punishable by or under this Act shall be
instituted except within (twenty-four months from the date of the commission of
the offence, and no such prosecution shall be instituted without the precious
sanction of the chief inspector.
19.8 TRIAL OF OFFENCES

No offence made punishable by or under this Act shall be tried by a Court inferior to
that of a Presidency Magistrate of a Magistrate of the first class.
183
19.9 LET US SUM UP Indian Boilers Act
Indian Boilers Act was passed on 1923. Boiler means any closed vessel exceeding
622.75 liters in capacity which is used expressly for generating steam under pressure
and includes any mounting or other fitting attached to such vessel which is wholly or
partly under pressure when steam is shut off. This act highlighted the use of boiler
pending grant of certificate, revocation of certificate or provisional order production
of certificates, etc., and penalties for tempering with register mark.

How Indian Boilers Act applicable to health care sector. Discuss it with an Hospital
Administrator.
19.11 KEYWORDS
Boiler: It means any closed vessel exceeding 622.75 liters in capacity which is used
expressly for generating steam under pressure and includes any mounting or other
fitting attached to such vessel which is wholly or partly under pressure when steam is
shut off.
Economizer: It means any part of a feed-pipe that is wholly or partially exposed to the
action of flue gases for the purpose or recovery of waste heat.
Feed-pipe: It means any pipe or connected fittings which feed water passes directly to
a boiler and which does not form a integral part thereof.
Steam pipe: means any pipe through which steam passes from a boiler to a prime
mover or other user or both if:
z The pressure at which steam passes through such pipe exceeds 3.5 kilograms per
square centimeter above atmospheric pressure; or
z Such pipe exceeds 254 millimeters in internal diameter; and includes in other case
any connected fitting or a steam pipe.
Structural alteration addition or renewal: Structural alteration addition or renewal
shall not be deemed to include any renewal or replacement of a petty nature when the
part or fitting used for replacement is not inferior in strength efficiency or otherwise to
the replaced part or fitting.

Explain about the Indian Boilers Act.

1. Boiler means any closed vessel exceeding 622.75 liters in capacity which
is used expressly for generating steam under pressure and includes any
mounting or other fitting attached to such vessel which is wholly or partly
under pressure when steam is shut off.
2. Economizer means any part of a feed-pipe that is wholly or partially
exposed to the action of flue gases for the purpose or recovery of waste
heat.
3. Feed-pipe means any pipe or connected fittings which feed water passes
directly to a boiler and which does not form a integral part thereof.
4. Steam pipe means any pipe through which steam passes from a boiler to a
prime mover or other user or both.
184
185
LESSON Pollution Control Acts and
Regulations
20
POLLUTION CONTROL ACTS AND REGULATIONS
CONTENTS
20.1 Introduction
20.2 Pollution Regulations in India
20.3 Central and State Boards
20.4 Constitution and Authority of the Board
20.5 State Boards and their Functions
20.6 Water (Prevention and Control of Pollution) Act, 1974
20.7 Water (Prevention and Control of Pollution) CESS Act, 1977
20.8 Air (Prevention and Control of Pollution) Act, 1981
20.9 Environment (Protection) Act, 1986
20.10 National Environment Tribunal Act of 1995
20.11 National Environment Appellate Authority Act of 1997
20.12 Hazardous Waste (Management and Handling) Rules, 1989
20.13 Public Liability Insurance Act, 1991
20.14 Pollution from Automobiles and their Standards
20.15 Other Regulatory Requirements
20.16 List of Projects Requiring Environmental Clearance
20.17 Industries which Require Industrial Licensing
20.18 List of Polluting Industries
20.19 Let us Sum up
20.21 Keywords

z Know about the Water (Prevention and Control of Pollution) Act
z Know about the Air (Prevention and Control of Pollution) Act
z Understand the Environment (Protection) Act
z Understand the National Environment Tribunal Act
186 z Get an idea about the National Appellate Authority Act
z Understand about the Hazardous Waste (Management and Handling) Rules
20.1 INTRODUCTION
In 1976, when the Indian Parliament passed the 42nd Amendment to its Constitution
safeguarding the environment, it became the first country in the world to do so. The
amendment was to “endeavor to protect and improve the environment and to
safeguard the forests and wild life of the country.” It imposes a duty on every Indian
citizen “to protect and improve the natural environment including forests, lakes,
rivers, and wild life, and to have compassion for living creatures.”
20.2 POLLUTION REGULATIONS IN INDIA

According to the Environment Protection Act of 1986, Environment is that which
includes the “inter-relationship which exists among and between water, air, and land
and human beings, other living creatures, plants, micro-organism and property.”
Essentially, The Water (Prevention & Control) Act, 1974 can be considered to be truly
the first regulations. It has been amended many times since then.
Basically, there are seven pollution regulations:
1. The Water (Prevention & Control of Pollution) Act, 1974, and its amendments;
2. The Water (Prevention & Control of Pollution) Cess Act, 1974 and its
amendments;
3. The Air (Prevention & Control of Pollution) Act, 1981 and its amendments;
4. The Environment (Prevention) Act, 1986 and its amendments:
a) National Environment Tribunal Act of 1995, and
b) National Environment Appellate Authority Act of 1997;
5. Hazardous Waste (Management and Handling) Rules, 1989 and
6. The Public Liability Insurance Act, 1991.
7. The Public Liability Insurance Act, 1991 has been included as the sixth
environmental regulation because it is the first regulation which gives some teeth
to the other five pollution regulations listed above.
20.3 CENTRAL AND STATE BOARDS

It was the Water Act of 1974, which established a Central Pollution Board and a State
Pollution Control Board. Subsequently, the same Boards have been given the power to
govern all the pollution regulations passed since then and any other to be put in
regulations in the future.
20.4 CONSTITUTION AND AUTHORITY OF THE BOARD

Pollution Boards are to be headed by a Chairman and a few members who are all
appointed. The Chairman as well as the Board members are appointed by the
respective governments. The members to be appointed to the Boards are to be selected
from various interest groups such as Corporations, Public Health Engineering,
Agriculture, Forestry, Fishery, etc. Basic purposes of these Boards are to advice their
respective governments on any matter concerning the prevention and control of
pollution in their area of jurisdiction. The Central Board coordinates as well as
oversees al the other.
187
20.5 STATE BOARDS AND THEIR FUNCTIONS Pollution Control Acts and
Regulations
To implement any environmental pollution control act, the Board has the power to
obtain information “make surveys of any area and gauge and keep records of the flow
of volume... of the stream.” It has the power to take samples, analyze any matter from
the industry. The Boards also have the authority to establish or recognize any
laboratory for chemical analytical work.
20.6 WATER (PREVENTION AND CONTROL OF

POLLUTION) ACT, 1974
The purpose of this act is “to provide for the prevention and control of water pollution
and the maintenance or restoring wholesomeness of water for the establishment, with
a view to carrying out the purpose of aforesaid of Boards for the prevention and
control of water pollution, for conferring on and assigning to such Boards powers and
functions relating thereto and for matters connected therewith.” This is the Act that
established the Central and a State Board and also the authority and power to
constitute as many committees as it feels essential to carry out specific functions for it.
The Act specifically prohibits “any poisonous, noxious or polluting matter” into any
stream or well. Consent from the State Board is required for any type of new
discharge into any new stream or well. This also includes consent for “temperature”
discharges as done by cooling tower users. In general, this means that a State consent
or permit is required for all types of intake and/or discharge of any type of liquid or
water either from a running stream or well.
Under these rules, “effluent standards to be complied with by persons while causing
discharge of sewage or sullage or both” have been specified. Standards for small scale
industries have been specified separately.
Penalties for non-compliance with the permit or polluting in any way are
imprisonment for three months and fine of Rs. 10,000 (One US Dollar equals about
thirty six Indian Rupees) or fine up to Rs. 5,000 per day of violation or both plus any
expenses incurred by the Board for sampling, analysis, inspection etc. These penalties
can also be imposed for “obstructing any person acting under the orders or direction
of the Board” or for “damages to any work or property of the Board.”
There are penalties also which extend up to seven years plus other monetary fines for
other similar offenses. Any “director, manager, secretary or other officer of the
company may also be deemed to be guilty” if proved that the offense occurred with
their “consent or connivance.” In case of the government, department head could be
held liable.
Laboratory: The central as well as the state government can start a lab to do analysis
on samples of water or of sewage or trade effluents for tests. A fee will be charged for
these services.
The law can also stop or restrain a person from discharging any pollutant to any
stream or well “which is likely to cause such pollution from so causing.”
Imprisonment up to three months and a fine up to Rs. 10,000 for every day of
violation during which such failure continues after the conviction for first such
offense.
20.7 WATER (PREVENTION AND CONTROL OF

POLLUTION) CESS ACT, 1977
This law provides for the levy and collection of a CESS on water consumed by
persons carrying on certain industries and by local authorities, with a view to augment
the resources of the Central and State Boards for the prevention and control of water
188 pollution constituted under the Water (Prevention and Control of Pollution) Act, 1974.
Industries were specified in Schedule I. They are:
Schedule I
1. Ferrous: Metallurgical industry
2. Non-Ferrous: Metallurgical industry
3. Mining industry
4. Ore processing industry
5. Petroleum industry
6. Petro-chemical industry
7. Chemical industry
8. Ceramic industry
9. Cement industry
10. Textile industry
11. Paper industry
12. Fertilizer industry
13. Coal (including coke) industry
14. Power (thermal and diesel) generating industry
15. Processing of animal or vegetable products industry
20.8 AIR (PREVENTION AND CONTROL OF

POLLUTION) ACT, 1981
This Act was passed for the “prevention, control and abatement of air pollution.” This
law defined an air pollutant as “any solid, liquid or gaseous substance present in the
atmosphere in such concentration as may be or tend to be injurious to human beings or
other living creatures or plants or property or environment.”
In this Act, power to declare air pollution, control areas has been given to the state
government after consulting the State Board. By this, it may control or even prohibit
burning of certain materials in those specific areas.
This Act requires approval prior to operating any industrial plant. Government may
suggest “control equipment” prior to giving its consent to any industry for its
operation. It may include chimney etc. In case there is any new technology for
emission control, then the Board may insist on this to being installed. Standards
specific to industries have been specified.
Penalties were for a minimum of six months imprisonment to a maximum of seven
years and fine up to Rs. 5,000 for every day during which contravention continues
after conviction for the first such contravention. This law makes it clear that when
offenses are committed by a company, its director, manager, secretary or other
officers could be held guilty and punished accordingly.
20.9 ENVIRONMENT (PROTECTION) ACT, 1986

The Act was enacted to “provide for the protection and improvement of environment
and for matters connected therewith.” This act defined environment which includes
water, air, and land and the inter-relationship which exists among and between “water,
air and land, and human beings, other living creatures, plants, micro-organisms and
property.” It also defined a hazardous substance as “any substance or preparation 189
Pollution Control Acts and
which, by reason of its chemical or physics-chemical properties, or handling, is liable Regulations
to cause harm to human beings, other living creatures, plants, microorganisms,
property or the environment.”
This law enlists general powers of the Central Government which included “all such
measures as it deems necessary or expedient for the purpose of protecting and
improving the quality of the environment and preventing, controlling and abating
environmental pollution.” The law also included “the standards of quality of air,
water, or soil for various areas and purposes, the maximum allowable limits of
concentration of various environmental pollutants. procedures and safeguards for the
handling of hazardous substances.”
The Act also deals with prevention, control and abatement of environmental pollution
by specifying the restrictions allowed to the discharge or emit any environmental
pollutant in excess of such standards as may be prescribed. Nor is anyone allowed to
handle hazardous substances except “as may be prescribed.” In case of discharge of
excess of any material the industry must forthwith.
Under Section 3(1) and Rule 5(3)(d) of this Act, Coastal Regulation Zone (CRZ) have
been declared and which restrictions on industries and processes have been imposed.
This restricts setting up or expansion of any industry.
a) Intimate the fact of such occurrence, or
b) be bound, if called upon, to render all assistance, to such authorities or agencies.
This law requires that all companies must have some sort of a Spill Prevention
Control and Countermeasures Plan (SPCC). Environmental auditing is required by
this law starting in 1993. This report is to be submitted to the State Pollution
Control Board. The law indicates that the government may “recognize one or more lab
as environmental lab to carry out tests, etc.”
Penalty for contravention of the act may be punishable by imprisonment up to seven
years or fine up to Rs 1 lakh (One lakh equals one hundred thousand). Additional fine
of up to Rs 5,000 for every day of violation.
Specific standards for emission or discharge of environmental pollutants from
industries, operations or processes have been specified. However, the government
may prohibit or limit certain emissions from specific locations due to environmental
factors.
It is under this Act that makes it mandatory for the specified 29 industries which have
investment beyond certain threshold that an Environmental Impact Assessment (EIA)
is required. They require public hearings. The Amendment was issued on January
27th and subsequently amended on May 4, 1994. EIA was initially introduced for the
River Valley Projects in 1978-79. Also under this Act, National Environment Tribunal
Act of 1995 and National Environmental Appellate Authority Act of 1997 were
enacted.
20.10 NATIONAL ENVIRONMENT TRIBUNAL

ACT OF 1995
The National Environment Tribunal Act of 1995 was enacted to provide for strict
liability for damages arising out of any accident occurring while handling any
hazardous substance and for the establishment of a National Environment Tribunal for
effective and expeditious disposal of cases arising from such accidents, with a view to
giving relief and compensation for damages to persons, property and the environment
and for matters connected therewith or incidental thereto.
190
Health Laws and Policies 20.11 NATIONAL ENVIRONMENT APPELLATE
AUTHORITY ACT OF 1997
This Act has been enacted to “hear appeals with respect to restriction of areas in
which any industries, operations or processes or class of industries, operations or
process shall not be carried out or shall be carried out subject to certain safeguards
under the Environment (Protection) Act, 1986 and for matters connected therewith or
incidental thereto.” According to Section 12 of the Act the Authority shall not be
bound by the procedure laid down in the Code of Civil Procedure, 1908, but shall be
guided by the principles of natural justice. Subject to the other provisions of this Act
and of any rules made by Central Government, the Authority shall have power to
regulate its own procedure, including the fixing of places and times of its enquiry and
deciding whether to sit in public or private. Also, with the effect from the date of
establishment of the Authority, no civil court or other authority shall have jurisdiction
to entertain any appeal in respect of any matter with which the Authority is
empowered by or under this Act.
20.12 HAZARDOUS WASTE (MANAGEMENT AND

HANDLING) RULES, 1989
The Ministry of Environment and Forests came out with Wastes (Management and
Handling) Rules, 1989 under the Environment (Protection) Act, 1986. The main
purpose for promulgation of these rules was for management and handling of
hazardous substances.
The basis of any environmental pollution has been the generation and disposal of
hazardous substances. To regulate them, all the above regulations have been
promulgated. Proper disposal is probably the most important aspect of any industry.
For this reason, guidelines have been issued under this set of rules:
1. Guidelines for Occupier/Generator of Hazardous Wastes: These rules apply to
listed hazardous wastes. The occupier or generator is required to take all the
necessary steps for proper handling and disposal of these chemicals. The occupier
or generator is also responsible “for collection, reception, treatment, storage and
disposal of these wastes either himself or through the operator of a facility.”
The generator is allowed to store a maximum quantity of 10,000 Kilograms or a
truck load, whichever is less of his hazardous wastes on-site for a maximum
period of 90 days. They may extend the storage period under unforeseen
circumstances on a case-by-case basis. The occupier/generator may be allowed to
store their hazardous wastes only in closed specified containers in the designated
protected area.
When the hazardous waste are to be shipped for disposal, it must be done through
the use of manifest. This is to track the waste from the point of its production until
its final disposal, sometimes referred to as “cradle to grave.”
2. Guidelines for Transportation of Hazardous Waste: The Board is required to
register the authorized transports for transportation of hazardous wastes only in
the specified transport vehicles. This is required to make sure that the transports of
the waste, such as drivers and helpers, are sufficiently trained to respond to any
spill, accident or any other emergency situation that may develop during the
transit of the vehicle.
The law specifically prohibits import of hazardous wastes for dumping and
disposal into the country. However, import of such wastes may be allowed for
processing or re-use as raw material. This must be approved by the Board before
import of the chemical.
3. Guidelines for Owner/Operator of Hazardous Waste: Storage, Treatment and 191
Disposal Facility The Board is required to issue license to the owner/operator of Regulations
Hazardous Wastes Management facility for storage, treatment and disposal after
having verified their technical, financial, and managerial capabilities.
These sites are on an approved location taking into consideration factors such as the
damage to the environment in case of a spill or any other accident. Licenses to such
sites are to be given after due inspection of the facility at the time of construction and
operation and also closure of landfill facility.
The Board has to identify and establish standards for Principal Organic Hazardous
Constituents (POHC) for stack emissions from incinerator. Also, the Board is to
monitor the stack emissions, effluent and ground water quality regularly.
Each hazardous waste management facility must have an approved Emergency/
Contingency Plan which must have been duly approved by the Board. The Board is
required to inspect the facility after any incident for appropriate measures taken in
order to avert such incidents and also to make sure that the Emergency/Contingency
Plan is modified accordingly.
It is the responsibility of the waste facility to make sure that the copy of the manifest
reaches the authorities after receiving the hazardous waste from the occupier/
generator. The owner/operator should indicate the proposed treatment and disposal
scheme to be followed for the hazardous waste. The copy of the manifest should be
linked with the copy of the manifest sent by the occupier/generator. This is to make
sure that the waste has been delivered from the “cradle to grave” safely.
20.13 PUBLIC LIABILITY INSURANCE ACT, 1991

The purpose of this Act is to provide for public liability insurance for the purpose of
providing immediate relief to the persons affected by accident occurring while
handling any hazardous substance and for matters connected therewith or incidental
thereto.
The Act defines an “accident” as involving a fortuitous, sudden or unintentional
occurrence while handling any hazardous substance resulting in continuous damage to
any property but does not include an accident by reason only of war or radioactivity.
For the first time, this Act holds the owner liable for death or injury to any person,
damage to any property resulting from an accident. The claimant shall not be required
to plead and establish that death, injury or damage in respect of which the claim has
been made was due to any wrongful Act, neglect or default of any person. Only
Workman has been excluded from this Act as he is covered under the Workmen’s
Compensation Act, 1923 (8 of 1923).
The owner is required to take out insurance policies so that he can give relief under
sub-section (1) of Section 3. This insurance is required within a period of one year
from such commencement. Minimum amount of insurance is the paid-up capital of the
undertaking handling any hazardous substance or Rs. 5 crores maximum. Penalty for
not taking insurance coverage is imprisonment for one year and six months and fine of
not less than one lakh rupees or both.
Under this Act, Environment Relief Fund has been established. This fund may be used
in case of any emergency.
Non-compliance is punishable by 3 months imprisonment or fine which may extend to
Rupees ten thousand or both. Medical expenses are also payable under this Act.
This Act provides for immediate relief of Rs. 25,000 per person in case of death and
Rs. 12,500 in case of injury to be paid immediately. This amount is payable by the
insurance coverage of the spiller or the company where the accident has occurred.
Additional compensation, if any, will have to be settled through court.
192 List of chemicals with quantities for Application of Public Liability Insurance Act are
specified. It also lists chemicals which are extremely hazardous.
20.14 POLLUTION FROM AUTOMOBILES AND

THEIR STANDARDS
To combat this increasing pollution from vehicles, new and tougher auto standards are
being enforced. The Environment (Pollution) Rules, 1986 contain these regulations.
The standards recommended during idling for all four wheeled petrol driven vehicles
for carbon monoxide shall not exceed 3 percent by volume. Idling carbon monoxide
emission limit for all two and three wheeled petrol driven vehicles shall not exceed
4.5 percent by volume.
Cars with mass less than 1,020 kg. load on the axle will be permitted to emit a
maximum of five grams of carbon monoxide per kilometer. The combined emission of
nitrous oxide and hydro carbons shall not exceed 2 grams per kilometer.
The above standards are for petrol driven vehicles only. For diesel driven vehicles, the
regulations are different. For all medium and heavy diesel vehicles with capacity over
3.5 tons, they should not emit more than 11.2 gms. of carbon monoxide per kilowatt
hour (kWh) equivalent burning of fuel. The maximum permissible levels for nitrous
oxide and hydro carbons are 14.4 and 2.4 gms. per kWh.
The Ministry of Environment and Forests, Government of India now also issues the
ECOMARK notifications. They are issued to consumer products that meet certain
Indian Standards Institute guidelines. The product should be friendly to the
environment.
20.15 OTHER REGULATORY REQUIREMENTS

As per Ministry of Environment and Forest notification dated March 13, 1992,
environmental audit is required for every industry, operation or process requiring
consent to operate under Section 25 of the Water (Prevention and Control of
Pollution) Act, 1974 (6 of 1974) or under Section 21 of the Air (Prevention and
Control of Pollution) Act, 1981 (14 of 1981), or both, or authorization under the
Hazardous Wastes (Management and Handling) Rules, 1989, issued under the
Environment (Protection) Act, 1986 (29 of 1986). The notification requires that an
Environmental Statement for the financial year ending on the 31st March be submitted
to the concerned State Pollution Control Board on or before the 30th September of the
same year.
Besides the above regulations, the government has issued many policies. Some of
them are:
z The National Forest Policy
z The National Wild Life Action Plan
z Forest (Conservation) Act
z The Policy Statement for Abatement of Pollution
z The National Conservation Strategy and Policy Statement on Environment and
Development
Regulatory agencies are now enforcing the regulations more and more. They have
taken many industries to the courts enabling many landmark decisions to come out in
support of enforcement of these regulations. In 1987, Justice P.N. Bhagwati enforced
the “Polluter pays” principle. In April 1996, the Supreme Court ordered the closure of
513 polluting industries.
India’s approach for the safeguard of the environment was summed up by Mahatma 193
Gandhi when he said, “Earth has enough to cater to our needs, but it surely will not Regulations
put up with our greed.”
20.16 LIST OF PROJECTS REQUIRING

ENVIRONMENTAL CLEARANCE
1. Nuclear Power and related projects such as Heavy Water Plants, Nuclear Fuel
Complex, Rare Earths.
2. River Valley projects including Hydropower, major irrigation and their
combination including flood control.
3. Ports, Harbors, Airports (except minor ports and harbors).
4. Petroleum Refineries including crude and product pipelines.
5. Chemical Fertilizers (Nitrogenous and Phosphates other than single super
phosphate).
6. Pesticides (Technical).
7. Petrochemical complexes (Both Olefinic and aromatic) and Petro-chemical
intermediates such as DMT, Caprolactam LAB etc. and production of basic
plastics such as LLDPE, HDPE, PP, PVC.
8. Bulk drugs and pharmaceuticals.
9. Exploration for oil and gas and their production, transportation and storage.
10. Synthetic Rubber.
11. Asbestos and Asbestos products.
12. Hydrocyanic acid and its derivatives
13. (I) Primary metallurgical industries (such as production of Iron and Steel,
Aluminum, Copper Zinc, Lead and Ferro Alloys) and also (II) Electric arc
furnaces (Mini Steel Plants).
14. Chlor-alkali industry.
15. Integrated paint complex including manufacture of resins and basic raw materials
required in the manufacture of paints.
16. Viscose Staple fiber and filament yarn.
17. Storage batteries integrated with manufacture of oxides of lead and lead antimony
alloys.
18. All tourism projects between 200m - 500 meters of High Water Lin and at
locations with an elevation of more than 1,000 Meters with investment of more
than Rs. 5 crores.
19. Thermal Power Plants.
20. Mining Projects (major minerals) with leases more than 5 hectares.
21. Highway Projects.
22. Tarred Roads in Himalayan and or Forest areas.
23. Distilleries.
24. Raw Skins and Hides.
25. Pulp, Paper and newsprint.
26. Dyes.
194 27. Cement.
28. Foundries (individual).
29. Electroplating.
20.17 INDUSTRIES WHICH REQUIRE INDUSTRIAL

LICENSING
1. Coal and Lignite.
2. Petroleum (other than crude) and its distillation products.
3. Distillation and brewing of alcoholic drinks.
4. Sugar.
5. Animal fats and oils and their preparations.
6. Cigars and cigarettes of tobacco and manufactured tobacco substitutes.
7. Asbestos and asbestos-based products.
8. Plywood, decorative veneers and other wood based products such as particle-
board, medium density fiberboard, and block board.
9. Leather.
10. Tanned or dressed furskins.
11. Paper and Newsprint except bagasse based unit. (i.e. except units based on
minimum 75% pulp from agricultural residues, bagasse and other non-
conventional raw materials).
12. Electronic aerospace and defense equipment all types.
13. Industrial explosives including detonating fuses, safety fuses, gun powder,
nitrocellulose and matches, explosives; pyrotechnic products; matches; pyrophoric
alloys; certain combustible preparations.
14. Drugs and Pharmaceuticals (according to Drug Policy)
15. Entertainment electronics (VCRs, color TVs, CD players, tape recorders).
20.18 LIST OF POLLUTING INDUSTRIES

1. Primary metallurgical producing industries viz. zinc, lead, copper, aluminum and
steel.
2. Paper, pulp and newsprint
3. Pesticides/insecticides
4. Refineries
5. Fertilizers
6. Paints
7. Dyes
8. Leather tanning
9. Rayon
10. Sodium/potassium cyanide
11. Basic drugs
12. Foundry
13. Storage Batteries (lead acid type) 195
14. Acids/alkalis Regulations
15. Plastics
16. Rubber-synthetic
17. Cement
18. Asbestos
19. Fermentation industry
20. Electro-plating industry.
Check Your Progress
1. What are the seven important pollution regulations in India?
……………………………………….……………………………………..
……………………………………….……………………………………..
2. Give any five example projects requiring environmental clearance.
……………………………………….……………………………………..
……………………………………….……………………………………..
3. Give any five example polluting industries.
……………………………………….……………………………………..
……………………………………….……………………………………..
20.19 LET US SUM UP

In 1976, when the Indian parliament passed the 42nd Amendment. The amendment
was to endeavor to protect and improve the environment and to safeguard the forests
and wild life of the country. Basically, there are seven pollution regulations that are:
z The Water (Prevention & Control of Pollution) Act, 1974, and its amendments;
z The Water (Prevention & Control of Pollution) Cess Act, 1974 and its
amendments;
z The Air (Prevention & Control of Pollution) Act, 1981 and its amendments;
z The Environment (Prevention) Act, 1986 and its amendments;
National Environment Tribunal Act of 1995; and
National Environmental Appellate Authority Act of 1997;
z Hazardous Waste (Management and Handling) Rules, 1989 and
z The Public Liability Insurance Act, 1991.
z The Public Liability Insurance Act. The purpose of the Water (Prevention and
Control of Pollution) Act, 1974 and its amendments is to provide for the
prevention and control of water pollution and the maintenance or restoring
wholesomeness of water for the establishment, with a view to carrying out the
purpose of aforesaid of Boards for the prevention and control of water pollution,
for conferring on and assigning to such Boards powers and functions relating
thereto and for matters connected therewith. This is the Act that established the
Central and a State Board and also the authority and power to constitute as many
committees as it feels essential to carry out specific functions for it. The Act
specifically prohibits “any poisonous, noxious or polluting matter into any stream
or well. The Air (Prevention and Control of Pollution) Act, 1981 was passed for
196 the prevention, control and abatement of air pollution. This law defined an air
pollutant as any solid, liquid or gaseous substance present in the atmosphere in
such concentration as may be or tend to be injurious to human beings or other
living creatures or plants or property or environment. The Environment
(Protection) Act, 1986 was enacted to provide for the protection and improvement
of environment and for matters connected therewith. This Act defined
environment which includes water, air, and land and the inter-relationship which
exists among and between water, air and land, and human beings, other living
creatures, plants, micro-organisms and property. The National Environment
Tribunal Act of 1995 was enacted to provide for strict liability for damages
arising out of any accident occurring while handling any hazardous substance and
for the establishment of a National Environment Tribunal for effective and
expeditious disposal of cases arising from such accidents, with a view to giving
relief and compensation for damages to persons, property and the environment
and for matters connected therewith or incidental thereto. National Appellate
Authority Act of 1997 has been enacted to hear appeals with respect to restriction
of areas in which any industries, operations or processes or class of industries,
operations or process shall not be carried out or shall be carried out subject to
certain safeguards under the Environment (Protection) Act, 1986 and for matters
connected therewith or incidental thereto. The Ministry of Environment and
Forests came out with Wastes (Management and Handling) Rules, 1989 under the
Environment (Protection) Act, 1986. The main purpose for promulgation of these
Rules was for management and handling of hazardous substances. The Public
Liability Insurance Act, 1991 is to provide for public liability insurance for the
purpose of providing immediate relief to the persons affected by accident
occurring while handling any hazardous substance and for matters connected
therewith or incidental thereto. Besides the above regulations, the government has
issued many policies. Some of them are:
The National Forest Policy
The National Wild Life Action Plan
Forest (Conservation) Act
The Policy Statement for Abatement of Pollution
The National Conservation Strategy and Policy Statement on
Environment and Development.

What are the steps taken by the health care sector to prevent the pollution?
20.21 KEYWORDS
Air Pollutant: Any solid, liquid or gaseous substance present in the atmosphere in
such concentration as may be or tend to be injurious to human beings or other living
creatures or plants or property or environment.
Environment: Includes water, air, and land and the inter-relationship which exists
among and between “water, air and land, and human beings, other living creatures,
plants, micro-organisms and property.”
Hazardous substance: Any substance or preparation which, by reason of its chemical
or physics-chemical properties, or handling, is liable to cause harm to human beings,
other living creatures, plants, microorganisms, property or the environment.
197
20.22 QUESTIONS FOR DISCUSSION Pollution Control Acts and
Regulations
1. Explain the pollution regulations in India.
2. Explain the act which is applicable to water and air pollutions.
3. What are hazardous wastes? What are the guidelines applicable to regulate the
hazardous waste?
4. List the projects requiring environmental clearance.
5. Give a list of polluting industries.

1. z The Water (Prevention & Control of Pollution) Act, 1974, and its
amendments;
z The Water (Prevention & Control of Pollution) Cess Act, 1974 and its
amendments;
z The Air (Prevention & Control of Pollution) Act, 1981 and its
amendments;
z The Environment (Prevention) Act, 1986 and its amendments;
National Environment Tribunal Act of 1995; and
National Environment Appellate Authority Act of 1997;
z Hazardous Waste (Management and Handling) Rules, 1989; and
z The Public Liability Insurance Act, 1991.
z The Public Liability Insurance Act, 1991 has been included as the
sixth environmental regulation because it is the first regulation which
gives some teeth to the other five pollution regulations listed above.
2. z Nuclear Power and related projects
z River Valley projects
z Ports, Harbors, Airports
z Petroleum Refineries
z Chemical Fertilizers
3. z Refineries
z Fertilizers
z Paints
z Dyes
z Leather tanning

Sharma, H. C., “Environmental Pollution Compliance”, CBS Publishers, New Delhi, India,.
1994.
Sharma, H. C., “A Dictionary of Environmental Terms (With Hindi Translation)”, CBS
Publishers, New Delhi, India, 1999.
198
21
REGULATION OF STOCK EXCHANGES
CONTENTS
21.1 Introduction
21.2 Securities Contracts (Regulation) Act, 1956
21.2.1 Main Provisions of the Act
21.2.2 Directorate of Stock Exchanges
21.2.3 Critical Evaluation of the Act
21.3 Securities and Exchange Board of India (SEBI)
21.3.1 Salient Features of SEBI Act, 1992
21.3.2 Powers and Functions of the Board
21.3.3 Registration Certificate
21.3.4 Finance Accounts and Audit
21.3.5 Powers of the Central Government
21.3.6 Appeals
21.3.7 Penalty
21.3.8 Achievements of SEBI
21.3.9 Function Performance of SEBI
21.4 Governing Board of Stock Exchanges
21.5 Capital Issues (Control) Act, 1947
21.6 Let us Sum up
21.8 Keywords

z Get an idea about Securities Contracts (Regulation) Act, 1956
z Understand about Securities and Exchange Board of India
z Know about Governing Board of Stock Exchanges
z Know about Capital Issues (Control) Act, 1947
199
21.1 INTRODUCTION Regulation of Stock Exchanges
A certain amount of speculation is indispensable for the proper functioning of a stock
exchange. But very often-uncontrolled speculation degenerates into gambling and
creates undesirable consequences in the stock market. Therefore, it is universally
recognized that the Government should exercise some sort of control over speculative
transactions and on the functioning of the stock exchanges.
The following regulatory authorities regulate stock exchanges:
1. Securities Contracts (Regulation) Act, 1956.
2. Securities and Exchange Board of India.
3. Governing Board of Stock Exchanges.
4. Capital Issues (Control) Act, 1947.
21.2 SECURITIES CONTRACTS (REGULATION) ACT, 1956

The need for control of speculative activities was felt even long before Independence.
In 1923, the Legislative Council of Bombay appointed the Atlay Committee to look
into working of the Bombay Stock Exchange and to suggest suitable measures to
control, direct and regulate the exchange. On the basis of the recommendations of the
Atlay Committee, the Bombay Securities Contract Control Act was passed in 1925.
But it was not an effective measure. The Act declared all the transactions outside the
stock exchange only as void but not illegal. As a result of it many unauthorized
exchanges came into being and flourished well. Therefore, in 1936, the Bombay
Government appointed another Committee, known as Morrison Committee. This
Committee also put forward various suggestions to remedy the several ills of
speculation. But no action was taken on them due to the outbreak of the Second World
War. However, during the Second World War a few steps were taken under Defense
of India Rules. The Stock Exchanges were prohibited form providing facilities for
budla (carry over) transactions and for the making of contracts other than ready
delivery contracts. This measure, however, did not prove to be effective. Moreover,
the rule lapsed in September 1946 itself.
However, the post war boom and its aftermath once again made the Government to
realize the need and urgency of an all India reform and legislation of the stock
exchanges. The then Economic Adviser Dr. P.J. Thomas was asked by the
Government to make a comprehensive study of the subject. An Official Committee
examined the recommendation made by Dr. Thomas in 1948 and the committee also
made several recommendations. In 1951, another informal committee was set up to
process the recommendations of the Official Committee and to prepare a draft model
bill. The informal Committee also prepared one draft model bill.
At this stage, the Government felt that neither the informal Committee nor the official
Committee consisted of the representative of the business community or the stock
exchange and so their recommendations should not be implemented unilaterally.
Hence, it appointed another Committee under the Chairmanship of Shri A.D.
Gorwala. The Presidents of all-important stock exchanges, representative of banking
and insurance companies were also members of the Committee. The Committee
submitted its report along with a revised draft bill. The report of the Gorwala
Committee was also circulated amongst the principal stock exchanges, Chambers of
Commerce and other interested individuals. Finally, the Securities Contracts
(Regulation) Bill was introduced in the Lok Sabha on December 24, 1954 and was
finally passed with some amendments in 1956.
21.2.1 Main Provisions of the Act

The main object of the Act is to establish unitary controls over all the stock exchanges
in India and thereby make them really helpful to the economic development of the
200 country. It aims to build up a healthy investment market and to protect the interests of
the genuine investors. It provides for a general apparatus of control and regulation
both internal and external. The main provisions of the Act are summed up as follows:
z Recognition of Stock Exchanges: Only recognized stock exchanges can function
in our country. Therefore, unrecognized stock exchanges are illegal. For obtaining
recognition, each stock exchange should apply to the Central Government and
should satisfy itself about the following conditions:
1. The rules and bye-laws of the exchange are in conformity with the conditions
prescribed by the Government.
2. The exchange is willing to act in accordance with any conditions that the
Government may impose on it.
3. Such recognition is found essential in the interest of the trade and the public.
The Government is also empowered to withdraw or cancel the recognition granted to
any stock exchange after giving an opportunity to the exchange to be heard. The
Government can also refuse to recognize any exchange.
z Regulation of the Working: Every recognized stock exchange is left free to make
its own byelaws however, subject to the approval of the Central Government. The
Central Government is also empowered to amend the byelaws framed by the
exchange. The Government can regulate the following important matters through
the byelaws of the exchange.
z Powers of the Government: The Act gives wide powers to the Central
Government with a view to bring the stock exchange under its effective control.
The following powers are worth mentioning:
Power to Call for Information: The stock exchanges are required to supply
such explanations and information as the Central Government may require.
They should also furnish periodical returns about their affairs to the Central
Government. A copy of every annual report should also be submitted by the
exchange to the Government.
Power to Order for an Enquiry: The Central Government is also empowered
to order for an enquiry into the affairs of any stock exchange whenever it
thinks fit. It can also direct the exchange to adopt a rule or amend any rule
relating to the administration or its constitution.
Power to Supersede the Governing Body: The Central Government in extreme
cases can supersede the governing body of any stock exchange and appoint
any person or persons to exercise and perform all the powers and duties of the
governing body. It can also call upon the exchange to reconstitute the
governing body in accordance with its rules. The Government can also
appoint its own nominee on the governing board of an exchange subject to a
maximum limit of three representatives.
Power to Suspend Business: In case of an emergency, the Government may
direct any stock exchange to suspend its business activities for a period not
exceeding 7 days. The period of suspension can also be further extended.
Besides, it may also prohibit contracts for sale or purchase of certain
securities without its permission. It has also the power to declare every
contract that may be entered into in a state or area under certain circumstances
as illegal.
Power to Compel Listing of certain Securities: The Central Government, in
the interest of the investing public can also compel any public company to get
its shares listed on a stock exchange. However, the company should be given
an opportunity of being heard.
Power to Order the Exchange to List the Securities: When a stock exchanged 201
has refused to list the securities of a public company or failed to dispose of an Regulation of Stock Exchanges
application within a specified time, the company may prefer an appeal to the
Government. The Government if satisfied may vary or set aside the decision
of the exchanged and order the exchange to list such securities.
z Regulation of Speculation: The Government is also vested with powers to
prohibit the sale or purchase of any security if it considers that such transactions
may lead to undesirable speculation.
z Prohibition of Options in Securities: The Act provides that all option dealings in
securities entered into after the commencement of the Act would be illegal.
Similarly, kerb trading is also declared as illegal. Kerb trading is the business,
transacted by dealers in securities outside the stock exchange. Prior to the Act, the
Karni Market of Calcutta and the Grey Market of Bombay had been important
Kerb markets.
z Regulation of Blank Transfer: Although the Act does not prohibit blank
transfers, it indirectly discourages the practice of blank transfers. Under this Act,
any person who claims the dividend on any share should get such shares
registered in his name at least 15 days before the dividend becomes due. The
Companies Act also restricts the life of blank transfers to six months.
z Licensing of Dealers in Securities: The Act envisages a licensing system for
dealings in stock exchanges. Therefore, only licensed dealers can transact
business in securities. The object of this system is to protect small and uniformed
investors from the undesirable activities of the brokers.
21.2.2 Directorate of Stock Exchanges

The directorate was set up in 1959, by the Government to ensure administration of the
regulatory link between the Central Government and the stock exchanges in the
country. The functions of the Directorate are the following:
1. It keeps constant vigilance over the activities of the stock exchanges.
2. It studies the annual reports and other periodical report submitted by the stock
exchanges and takes effective steps to curb over trading by the members of the
exchanges.
3. It checks kerb trading and option dealings.
4. It ensures enforcement of listing requirements and non-discrimination against any
company by a recognized stock exchange.
21.2.3 Critical Evaluation of the Act

The Securities Contracts (Regulation) Act is, of course, a bold attempt to regulate the
functioning of the stock exchange in our country. It has removed the slackness in their
organization. The Act has also prohibited certain undesirable practices, which
prevailed before the commencement of the Act. However, it has not satisfied many
people. It has been criticized by them on the following grounds:
1. The Act places intolerable restrictions on the internal autonomy of the exchanges.
They should be allowed to function feely. But this argument appears to run
against the very basis of the Act.
2. Some people argue that the Act does not contain effective provisions to prevent
unhealthy and unfair practices. It does not deal effectively with corners and wash
sales etc.
3. The Act does not make any clear-cut distinction between taravaniwalas and
brokers. Such a distinction is necessary to protect the interests of the genuine
investors.
202 4. The Act does not abolish “Forward Trading” in the securities, which resulted in
speculative transactions. The facility of carry over or budla further encourages
such transactions. Therefore, it is placed that no reforms of the stock exchange is
possible without banning the forward trading and carry over or budla transactions.
However, in our country, such transactions are not allowed only in some
exchanges such as Bangalore, Hyderabad and Indore Stock Exchanges.
1. Point out the regulatory authorities regulating the stock exchange.
……………………………………………………………………………...
……………………………………………………………………………...
2. List out the main provisions of Securities Contract Act.
……………………………………………………………………………...
……………………………………………………………………………...
21.3 SECURITIES AND EXCHANGE BOARD OF INDIA

(SEBI)
The SEBI was set up as an administrative body in April 1988. It was given statutory
status on 30.01.92 by promulgation of SEBI Ordinance, which has since become an
Act of Parliament. The basic purpose of establishing SEBI is to protect the interests of
investors in securities and to promote, develop, and regulate the securities market and
the matters connected therewith or incidental thereto.
21.3.1 Salient Features of SEBI Act, 1992

The salient features of the SEBI Act, which is deemed to have come into force on the
30th day of January 1992 are briefly stated as follows:
z Establishment of the SEBI: Sec. 3 of the Act states that with effect from such
date as the Central Government may notify, a Board by the name of SEBI shall be
established. It shall be a body corporate with perpetual succession and a common
seal. The Head Office of the board shall be at Bombay though it may establish its
offices at other places in India.
z Management of the Board: The Board shall consist of the following members
viz.:
a) A chairman;
b) Two members from amongst the officials of the Ministries of the Central
Government dealing with Finance and Law;
c) One member from amongst the officials of the Reserve Bank of India;
d) Two other members, to be appointed by the Central Government.
The Chairman and members referred to in clauses (a) and (d) shall be appointed by the
Central Government and the members referred to in clauses (b) and (c) shall be
nominated by the Central Government and the Reserve Bank of India respectively
[Sec. 4(4)].
The Chairman and other members referred to in clauses (a) and (d) above shall be
persons of ability, integrity and standing who have shown capacity in dealing with
problems relating to securities market or have special knowledge or experience of law,
finance, economics, accountancy, administration or in any other discipline which, in
the opinion of the Central Government, shall be useful to the Board [Sec. 4(5)].
The general superintendence, direction and management of affairs of the Board shall 203
vest in a Board of Members, which may exercise all powers and do all acts and things, Regulation of Stock Exchanges
which may be exercised or done by the Board. These powers also vest in and can be
exercised by the Chairman except as otherwise provided by regulations.
z Term of Office of Chairman and Members of the Board: The term of office and
other conditions of service of Chairman and other members of the Board as are
appointed by the Central Government shall be as may be prescribed by rules made
under the Act. The Central Government will have the right to terminate the
services of the Chairman or the other members appointed to the Board (other than
its own officials or of the Reserve Bank on the Board) at any time before the
expiry of their tenure by giving three months notice in writing or salary and
allowance in lieu thereof. The Chairman and other members shall equally have the
right to relinquish office at any time before the expiry of their tenure by giving a
notice of three months in writing to the Central Government.
z Removal of Members of the Board: The Central Government shall have the
power to remove a member or the Chairman appointed to the Board, if he:
1. At any time has been adjudicated as insolvent,
2. Has been declared by a competent court to be of unsound mind,
3. Has been convicted of an offence involving moral turpitude in the opinion of
the Central Government,
4. Is appointed as a director of a company, or [This clause has been deleted by
the Securities Laws (Amendment) Act, 1995 w.e.f. 25-1-95],
5. Has so abused his position as to render his continuance in office detrimental
to the public interest.
Before removing a member or the Chairman, he will be given a reasonable
opportunity of being health in the matter.
z Meeting of the Board: The Board shall meet at such time and places and shall
observe such rules or procedure in regard to the transaction of business at its
meetings (including quorum at such meetings) as may be provided by regulations
made under Sec. 30 of the Act.
In the absence of the Chairman, for any reason, any other member chosen by the
members present from amongst themselves at the meeting shall preside over the
meeting. All questions which come up before the Board shall be decided by
majority vote of the members present and voting, and in the event of equality of
votes, the Chairman or the presiding member will have a second or casting vote.
Any vacancy (other than casual) in the Board (Sec. 8) shall not invalidate any of
its acts or proceedings. Similarly, any defect in the constitution of the Board or in
the appointment of any person or member of the Board or any irregularity in the
procedure of the Board shall not invalidate the merits of a case before the Board.
Any member, who is a director of a company and who as such director has any
direct or indirect pecuniary interest in any matter coming up for consideration at a
meeting of the Board, shall, as soon as possible after relevant circumstances have
come to his knowledge, disclose the nature of his interest at such meeting and
such disclosure shall be recorded in the proceedings of the Board, and the member
shall not take any part in any deliberation or decision of the Board with respect to
the matter [Sec. 7A inserted by the Securities Laws (Amendment) Act, 1995 (9 of
1995) w.e.f. 25.1.95].
z Officer and Employees of Board: The Board has been empowered to appoint
such other officers and employees, as it considers necessary for the efficient
discharge of its functions under the Act. The term of office and other conditions
204 of service of such officers and employees shall be determined by regulations to be
made by the Board under Sec. 30 of the Act. All members, officers and other
employees of the Board shall be deemed to be public servants (Sec. 22) within the
meaning of Sec. 21 of the Indian Penal Code, 1860 when acting or purporting to
act in pursuance of any provisions of the Act.
21.3.2 Powers and Functions of the Board

z Functions of SEBI: Sec. 11(1) of the Act casts upon SEBI, the duty to protect the
interests of investors in securities and to promote and development of, and to
regulate the securities market through appropriate measures. These measures
provide for:
1. Regulating the business in stock exchanges and any other securities markets,
2. Registering and regulating the working of stock brokers, sub-brokers, share
transfer agents, bankers to an issue, trustees of trust deeds, registrars to an
issue, merchant bankers, underwriters, portfolio managers, investment
advisers and such other intermediaries who may be associated with securities
markets in any manner,
3. Registering and regulating the working of the depositories, participants,
custodians of securities, foreign institutional investors, credit rating agencies
and such other intermediaries as the Board may, by notification, specify in
this behalf,
4. Registering and regulating the working of collective investment schemes
including mutual funds,
5. Promoting and regulating self self-regulatory organizations,
6. Promoting investors’ education and training of intermediaries of securities
markets,
7. Prohibiting fraudulent and unfair trade practices in securities market,
8. Prohibiting insider trading in securities,
9. Regulating substantial acquisition of shares and take-over of companies,
10. Calling for information from, undertaking inspection, conducting enquiries
and audits of the stock exchanges, mutual funds and other persons associated
with the securities market and intermediaries and self-regulatory
organizations in the securities market,
11. Performing such functions and exercising such powers under the provisions
of the Capital Issues (Control) Act, 1947 (subsequently repealed) and the
Securities Contracts (Regulation) Act, 1956, as may be delegated to it by the
Central Government,
12. Levying fees or other charges for carrying out the purposes of Sec. 11 of the
Act,
13. Conducting research for the above purposes,
14. Calling from or furnishing to any such agencies, as may be specified by the
Board, such information as may be considered necessary by it for the efficient
discharge of its functions, and
15. Performing such other functions as may be prescribed by the Government.
z Powers of SEBI as a Civil Court: While exercising the powers given in point
No. 8 above, the Board shall have the same powers as are vested in a Civil Court
under the Code of Civil Procedure, 1908 (5 of 1908) while trying a suit, in respect
of the following matters namely:
1. The discovery and production of books of account and other documents, at 205
such place and such time as may be specified by the Board, Regulation of Stock Exchanges
2. Summoning and enforcing the attendance of persons and examining them on

oath, and
3. Inspection of any books, registers and other documents of any person referred
to in Section 12, at any place.
z Powers of SEBI in Relation to Stock Exchanges: The SEBI Act amends the
Securities Contracts (Regulation) Act, 1956, so as to empower the SEBI in respect
of the following matters. Prior to the Act, the Central Government was exercising
such powers:
1. Power to call for periodical returns from stock exchanges [Sec. 6(1)].
2. Power to prescribe maintenance of certain documents by the stock exchange
[Sec. 6(2)].
3. Power to call upon the exchange or any member to furnish explanation or
information relating to the affairs of the stock exchange or any member(s);
power to appoint any person to make enquiry into the affairs of the governing
body of any stock exchange, or any member of the stock exchange [Sec.
6(3)].
4. Power to approve byelaws of the stock exchanged(s) for regulations and
control of contracts [Sec. 9].
5. Power to amend bylaws of stock exchange(s) [Sec. 10].
6. Licensing of dealers in securities in certain areas [Sec. 17].
7. Power to compel a public company to list its shares [Sec. 21].
An enabling provision (new Section 29) has been incorporated in the Securities
Contracts (Regulation) Act (SCRA) whereby the Central Government may
simultaneously vest with SEBI certain powers exercisable by the Central Government
under the Act. This power is subject to such conditions as may be specified in the
Order. Here also, there is no provision for a complete transfer of powers to the SEBI.
There is only a power to delegate, which means such delegated powers can also be
withdrawn. In effect, after the enactment of the Act, the Central Government has
delegated the following powers under the SCRA.
1. Power to grant recognition to a stock exchange (Sec. 4),
2. Furnishing of Annual Report (Sec. 7),
3. Power to direct any stock exchange to amend the rules relating to the constitution
of stock exchange, (Sec. 8),
4. Power to supersede governing body of any exchange (Sec. 11),
5. Power to suspend business of a recognized stock exchange (Sec.12), and
6. Power to prohibit contracts in certain cases (Sec.16),
z Power of SEBI in Relation to the Companies Act: Certain additional powers
have been conferred on SEBI with regard to certain provisions under the
Companies Act. The sections of the companies Act the violation of which can be
tried by the SEBI include:
1. Sec. 56(3). It entails that every application form must be accompanied by a
memorandum containing salient features of a prospectus.
2. Secs. 57 and 58. According to these sections, the experts mentioned in the
prospectus should be unconnected with the formation or the management of
206 company. Also, the consent of the expert to the issue of the prospectus
containing statement by him is necessary.
3. Sec. 59. It contains penal provisions in respect of violations under Sections
57 and 58.
4. Sec. 73(2). It deals with the provision that over subscription money is
returned with a specified time, can also be tried directly by SEBI.
5. Sec. 113(1). It entails that the shares be issued within 3 months of their
allotment and the shares, be transferred within two months of their lodgment.
21.3.3 Registration Certificate

Sec. 12(1) of the Act provides for the compulsory registration of various persons such
as stock brokers, sub-brokers, share transfer agents, merchant bankers, underwriters,
registrars and bankers to public issues, portfolio managers, investment advisers,
trustees of trust deeds and all other intermediaries associated with the securities
market with SEBI:
1. As per Sec. 12(1A), no depository, participant, custodian of securities, foreign
institutional investor, credit rating agency or any other intermediary associated
with the securities market as the Board may by notification in this behalf specify,
shall buy or sell or deal in securities except under and in accordance with the
conditions of a certificate of registration obtained from the Board in accordance
with the regulations made under this Act.
2. However, a person buying or selling securities or otherwise dealing with the
securities market as a depository, participant, custodian of securities, foreign
institutional investor or credit rating agency immediately before the
commencement of the Securities Laws (Amendment) Act, 1995, for which no
certificate of registration was required prior to such commencement, may
continue to buy or sell securities or otherwise deal with the securities market until
such time regulations are made under clause (d) of sub-section (2) of Section 30.
3. According to Sec. 12(1B), no person shall sponsor or cause to be sponsored or
carry on or cause to be carried on any venture capital funds or collective
investment schemes including mutual funds, unless he obtains a certificate of
registration from the Board in accordance with the regulations.
4. However, any person sponsoring or causing to be sponsored, carrying or causing
to be carried on any venture capital funds or collective investment schemes
operating in the securities market immediately before the commencement of the
Securities Laws (Amendment) Act, 1995 for which no certificate of registration
was required prior to such commencement, may continue to operate till such time
regulations are made under clause (d) of sub-section (2) of Section 30.
5. Every application for registration shall be in such manner and on payment of such
fees as may be determined by regulations [Sec. 12(2)]. The Board may, by order,
suspend or cancel a certificate of registration in such manner as may be
determined by regulations [Sec. 12(3)]. However, no order under this sub-section
i.e. Sec. 12(3) shall be made unless the person concerned has been given a
reasonable opportunity of being heard.
21.3.4 Finance Accounts and Audit

The Act says that the Central Government shall provide for the maintenance of proper
accounts and other relevant records and also for the audit of the accounts by the
Comptroller and Auditor General of India. Besides, the Central Government shall also
make appropriate grants to the Board.
21.3.5 Powers of the Central Government 207
Regulation of Stock Exchanges
The Central Government has been granted wide powers under the Act. They are given
below:
1. To issue directions to the Board on policy matters.
2. To supersede the Board: (a) in the event of any grave emergency disabling the
Board form performing its functions or duties or (b) in the event of default by the
Board in complying with any direction issued by the Central Government under
the Act or (c) in the interest of the public in certain circumstances.
3. To exempt any person or class of persons dealing in the securities market from the
requirement of compulsory registration.
4. To make rules for carrying out the purpose of this Act after making the necessary
notification.
21.3.6 Appeals
The Act provides that any person aggrieved by the Board’s order on any matter under
this Act may prefer an appeal to the Central Government in the prescribed manner and
within the prescribed period [Sec. 20(1)].
21.3.7 Penalty
Contravention of any of the provisions of this Act or any Rules of regulations made
there under shall be punishable with imprisonment up to one year or with fine, or with
both.
21.3.8 Achievements of SEBI

Its achievement can be listed out as below:
1. Guidelines on disclosure and investor protection issued and clarified from time to
time.
2. Proper disclosure to investors through prospectus made obligatory.
3. Guidelines for merchant bankers issued.
4. Advertising code for mutual funds.
5. Mutual funds required publishing balance sheets.
6. Code for Takeovers and Mergers.
7. Guidelines on share transfer agents and registrars to an issue issued.
8. Portfolio management service guidelines.
9. Guidelines on insider trading, takeover bids etc. issued.
10. Stock invest scheme to eliminate delayed refunds.
11. Bombay Stock Exchange persuaded to pass a resolution admitting corporate
members.
12. Proposed that the exchanges take a percentage of the issue amount as deposit from
companies seeking listing.
13. Bombay Stock Exchange made to publicize outstanding trading position on some
scrips.
14. Suggested detailing brokerage/commission in contract notes.
15. Registered a number of investor associations.
208 16. Set up self-regulatory organizations like the Association of Merchant Bankers of
India.
17. Total ban on forward trading.
18. Commenced registration of intermediaries associated with the Stock Exchange.
19. Issuing guidelines for foreign institutional investors for portfolio investments in
India.
20. Guidelines for lead managers for inter se allocation of responsibilities issued.
21. Format for reporting to SEBI by companies for public/right issues drafted.
22. A series of advertisements are being issued to educate and enlighten investing
public.
Further, it is required that all security exchanges submit a detailed report on the
volume of turnover in the securities and the outstanding position of transactions in
securities to SEBI so as to monitor a security’s market. SEBI is taking active steps
with respect to investor protection by identifying them to redress investor’s grievances
promptly. It has asked the Company Law Board to prosecute the companies delaying
share transfer and thereby reducing the floating stock and increasing share prices.
Thus can say that establishment of SEBI is a welcome mover in the history of stock
dealings in India.
21.3.9 Function Performance of SEBI

As we have seen above under Sec. 11(1) of the Act, SEBI has some duty to protect the
interests of investors and to promote the development of any to regulate the securities
market through appropriate measures. We shall now see how SEBI has performed in
meeting the above said duties under the respective heads briefly as shown below:
z Regulation of Business in the Stock Exchanges: Under the SEBI Act, 1992, the
SEBI has been empowered to conduct inspection of stock exchanges. The SEBI
has been inspecting the stock exchanges once in a year since 1995-96.
Based on the observations/suggestions made in the inspection reports, the
exchanges are advised to send a compliance report to SEBI within one month of
the receipt of the inspection report by the exchange and thereafter quarterly
reports indicating the progress made by them in implementing the suggestions
contained in the inspection report. The SEBI’s nominee directors and public
representatives on the governing board/council of management of the stock
exchanges also pursue the matters in the meetings of the governing board/council
of management. If the performance of the exchanges, whose renewal of
recognition is due, is not found satisfactory, the SEBI grants further recognition
for a short period only, subject to fulfillment of certain conditions.
z Regulation and Regulation of Working of Intermediaries: The SEBI regulates
various intermediaries in the primary and secondary markets through various
regulations framed for respective intermediary. These regulations allow the SEBI
to inspect the functioning of these intermediaries and collect registration/renewal
fees from them. Details of the registered intermediaries and regulation of the
working of intermediaries are presented in the following sub-sections:
Primary Market Intermediaries
Merchant Bankers: During 1997-98, 14 merchant bankers were granted
registration. The registration of 44 merchant bankers was cancelled. The
cancelled cases include those that were not renewed as they did not fulfill
net-worth criteria and those cancelled on completion of enquiry
proceedings.
Registrars to an Issue and Share Transfer Agents: Registrars to an Issue 209
(RTI) and Share Transfer Agents (STA) are registered and regulated by Regulation of Stock Exchanges
the SEBI (Registrars to an Issue and Share Transfer Agents) Rules and
Regulations, 1993. Under these regulations, registration commenced in
1993-94 and was granted under two categories viz., category I to act as
both registrar to an issue and share transfer agent and Category II to act as
either registrars to an issue or share transfer agents. As on 31-03-98, 183
persons were granted registration for category I, and 151 persons were
granted registration for category II.
Debenture Trustees: Debenture Trustees are registered and regulated by
the SEBI (Debenture Trustees) Rules and Regulations, 1993. Under these
regulations, registration commenced in 1993-94. As on March 31, 1998,
32 Debenture Trustees were registered with the SEBI.
Bankers to an Issue: Bankers to an Issue are registered and regulated by
the SEBI (Bankers to an Issue) Rules and Regulations, 1994. Under these
regulations, registration commenced in 1993-94. As on 31-3-98, 32
Bankers to an Issue were registered with the SEBI.
Underwriters: The number of underwriters registered with the SEBI in
terms of SEBI (Underwriters) Rules and Regulations, 1993 was 43 at the
end of 1997-98 and was 38 for 1996-97 and 6 underwriters were granted
registration / renewal during the year 1997-98 and one was cancelled.
Portfolio Managers: During 1997-98, one portfolio manager was granted
registration and one was cancelled. Thus the number of portfolio
managers remained the same at 16 for the year 1997-98 as well as for
1996-97.
Secondary Market Intermediaries
Stock Brokers: All stockbrokers are registered with the SEBI in terms of
the SEBI [Stock Brokers and Sub Brokers] Regulations, 1992 the total
number of registered brokers as on March 31, 1998, stood at 9,005.
During the year 1997-98, there was a significant increase in the number of
corporate brokers.
Sub-Brokers: Sub-brokers are an important link between retail or small
investors and the capital markets. The SEBI initiated a number of
measures for bringing sub-brokers under the regulatory framework in the
interest of the investors. In July 1997, the SEBI decided as a policy
measure that share transfer deeds not bearing the rubber stamp of a
registered sub-broker would be considered bad delivery of shares in the
market. As a result, there has been a substantial increase in the number of
applications received for registration as sub-brokers. As on 31.3.98, the
number of sub-brokers registered with SEBI stood at 3,760.
z Registration and Regulation of Collective Investment Schemes including
Mutual Funds: During the year, registration was granted to one new mutual fund
in the private sector. With this registration, there were a total of 37 mutual funds.
z Promotion and Regulation of Self-Regulatory Organisations: SEBI has granted
recognition to the following self-regulatory organizations:
1. Association of Merchant Bankers of India – working towards improving
disclosure standards in the offer documents as well as meeting the statutory
requirement in a systematic manner.
2. Association of Custodial Agencies of India – deals with dematerialization of
securities.
210 3. Registrars Association of India – the SEBI interacts with it in formulating the
policies relating to their role in the issue process.
4. Association of Mutual Funds of India – the SEBI conducts regular meeting
with it on various issues affecting mutual funds.
z Fraudulent and Unfair Trade Practices: After enacting the SEBI (Prohibition of
Fraudulent and Unfair Trade Practices Relating to the Securities Market)
Regulations, which enabled SEBI to investigate into market manipulation,
vigorous efforts were undertaken to enforce these regulations. During 1997-98, 29
cases were taken up for alleged market manipulation and price rigging; and 14
cases were taken up for alleged “Issue,” related manipulation.
z Prohibition of Insider Trading: During the year under review, 5 new cases were
taken up, as against 4 cases in 1996-97. An investigation in the case of Hindustan
Lever Limited was completed during 1997-98 and investigations in other cases
are in the advanced stages of completion. In the proposed Stock Watch System,
surveillance over insider trading would be further strengthened.
z Substantial Acquisition of Shares and Take-over: The SEBI has adjudicated
cases in respect of 13 entities in 1997-98 under the SEBI (Substantial Acquisition
of Shares and Takeover) Regulations, 1997. The SEBI took up 3 cases of alleged
violation of the takeover regulations and the investigations are at an advance
stage.
21.4 GOVERNING BOARD OF STOCK EXCHANGES

The governing body of a recognized stock exchange has wide governmental and
administrative powers. It is the decision-making body. It has the power, subject to
Government approval, to make, amend and suspend the operation of the rules,
byelaws and regulations of the exchanges. It also has complete jurisdiction over all
members and in practice, its power of management and control is almost absolute.
Under the constitution, the governing body has the following powers:
1. To admit and expel members,
2. To warn, censure, fine and suspend members and their partners, attorneys,
remisers, authorized clerks and employees,
3. To approve the formation and dissolution of partnerships and appointment of
attorneys, remisers and authorized clerks,
4. To enforce attendance and information,
5. To adjudicate disputes and impose penalties,
6. To determine the mode and conditions of sock exchange business and regulate
stock exchange trading in all its aspects, and
7. To supervise, direct and control all matters and activities affecting the stock
exchange.
The organization of Bombay Stock Exchange is explained here for an understanding.
In Bombay Stock Exchange, the members on roll elect 16 members to be Directors on
the Governing Board. They elect a President, Vice-President and Treasurer. The
Government appoints Executive Director on the recommendation of the Governing
Board. There are also three representatives from the Government, three from the
public and one from the RBI on the Board to represent their interests. As per the SEBI
guidelines, the Exchanges have agreed to have 50% representation to non-members on
the Governing Board.
211
21.5 CAPITAL ISSUES (CONTROL) ACT, 1947 Regulation of Stock Exchanges
The Capital Issues (Control) Act, 1947 has been enacted in the year 1956 by
reformulating the Capital Issues (Continuance of Control) Act. The Act was abolished
in the year 1992 and its powers have been vested with SEBI. Till that period, all the
capital issues made in the country were controlled and regulated by the Act. Its
objectives were:
1. To ensure the sound capital structure for corporate enterprises.
2. To protect the interest of the investors from the fraudulent practices.
3. To regulate, direct and distribute new issues between different periods of the year.
4. To channels the balanced flow of resources to industries, agriculture and social
services in accordance with the five-year plans.
5. To promote rational and healthy expansion of corporate sector in the public
interest.
6. To regulate bonus issue and pricing of new issues.
7. To control re-organization programmes of mergers, amalgamations etc., which
require additional issue of capital instruments.
As per the provisions of the Act, prior consent of the Controller of Capital Issues
should be obtained for any sort of public issue for flotation of capital made by public
or private companies. It extends to the issue of bonus shares, conversion of partly paid
up shares into fully paid-up shares, and increase of paid up value or par value of
shares/securities.
The capital issues control was administered by the Controller of Capital Issues (CCI)
as per the principles and policies laid down by the Central Government. Such
guidelines covered the aspects of adequacy of capital, sound capital structure, public
issue, promoters interest, listing of shares in stock exchanges, issue price, timing of
issue, conditions as to rights issue, allotment and refund of application money etc. The
CCI had extensive powers to control capital issues as a measure of investor protection.
With the abolition of CCI, companies for their new issues of capital no longer require
prior consent of CCI. They are free to enter into capital market subject to the
clearance of their offer documents by SEBI.
1. Who are all the members of SEBI’s management Board?
……………………………………………………………………………...
……………………………………………………………………………...
2. What is the penalty for contravening the SEBI Act?
……………………………………………………………………………...
……………………………………………………………………………...
21.6 LET US SUM UP

Securities Contracts (Regulation) Act, 1956. The main provisions of the act are
recognition of stock exchanges, regulation of the working, powers of the government,
regulation of speculation prohibition of options in securities, regulation of blank
transfer and licensing of dealers in securities. Securities and Exchange Board of India
(SEBI) was set up as an administrative body in April 1988. Salient features of SEBI
Act, 1992 are establishment of the SEBI, the management of the board, term of office
of chairman and members of the board, removal of members of the board, meeting of
the board, officer and employees of board, powers and functions of the board. And the
212 achievements of the SEBI are also highlighted in this lesson. Governing board of
stock exchanges has wide governmental and administrative powers. The Capital
Issues (Control) Act, 1947 has been enacted in the year 1956 by reformulating the
Capital Issues (Continuance of Control) Act. The Act was abolished in the year 1992
and its powers have been vested with SEBI. Till that period, all the capital issues
made in the country were controlled and regulated by the Act.

To start a Corporate Hospital, a Hospital Administrator should know about the above
said Regulations of Stock exchange. Why?
21.8 KEYWORDS
SEBI: Securities and Exchange Board of India.
Stock Exchange: A highly organized market for the purchase and sale of second-hand
quoted or listed securities.
Listing of a Security: Incorporating the security in the register of the stock exchange.

1. Explain the main provisions of securities contract.
2. What are the salient features of SEBI Act?
3. Explain the functional performance of SEBI.
4. Explain the Governing Board of Stock Exchanges
5. Describe the Capital Issues (Control) Act.

CYP 1
1. The regulatory authorities regulate stock exchanges are:
Securities Contracts (Regulation) Act, 1956.
Securities and Exchange Board of India.
Governing Board of Stock Exchanges.
2. Capital Issues (Control) Act, 19472. Main provisions of the Securities
Contract Act are:
Recognition of Stock Exchanges
Regulation of the Working
Powers of the Government
Regulation of Speculation Prohibition of Options in Securities
Regulation of Blank Transfer
CYP 2
1. A chairman;
Two members from amongst the officials of the Ministries of the
Central Government dealing with Finance and Law;
One member from amongst the officials of the Reserve Bank of India;
Two other members, to be appointed by the Central Government.
Contd….
2. Contravention of any of the provisions of this Act or any rules of 213
regulations made thereunder shall be punishable with imprisonment up to Regulation of Stock Exchanges
one year or with fine, or with both.

Bhalla, V.K., “Investment Management”, S. Chand & Company Ltd., New Delhi.
214
22
NEGOTIABLE INSTRUMENTS ACT
CONTENTS
22.1 Introduction
22.3 Definitions
22.4 Promissory Note
22.4.1 Features of a Promissory Note
22.5 Parties to a Bill of Exchange
22.5.1 Features of a Bill of Exchange
22.6 Cheques
22.6.1 Features of a Cheque
22.6.2 Types of Cheque
22.7 Hundis
22.7.1 Types of Hundis
22.8 Features of Negotiable Instruments
22.9 Let us Sum up
22.11 Keywords

z Know the meaning of negotiable instruments
z Understand the features of negotiable instruments
z Get an clear idea about the various negotiable instruments
22.1 INTRODUCTION
In India, there is reason to believe that instrument to exchange were in use from early
times and we find that papers representing money were introducing into the country
by one of the Mohammedan sovereigns of Delhi in the early part of the fourtheenth
century. The word 'hundi', a generic term used to denote instruments of exchange in
vernacular is derived from the Sanskrit root 'hund' meaning 'to collect' and well
expresses the purpose to which instruments were utilised in their origin. With the
advent of British rule in India commercial activities increased to a great extent. The
growing demands for money could not be met be mere supply of coins; and the 215
Negotiable
instrument of credit took the function of money which they represented. Instruments Act
The history of the present Act is a long one. The Act was originally drafted in 1866 by
the India Law Commission and introduced in December, 1867 in the Council and it
was referred to a Select Committee. Objections were raised by the mercantile
community to the numerous deviations from the English Law which it contained. The
draft thus prepared for the fourth time was introduced in the Council and was passed
into law in 1881 being the Negotiable Instruments Act, 1881 (26 of 1881).

z This Act may be called the Negotiable Instruments Act, 1881.
z Local extent, Saving of usage relating to hundis, etc., Commencement: It
extends to ‘the whole of India’ but nothing herein contained affects the Indian
Paper Currency Act, 1871 (3 of 1871), section 2, or affects any local usage
relating to any instrument in an oriental language: Provided that such usages may
be excluded by any words in the body of the instrument, which indicate and
intention that the legal relations of the parties thereto shall be governed by this
Act; and it shall come into force on the first day of March, 1882. Application of
the Act:- Every negotiable instrument shall be governed by the provisions of this
Act, and no usage or custom at variance with any such provision shall apply to
any such instrument.
22.3 DEFINITIONS
z “Negotiable Instrument”: According to section 13 of the Negotiable Instruments
Act, 1881, a Negotiable instrument means “promissory note, bill of exchange, or
cheque, payable either to order or to bearer”.
Explanation (I)-A promissory note, bill of exchange or cheque is payable to order
which is expressed to be so payable or which is expressed to be payable to a
particular person, and does not contain words prohibiting, transfer or indicating an
intention that it shall not be transferable.
z "accommodation party" means a person who has signed a negotiable instrument
as a marker, drawer acceptor or endorser without receiving the value thereof and
for the purpose of lending his name to some other person;
z "banker" means a person transacting the business of accepting, for the purpose of
lending or investment, of or deposits of money from the public, repayable on
demand otherwise withdrawable by cheque, draft, order, or otherwise, and
includes any Post Office Savings Bank;
z "bearer" means a person who by negotiable comes into possession of a
negotiable instrument, which is payable to bearer,
z "delivery" means transfer of possession actual or constructive, from one person to
another;
z "issue" means the first delivery of a promissory notice, bill of exchange of
cheque complete in form to a person' who takes it as holder .
z "material alteration" in relation to a Promissory note, bill, of exchange or cheque
includes an alteration of the date, the sum payable, the time of payment, the of
payment, and, where any such instrument has been accepted generally, the
addition of a place of payment without the acceptor's assent, and
z "notary public" includes any person appointed by the Central Government to
perform the functions of notary public under this Act and a notary appointed
under the Notaries Ordinance, 1961.
216 z "Promissory note" a "promissory note" is in an instrument in writing (not being a
bank-note or a currency note) containing an unconditional undertaking signed by
the maker, to pay on demand or at a fixed or determinable future time] a certain
sum of money only to, or to the order of a certain person, or to the bearer of the
instrument.
z "Bill of exchange" is an instrument in writing containing an unconditional order,
signed by the maker, directing a certain person to pay on demand or at a fixed or
determinable future time a certain sum of money only to, or to the order of, a
certain person or to the bearer of the instrument.
z "Cheque" a "cheque" is a bill of exchange drawn on a specified banker and not
expressed payable otherwise than on demand.
z "Drawer", "Drawee": The marker of a bill of exchange or cheque is called the
"drawer;" the person thereby directed to pay is called the "drawee."
z "Drawee in case of need" When in the bill or in any endorsement thereon the
name of any person is given in addition to the drawee to be resorted to in case of
need such person is called a "drawee in case of need".
z "Acceptor" After the drawee of a bill has signed his assent upon the bill, or, if
there are more parts thereof than one, upon one of such parts, and delivered the
same, or given notice of such signing to the holder or to some person on his behalf
he is called the "acceptor."
z "Acceptor for honour": When a bill of exchange has been noted or protested for
non-acceptance or for better security, and any person accepts is supra protest for
honour of the drawer or of any one of the endorsers, such person is called an
"acceptor for honour."
z "Payee": The person named in the instrument, to whom or to whose order the
money is by the instrument directed to be paid is called the "payee."
z "Holder": The "holder" of a promissory note, bill of exchange or cheque means
the payee or endorsee who is in possession of it or the bearer thereof but does not
include a beneficial owner earning through a benamidar.
z "Holder in due course": "Holder in due course" means any person who for
consideration becomes the possessor of a promissory note, bill of exchange or
cheque if payable to bearer, or the payee or endorsee thereof, if payable to order,
before it became overdue, without notice that the title of the person from whom he
derived his own title was defective.
z "Payment in due course": "Payment in due course" 'means payment in
accordance with the apparent tenor of the instrument in good faith and without
negligence to any person in possession thereof under circumstances which do not
afford a reasonable ground for believing that he is not entitled to receive payment
of the amount therein mentioned.
z Inland instrument: A promissory note, bill of exchange or cheque drawn or made
in Pakistan and made payable in, or drawn upon any person resident in, Pakistan
shall be deemed to be an inland instrument.
z Foreign Instrument: Any such instrument not so drawn, made or made payable
shall be deemed to be foreign instrument.
z Negotiation: When a promissory note, bill of exchange or cheque is transferred to
any person, so as to constitute that person the holder thereof, the instrument is said
to be negotiable.
z Endorsement: When the maker or holder of a negotiable instrument signs the
same, otherwise than as such maker, for the purpose of negotiable, on the back or
face thereof or on a slip of paper annexed thereto, or so signs for the same purpose 217
Negotiable
a stamped paper intended to be completed as a negotiable instrument, he is said to Instruments Act
endorse the same, and is called the "endorser".
z Ambiguous instruments: Where an instrument may be construed either as a
promissory note or bill of exchange, the holder may at his election treat it as either
and the instrument shall be then certificate reforward treated accordingly.
22.4 PROMISSORY NOTE

Negotiable Instruments Act, 1881 defines a promissory note as ‘an instrument in
writing (not being a bank note or a currency note) containing an unconditional
undertaking, signed by the maker, to pay a certain sum of money only to or to the
order of a certain person or to the bearer of the instrument’.
A signs instruments in the following terms:
a) “I promise to pay B or order Rs. 500.”
b) “I acknowledge myself to be indebted to B in Rs. 1,000 to be paid on demand, for
value received.”
c) “Mr B, I O U Rs. 1,000.”
d) “I promise to pay B Rs. 500 and all other sums which shall be due to him”
e) “I promise to pay B Rs. 500, first deducting there out any money which he may
owe me.”
f) “I promise to pay B Rs. 500 seven days after my marriage with C.”
g) “I promise to pay B Rs. 500 on D's death, provided D leaves me enough to pay
that sum.”
h) “I promise to pay B. Rs. 500 and to deliver to him my black horse on 1st January
next.”
The instruments respectively marked (a) and (b) are promissory notes. The
instruments respectively marked (c), (d), (e), (f), (g) and (h) are not promissory notes.
A signs instruments in the following terms:
a) “I promise to pay B or order Rs. 500.”
b) “I acknowledge myself to be indebted to B in Rs. 1,000 to be paid on demand, for
value received.”
c) “Mr B, I O U Rs. 1,000.”
d) “I promise to pay B Rs. 500 and all other sums which shall be due to him”
e) “I promise to pay B Rs. 500, first deducting there out any money which he may
owe me.”
f) “I promise to pay B Rs. 500 seven days after my marriage with C.”
g) “I promise to pay B Rs. 500 on D's death, provided D leaves me enough to pay
that sum.”
h) “I promise to pay B. Rs. 500 and to deliver to him my black horse on 1st January
next.”
The instruments respectively marked (a) and (b) are promissory notes. The
instruments respectively marked (c), (d), (e), (f), (g) and (h) are not promissory notes.
z Maker or Drawer: The person who makes the note and promises to pay the
amount stated therein.
218 z Payee: The person to whom the amount is payable.
In course of transfer of a promissory note by payee and others, the parties involved
may be
z Endorser: The person who endorses the note in favour of another person.
z Endorsee: The person in whose favour the note is negotiated by endorsement.
z Endorsement: Means transfer of any document or instrument to another person by
signing on its back or face or on a slip of paper attached to.
22.4.1 Features of a Promissory Note

1. A promissory note must be in writing, duly signed by its maker and properly
stamped as per Indian Stamp Act.
2. It must contain an undertaking or promise to pay. Mere acknowledgement of
indebtedness is not enough.
3. The promise to pay must not be conditional.
4. It must contain a promise to pay money only.
5. The parties to a promissory note, i.e. the maker and the payee must be certain.
6. A promissory note may be payable on demand or after a certain date.
7. The sum payable mentioned must be certain or capable of being made certain. It
means that the sum payable may be in figures or may be such that it can be
calculated.
22.5 PARTIES TO A BILL OF EXCHANGE

There are three parties involved in a bill of exchange. They are:
1. Drawer: The person who makes the order for making payment.
2. Drawee: The person to whom the order to pay is made. He is generally a debtor of
3. Payee: The person to whom the payment is to be made. The drawer can also draw
a bill in his own name thereby he himself becomes the payee. Here the words in
the bill would be Pay to us or order.
In a bill where a time period is mentioned, it is called a Time Bill. But a bill may be
made payable on demand also. This is called a Demand Bill.
22.5.1 Features of a Bill of Exchange

1. A bill must be in writing, duly signed by its drawer, accepted by its drawee and
properly stamped as per Indian Stamp Act.
2. It must contain an order to pay. Words like ‘please pay Rs. 5,000/- on demand and
oblige’ are not used.
3. The order must be unconditional.
4. The order must be to pay money and money alone.
5. The sum payable mentioned must be certain or capable of being made certain.
6. The parties to a bill must be certain.
22.6 CHEQUES
Cheque is a very common form of negotiable instrument. If you have a savings bank
account or current account in a bank, you can issue a cheque in your own name or in
favour of others, thereby directing the bank to pay the specified amount to the person 219
Negotiable
named in the cheque. Instruments Act
Therefore, a cheque may be regarded as a bill of exchange; the only difference is that
the bank is always the drawee in case of a cheque.
The Negotiable Instruments Act, 1881 defines a cheque as a bill of exchange drawn
on a specified banker and not expressed to be payable otherwise than on demand.
Actually, a cheque is an order by the account holder of the bank directing his banker
to pay on demand, the specified amount, to or to the order of the person named therein
or to the bearer.
22.6.1 Features of a Cheque

1. A cheque must be in writing and duly signed by the drawer.
2. It contains an unconditional order.
3. It is issued on a specified banker only.
4. The amount specified is always certain and must be clearly mentioned both in
figures and words.
5. The payee is always certain.
6. It is always payable on demand.
7. The cheque must bear a date otherwise it is invalid and shall not be honoured by
the bank.
22.6.2 Types of Cheque

There are four types of cheques:
a) Open cheque, and
b) Crossed cheque,
c) Bearer cheque,
d) Order cheque
z Open cheque: A cheque is called ‘Open’ when it is possible to get cash over the
counter at the bank. The holder of an open cheque can do the following:
1. Receive its payment over the counter at the bank,
2. Deposit the cheque in his own account,
3. Pass it to some one else by signing on the back of a cheque.
z Crossed cheque: Since open cheque is subject to risk of theft, it is dangerous to
issue such cheques. This risk can be avoided by issuing another types of cheque
called ‘Crossed cheque’. The payment of such cheque is not made over the
counter at the bank. It is only credited to the bank account of the payee. A cheque
can be crossed by drawing two transverse parallel lines across the cheque, with or
without the writing ‘Account payee’ or ‘Not Negotiable’.
z Bearer cheque: A cheque which is payable to any person who presents it for
payment at the bank counter is called ‘Bearer cheque’. A bearer cheque can be
transferred by mere delivery and requires no endorsement.
z Order cheque: An order cheque is one which is payable to a particular person. In
such a cheque the word ‘bearer’ may be cut out or cancelled and the word ‘order’
may be written. The payee can transfer an order cheque to someone else by
signing his or her name on the back of it.
220
Health Laws and Policies 22.7 HUNDIS
A Hundi is a negotiable instrument by usage. It is often in the form of a bill of
exchange drawn in any local language in accordance with the custom of the place.
Some times it can also be in the form of a promissory note. A hundi is the oldest
known instrument used for the purpose of transfer of money without its actual
physical movement. The provisions of the Negotiable Instruments Act shall apply to
hundis only when there is no customary rule known to the people.
22.7.1 Types of Hundis

z Shah-jog Hundi: This is drawn by one merchant on another, asking the latter to
pay the amount to a Shah. Shah is a respectable and responsible person, a man of
worth and known in the bazaar. A shah-jog hundi passes from one hand to another
till it reaches a Shah, who, after reasonable enquiries, presents it to the drawee for
acceptance of the payment.
z Darshani Hundi: This is a hundi payable at sight. It must be presented for
payment within a reasonable time after its receipt by the holder. Thus, it is similar
to a demand bill.
z Muddati Hundi: A muddati or miadi hundi is payable after a specified period of
time. This is similar to a time bill.
There are few other varieties like Nam-jog hundi, Dhani-jog hundi, Jawabee hundi,
Jokhami hundi, Firman-jog hundi, etc.
1. Define negotiable instrument.
…………………………………….………………………………………..
…………………………………….………………………………………..
2. Who is drawer and drawee?
…………………………………….………………………………………..
…………………………………….………………………………………..
3. What is endorsement?
…………………………………….………………………………………..
…………………………………….………………………………………..
4. List out the different types of cheques.
…………………………………….………………………………………..
…………………………………….………………………………………..
5. List out the different types of hundis.
…………………………………….………………………………………..
…………………………………….………………………………………..
22.8 FEATURES OF NEGOTIABLE INSTRUMENTS

z A negotiable instrument is freely transferable. Usually, when we transfer any
property to somebody, we are required to make a transfer deed, get it registered,
pay stamp duty, etc. But, such formalities are not required while transferring a
negotiable instrument. The ownership is changed by mere delivery (when payable
to the bearer) or by valid endorsement and delivery (when payable to order).
Further, while transferring it is also not required to give a notice to the previous 221
Negotiable
holder. Instruments Act
z Negotiability confers absolute and good title on the transferee. It means that a
person who receives a negotiable instrument has a clear and undisputable title to
the instrument. However, the title of the receiver will be absolute, only if he has
got the instrument in good faith and for a consideration. Also the receiver should
have no knowledge of the previous holder having any defect in his title. Such a
person is known as holder in due course.
z A negotiable instrument must be in writing. This includes handwriting, typing,
computer print out and engraving, etc.
z In every negotiable instrument there must be an unconditional order or promise
for payment.
z The instrument must involve payment of a certain sum of money only and nothing
else. For example, one cannot make a promissory note on assets, securities, or
goods.
z The time of payment must be certain. It means that the instrument must be
payable at a time which is certain to arrive. If the time is mentioned as ‘when
convenient’ it is not a negotiable instrument. However, if the time of payment is
linked to the death of a person, it is nevertheless a negotiable instrument as death
is certain, though the time thereof is not.
z The payee must be a certain person. It means that the person in whose favour the
instrument is made must be named or described with reasonable certainty. The
term ‘person’ includes individual, body corporate, trade unions, even secretary,
director or chairman of an institution. The payee can also be more than one
person.
z A negotiable instrument must bear the signature of its maker. Without the
signature of the drawer or the maker, the instrument shall not be a valid one.
z Delivery of the instrument is essential. Any negotiable instrument like a cheque or
a promissory note is not complete till it is delivered to its payee. For example, you
may issue a cheque in your brother’s name but it is not a negotiable instrument till
it is given to your brother.
z Stamping of Bills of Exchange and Promissory Notes is mandatory. This is
required as per the Indian Stamp Act, 1899. The value of stamp depends upon the
value of the pronote or bill and the time of their payment.
22.9 LET US SUM UP

Negotiable Instruments Act, 1881. A Negotiable instrument means promissory note,
bill of exchange, or cheque, payable either to order or to bearer. Promissory note as an
instrument in writing (not being a bank note or a currency note) containing an
unconditional undertaking, signed by the maker, to pay a certain sum of money only
to or to the order of a certain person or to the bearer of the instrument. Bill of
exchange is an instrument in writing containing an unconditional order, signed by the
maker, directing a certain person to pay on demand or at a fixed or determinable
future time a certain sum of money only to, or to the order of, a certain person or to
the bearer of the instrument. Cheque is a very common form of negotiable instrument.
If you have a savings bank account or current account in a bank, you can issue a
cheque in your own name or in favour of others, thereby directing the bank to pay the
specified amount to the person named in the cheque. There are four types of cheques:
(a) Open cheque, (b) Crossed cheque, (c) Bearer cheque and (d) Order cheque. A
Hundi is a negotiable instrument by usage. It is often in the form of a bill of exchange
drawn in any local language in accordance with the custom of the place. Some times it
222 can also be in the form of a promissory note. A hundi is the oldest known instrument
used for the purpose of transfer of money without its actual physical movement. The
provisions of the Negotiable Instruments Act shall apply to hundis only when there is
no customary rule known to the people Types of Hundis are: Shah-jog Hundi,
Darshani Hundi, Muddati Hundi, Nam-jog hundi, Dhani-jog hundi, Jawabee hundi ,
Jokhami hundi and Firman-jog hundi. This act highlights the features of negotiable
instruments, features of a cheque, features of a bill of exchange and the features of a
promissory note.

Dishonour of a cheque is punishable under law. How?
22.11 KEYWORDS
Negotiable instrument: According to Section 13 of the Negotiable Instruments Act,
1881, a Negotiable instrument means, promissory note, bill of exchange, or cheque,
payable either to order or to bearer.
Banker: It means a person transacting the business of accepting, for the purpose of
lending or investment, of or deposits of money from the public, repayable on demand
otherwise withdrawable by cheque, draft, order, or otherwise, and includes any Post
Office Savings Bank.
Bearer: It means a person who by negotiable comes into possession of a negotiable
instrument, which is payable to bearer.
Material alteration: Relation to a Promissory note, bill, of exchange or cheque
includes an alteration of the date, the sum payable, the time of payment, the of
payment, and, where any such instrument has been accepted generally, the addition of
a place of payment without the acceptor's assent.
Notary public: The includes any person appointed by the Central Government to
perform the functions of notary public under this Act and a notary appointed under the
Notaries Ordinance, 1961.

1. What is bill of exchange? Explain its features.
2. Differentiate promissory note and bill of exchange.
3. Differentiate cheques and hundis.
4. What is a promissory note? Write its special features.
5. What is a cheque? Classify it.
6. Explain the features of a cheque.
7. What is hundi? Classify it.
8. Write the features of hundis.
9. Explain the features of negotiable instruments.
Negotiable
1. A Negotiable instrument means “promissory note, bill of exchange, or Instruments Act
cheque, payable either to order or to bearer”.
2. The marker of a bill of exchange or cheque is called the “drawer;” the
person thereby directed to pay is called the “drawee.”
3. When the maker or holder of a negotiable instrument signs the same,
otherwise than as such maker, for the purpose of negotiable, on the back
or face thereof or on a slip of paper annexed thereto, or so signs for the
same purpose a stamped paper intended to be completed as a negotiable
instrument, he is said to endorse the same, and is called the “endorser”.
4. Four types of cheques are:
Open cheque
Crossed cheque
Bearer cheque
Order cheque
5. Types of Hundis are:
Shah-jog Hundi
Darshani Hundi
Muddati Hundi
Nam-jog hundi
Dhani-jog hundi
Jawabee hundi
Jokhami hundi
Firman-jog hundi

224
23
CENVAT (EARLIER MODVAT)
CONTENTS
23.1 Introduction
23.2 MODVAT (upto 31st March 2000)
23.3 CENVAT (Replaced MODVAT Scheme from 1st April 2000)
23.4 Feature of CENVAT Scheme
23.5 Meaning of Input and Capital Goods
23.6 Let us Sum up
23.8 Keywords

z Know about the MODVAT scheme
z Understand the CENVAT scheme
z Explain about capital goods.
23.1 INTRODUCTION
Ordinarily, tax on manufacture of any product is based selling price. However, in the
modern production technology, Often the final product of one manufacturer may
become input for another manufacturer, the final product of this another manufacturer
may be input for yet another manufacturer, and so on. Now, if excise duty is charged
on the selling price of the final product of each manufacturer, it is likely that each
subsequent sale will involve payment of duty on duty. In tax terminology, this means
cascading effect of multiple taxation.
The answer to multiple taxation is Value-Added Tax (VAT). Under it, either each
subsequent manufacturer only pays duty on the value added by him to the product, or
he gets credit for the duty paid by him on his inputs (whether raw material, component
or intermediate goods). As determination of the value added by each subsequent
manufacturer is relatively difficult to determine, the best course is grant him credit or
refund the duty paid by him on his inputs.
23.2 MODVAT (UPTO 31ST MARCH 2000)

Upto 31st March 2000, the Indian answer to multiple taxation on inputs was the
modified value added tax (MODVAT). Under it, the manufacturer received 75%
credit in respect of duty paid by him on inputs used by him – whether in actual 225
manufacture or in relation to manufacture of excisable goods. Thus, there was credit CENVAT (Earlier MODVAT)
no only in case of inputs that actually went into manufacture of excisable goods, but
also on inputs used in relation to such manufacture, such as, paints, packing materials,
fuel, inputs used for generation of electricity or accessories. Further, there was no
condition that the inputs should reflect in the final product or that there should be one-
to-one relationship between input and the final product. This means the manufacturer
would get credit soon after duty-paid inputs were received in factory. Subsequently,
MODVAT credit was also allowed in respect of purchase of capital goods.
23.3 CENVAT (REPLACED MODVAT SCHEME

FROM 1ST APRIL 2000)
Effective 1 April 2000, CENVAT (Central Value Added Tax) will replace MODVAT
(Modified Value Added Tax). The new CENVAT, like the outgoing MODVAT, aims
to grant credit to the manufacturer in respect of specified excise duties paid on inputs
or capital goods received by him in his factory. He will adjust the amount of credit
against basic duty, special excise duty, countervailing excise duty, National Calamity
Contingent Duty, etc. Payable by him on his final product. However, CENVAT credit
scores over MODVAT credit in two respects. One, it is unusually simple. Two, it is
free from man procedural hurdles that makes it easy to administer.
23.4 FEATURE OF CENVAT SCHEME

z Duty payments in respect of which CENVAT credit will be available. CENVAT
credit will be allowed to manufacturer in respect of certain excise duties paid by
him on inputs, components, or capital goods received by him in his factory. The
excise duties in respect of which CENVAT credit will be available are (a) Basic
excise duty, (b) Special excise duty, (c) Countervailing excise duty, (d) National
Calamity Contingent Duty, etc. For example, if any above, he can take credit fro it
against basic excise duty payable by him on his final product. National Calamity
Contingent Duty imposed in Budget 2003-04, is for one year only.
z CENVAT covers all inputs (except HSD and petrol) and capital goods. CENVAT
extends to all inputs and capital goods, except high-speed diesel and petrol.
23.5 MEANING OF INPUT AND CAPITAL GOODS

The scheme gives a concise definition of “inputs” and “capital goods”. Accordingly,
“Input” means all goods used in manufacture or in relation to manufacture of final
products. The use of input in, or in relation to manufacture may be direct or indirect,
the input may or may not form part of the final product, and it may be used as packing
material, or as fuel or for generation of electricity or steam. However, high-speed
diesel and petrol will not be input as CENVAT specifically excludes them from its
operation. However, lubricating oil, grease, coolants, accessories of final products
cleared along with final products, will be inputs.
“Capital goods” will include the following:
1. All goods falling under Chapters 82, 84, 85 or 90 of the First Schedule to the
Central Excise Tariff Act. Such goods should be used in the factory of
manufacture, either directly for manufacture of the final products, or for research
and development, quality control, testing, weighing or similar allied functions
related to the production of final products. However, office equipment will not be
capital goods for purposes of CENVAT.
2. Spare parts, components and accessories of the goods mentioned in: (1) above,
whether falling under the same Chapters or any other Chapter of the First
Schedule to the Central Excise Tariff Act:
226 (a) CENVAT credit covers all finished goods, except matches and duty-free
goods: CENVAT extends to all final products (except matches) that are liable
to excise duty. However, if any final product is itself not excisable, then the
scheme will not apply. A Small-scale undertaking (SSK) will be eligible for
CENVAT credit only when it crosses the exemption limit of Rs. 100 lakh and
starts paying duty, in respect of inputs lying in stock, inputs contained in
finished goods lying in stock, and inputs in process.
(b) CENVAT credit available immediately on receipt of inputs / capital goods in
factory: A manufacturer can take CENVAT credit immediately on receipt of
inputs/capital goods in his factory. Credit in respect of inputs will be available
in full soon after their receipt, even if these are yet to be used in the
manufacture of excisable final products. However, credit in respect of capital
goods is subject to two conditions. One, in the year of receipt of capital
goods, only credit equal to 50% of the specified duty paid on such capital
goods will be available. The balance 50% credit will be allowed only in a
subsequent financial year. Two, there will be no credit in respect of capital
goods (machinery / plant) which are subject to depreciation allowance under
Sec. 32, or deduction under any other provision of the Income-tax Act.
(c) Restricted CENVAT credit in case of FTZ, SEZ, 100% EOU, HTP or STP: In
case of inputs or capital goods produced or manufactured in a Free Trade
Zone (FTZ). Special Economic Zone (SEZ), 100% Export-Oriented
Undertaking (EOU), Hardware Technology Park (HTP) or Software
Technology Park (STP), there will be limitation on CENVAT credit.
Accordingly, the amount of credit will be only equal to the additional duty
levied on like goods under Customs Tariff Act, paid on such inputs or capital
goods.
(d) CENVAT credit allowable even when goods cleared for job work: A
manufacturer can claim credit even while clearing any input or capital goods
for further processing, testing repairs, etc. to a job worker. However, it is
necessary that the relevant records (challans, memo, and any other document)
should prove that such inputs/capital goods have been received back.
(e) Maintenance of separate records for dutiable and exempt goods: CENVAT
credit will be only available if the assesses manufacturers dutiable final
products. If he produces both dutiable as well as duty-exempt final product,
then he must maintain separate accounts for receipt, consumption and
inventory of inputs meant for use in the manufacture or each category of final
products. This is as it should be, because he can claim credit only in respect of
inputs used for manufacture of dutiable goods. What if any manufacturer does
not maintain separate records?
If the duty-exempt final products fall under any of the following categories,
he will debit an amount equal to the CENVAT credit relating to inputs
contained in such final products are the time of their clearance from the
factory:
(a) Products falling under Chapters 50 to 63 of the First Schedule to the
Central Excise Tariff Act; or
(b) Tyres of a kind used on animal-drawn vehicles, or handcarts and their
tubes, falling under Chapter 40, or
(c) Newsprint, in rolls or sheets.
If the duty-exempt final products belong to any other category, he will debit
an amount equal to 8% of the total price of the duty-exempt final product
charged by him for the sale of such final products at the time of clearance 227
from the factory. However, sales tax of any other tax paid in respect of final CENVAT (Earlier MODVAT)
products will be excluded from the price.

(f) CENVAT credit allowable whether inputs/capital goods are purchased form
first or second stage dealer. The manufacture will receive CENVAT credit on
inputs/capital goods purchased by him irrespective of whether such purchase
is from the first stage or second stage dealer of the manufacture of such
inputs/capital goods. However, credit in such a case will be subject to a
condition. The first/second stage dealer should maintain records to show that
amount of duty paid by the manufacturer on inputs or capital goods purchased
from him is indicated in the invoice issued by him.
(g) A first stage dealer is a person who purchases the goods directly under an
invoice – (a) From the manufacturer himself, any depot on manufacturer, or
premises of the consignment agent of manufacturer, or any other premises
from where goods are sold by or on behalf of manufacturer. (b) From any
importer himself, from depot of an importer, or premises of the consignment
agent of importer, under an invoice. A second dealer is a person who
purchases the goods from a first stage dealer.
(h) No prescribed documents and accounts: CENVAT credit can be claimed
based on invoice, bill of entry of any other document indicating payment of
duty by the manufacturer. However, the manufacturer should reasonably
ensure that the inputs/capital goods in respect of which he is taking credit are
the inputs or capital goods on which excise duty as indicated in the documents
of purchase, has been duty paid. Further the manufacturer of final products
should maintain proper records for the receipt, disposal, consumption and
inventory of the inputs/capital goods. These records should also give details
of the value of inputs/capital goods. Amount of duty paid and the person from
whom such inputs/capital goods have been purchased. This means it will be
for the manufacturer claiming credit to prove that the credit is indeed
admissible.
(i) Transfer of credit in case of shifting factory or transfer of the business itself:
CENVAT credit is factory specific. It is only allowable to the factory that has
purchased dutiable inputs/capital goods. As such, it alone can use its unused
credit balance, irrespective of whether there is shift in its location, transfer of
its ownership, or there is sale merger. Unused credit will be limited to the
credit on: (a) stock of inputs, (b) inputs in process, or (c) the capital goods,
that are transferred along with the factory.
(j) Consequence of wrong claim of credit: If any manufacturer wrongly takes or
utilizes CENVAT credit, he will be liable to recovery of the amount of credit
along with interest. In case wrong taking or use of credit is due to fraud,
deliberate misstatement, collusion or suppression of facts, or violation of any
provision with intention to evade payment of duty, the manufacturer will also
be liable to penalty.
Check Your Progress
1. What is the term in tax terminology for the payment of duty on duty?
………………………………………….…………………………………..
………………………………………….…………………………………..
2. Expand MODVAT.
………………………………………….…………………………………..
………………………………………….…………………………………..
Contd….
228 3. Expand CENVAT.
………………………………………….…………………………………..
………………………………………….…………………………………..
4. What is input?
………………………………………….…………………………………..
………………………………………….…………………………………..
23.6 LET US SUM UP

The final product of one manufacturer may become input for another manufacturer,
the final product of this another manufacturer may be input for yet another
manufacturer, and so on, if excise duty is charged on the selling price of the final
product of each manufacturer, it is likely that each subsequent sale will involve
payment of duty on duty. In tax terminology, this means cascading effect of multiple
taxation. In this chapter MODVAT (scheme upto 31st March 2000) also highlighted.
Under it, the manufacturer received 75% credit in respect of duty paid by him on
inputs used by him – whether in actual manufacture or in relation to manufacture of
excisable goods. Effective I April 2000, CENVAT (Central Value Added Tax) will
replace MODVAT (Modified Value Added Tax). The new CENVAT, like the
outgoing MODVAT, aims to grant credit to the manufacturer in respect of specified
excise duties paid on inputs or capital goods received by him in his factory. This
chapter also emphasized the important feature of CENVAT scheme.

How VAT is applicable to hospital service? Discuss with a hospital administrator.
23.8 KEYWORDS
MODVAT: Upto 31st March 2000, the Indian answer to multiple taxation on inputs
was the modified value added tax (MODVAT). Under it, the manufacturer received
75% credit in respect of duty paid by him on inputs used by him – whether in actual
manufacture or in relation to manufacture of excisable goods.
CENVAT: Like the outgoing MODVAT, aims to grant credit to the manufacturer in
respect of specified excise duties paid on inputs or capital goods received by him in
his factory.
Input: It means all goods used in manufacture or in relation to manufacture of final
products.

1. Explain the concept of cascading effect of taxation.
2. Describe the goods in respect of which CENVAT credit is allowable.
3. Define inputs and capital goods.

1. Cascading effect.
2. Modified Value added tax.
3. Central value added tax.
4. Input means all goods used in manufacture or in relation to manufacture
of final products.
229
23.10 SUGGESTED READING CENVAT (Earlier MODVAT)
230
24
INSURANCE REGULATORY AND DEVELOPMENT
AUTHORITY (IRDA)
CONTENTS
24.1 Introduction
24.2 Definitions
24.3 Procedure for Appointment of an Appointed Actuary
24.4 Effect of Rejection of the Application
24.5 Cessation of Appointment of Appointed Actuary
24.6 Powers of Appointed Actuary
24.7 Duties and Obligations
24.8 Absolute Privilege of Appointed Actuary
24.9 Let us Sum up
24.11 Keywords

z Understand about the procedure for appointment and rejection of actuary
z Know about powers and duties of actuary
24.1 INTRODUCTION
An Act provides the regulation of insurance and its authorities.
These regulations may be called the Insurance Regulatory and Development Authority
(Appointed Actuary) Regulations, 2000. They shall come into force from the date of
their publication in the Official Gazette.
24.2 DEFINITIONS
z “Act” means the Insurance Act, 1938 (4 of 1938);
z “Actuarial Society of India” means Actuarial Society of India registered under
Societies Registration Act 1860; (21 of 1860);
z “Appointed Actuary” means an actuary mentioned in Regulation 3 below;
z “Authority” means the Insurance Regulatory and Development Authority 231
Insurance Regulatory and Development
established under sub-section (1) of section 3 of the Insurance Regulatory and Authority (IRDA)
Development Authority Act, 1999 (41 of 1999);
z “Professional Standard” means the standard of practice specified, with the
concurrence of the Authority, by the Actuarial Society of India by issue of
guidance notes to its members.
24.3 PROCEDURE FOR APPOINTMENT OF AN

APPOINTED ACTUARY
z An insurer registered to carry on insurance business in India shall, subject to sub-
regulation (2), appoint an actuary, who shall be known as the 'Appointed Actuary'
for the purposes of the Act.
z A person shall be eligible to be appointed as an appointed actuary for an insurer, if
he or she shall be:
(i) Ordinarily resident in India;
(ii) A Fellow Member of the Actuarial Society of India;
(iii) An employee of the life insurer, in case of life insurance business;
(iv) An employee of the insurer or a consulting actuary, in case of general
insurance business;
(v) A person who has not committed any breach of professional conduct;
(vi) A person against whom no disciplinary action by the Actuarial Society of
India or any other actuarial professional body is pending;
(vii) Not an appointed actuary of another insurer;
(viii) a person who possesses a Certificate of Practice issued by the Actuarial
Society of India; and
(ix) Not over the age of seventy years.
z An insurer shall seek the approval of the Authority for the appointment of
appointed actuary, submitting the application in Form IRDA-AA-1.
z The Authority shall, within thirty days from the date of receipt of application,
either accept or reject the same.
Provided that before the rejecting the application, the Authority shall give an
opportunity of being heard to the insurer.
z If an insurer does not receive approval within thirty days of the receipt of such
application by the Authority, the insurer shall deem that the approval has been
granted by the Authority.
z An insurer, who is unable to appoint an appointed actuary in accordance with sub-
regulation (2), shall make an application to the Authority in writing for relaxation
of one or more conditions mentioned in sub-regulation (2).
z The Authority shall, on receipt of the application referred to in sub-regulation (6),
communicate its decision to the insurer within thirty days of receipt of such
application.
z The appointment of an appointed actuary shall take effect from the date of
approval by the authority.
232
Health Laws and Policies 24.4 EFFECT OF REJECTION OF THE APPLICATION
The insurer shall, within four weeks of rejection of the application referred to under
regulation 3, apply to the Authority for the appointment of a person other than the one
rejected by it under regulation 3 as an appointed actuary, for the purposes of these
regulations.
A life insurer shall not carry on business of insurance without an appointed actuary.
24.5 CESSATION OF APPOINTMENT OF APPOINTED

ACTUARY
z An appointed actuary shall cease to be so, if he or she has been given notice of
withdrawal of approval by the Authority on the following grounds:
(a) that he or she ceases to be eligible in accordance with sub-regulation (2) of
regulation (3), or
(b) that he or she has, in the opinion of the Authority, failed to perform
adequately and properly the duties and obligations of an appointed actuary
under these regulations.
z The Authority shall give an appointed actuary a reasonable opportunity of being
heard, if he or she has been given a notice of withdrawal of approval by it.
z If a person ceases to be an appointed actuary of an insurer otherwise than on the
grounds mentioned in sub-regulation (1), the insurer and the appointed actuary
shall intimate the Authority the reasons therefore within fifteen days of such a
cessation.
24.6 POWERS OF APPOINTED ACTUARY

z An appointed actuary shall have access to all information or documents in
possession, or under control, of the insurer if such access is necessary for the
proper and effective performance of the functions and duties of the appointed
actuary.
z The appointed actuary may seek any information for the purpose of sub-regulation
(1) of this regulation from any officer or employee of the insurer.
z The appointed actuary shall be entitled:
(a) to attend all meetings of the management including the directors of the
insurer;
(b) to speak and discuss on any matter, at such meeting:
(i) that relates to the actuarial advice given to the directors;
(ii) that may affect the solvency of the insurer;
(iii) that may affect the ability of the insurer to meet the reasonable
expectations of policyholders; or
(iv) on which actuarial advice is necessary.
(c) to attend:
(i) any meeting of the shareholders or the policyholders of the insurer; or
(ii) any other meeting of members of the insurer at which the insurer's annual
accounts or financial statements are to be considered or at which any
matter in connection with the appointed actuary's duties is discussed.
Who is eligible to be an Actuary? Authority (IRDA)
………………………………………….………………………………………
………………………………………….………………………………………
24.7 DUTIES AND OBLIGATIONS

In particular and without prejudice to the generality of the foregoing matters, and in
the interests of the insurance industry and the policyholders, the duties and obligations
of an appointed actuary of an insurer shall include:
(a) rendering actuarial advice to the management of the insurer, in particular in the
areas of product design and pricing, insurance contract wording, investments and
reinsurance;
(b) ensuring the solvency of the insurer at all times;
(c) complying with the provisions of the section 64V of the Act in regard to
certification of the assets and liabilities that have been valued in the manner
required under the said section;
(d) complying with the provisions of the section 64 VA of the Act in regard to
maintenance of required solvency margin in the manner required under the said
section;
(e) drawing the attention of management of the insurer, to any matter on which he or
she thinks that action is required to be taken by the insurer to avoid:
(i) any contravention of the Act, or
(ii) prejudice to the interests of policyholders;
(f) complying with the Authority's directions from time to time;
(g) in the case of the insurer carrying on life insurance business:
(i) to certify the actuarial report and abstract and other returns as required under
section 13 of the Act;
(ii) to comply with the provisions of section 21 of the Act in regard to further
information required by the Authority;
(iii) to comply with the provisions of section 40-B of the Act in regard to the
bases of premium;
(iv) to comply with the provisions of the section 112 of the Act in regard to
recommendation of interim bonus or bonuses payable by life insurer to
policyholders whose policies mature for payment by reason of death or
otherwise during the inter-valuation period;
(v) to ensure that all the requisite records have been made available to him or her
for the purpose of conducting actuarial valuation of liabilities and assets of
the insurer;
(vi) to ensure that the premium rates of the insurance products are fair;
(vii) to certify that the mathematical reserves have been determined taking into
account the guidance notes issued by the Actuarial Society of India and any
directions given by the authority;
(viii) to ensure that the policyholders' reasonable expectations have been
considered in the matter of valuation of liabilities and distribution of
234 surplus to the participating policyholders who are entitled for a share of
surplus;
(ix) to submit the actuarial advice in the interests of the insurance industry and
the policyholders.
(h) in the case of the insurer carrying on general insurance business to ensure:
(i) that the rates are fair in respect of those contracts that are governed by the
insurer's in-house tariff;
(ii) that the actuarial principles, in the determination of liabilities, have been used
in the calculation of reserves for incurred but not reported claims (IBNR) and
other reserves where actuarial advice is sought by the Authority.
(i) informing the Authority in writing of his or her opinion, within a reasonable time,
whether:
(i) the insurer has contravened the Act or any other Acts;
(ii) the contravention is of such a nature that it may affect significantly the
interests of the owners or beneficiaries of policies issued by the insurer;
(iii) the directors of the insurer have failed to take such action as is reasonably
necessary to enable him to exercise his or her duties and obligations under
this Regulation; or
(iv) an officer or employee of the insurer has engaged in conduct calculated to
prevent him or her exercising his or her duties and obligations under this
Regulation.
24.8 ABSOLUTE PRIVILEGE OF APPOINTED ACTUARY

z An appointed actuary shall enjoy absolute privilege to make any statement, oral or
written, for the purpose of the performance of his functions as appointed actuary.
This is in addition to any other privilege conferred upon an appointed actuary
under any other Regulations.
z Any provision of the letter of appointment of the appointed actuary, which
restricts or prevents his duties, obligations and privileges under these regulations,
shall be of no effect.
24.9 LET US SUM UP

Insurance Regulatory and Development Authority (Appointed Actuary) Regulations,
2000. This act emphasized the procedure for appointment of an appointed actuary,
effect of rejection of the application, cessation of appointment of appointed actuary,
powers of appointed actuary and the duties and obligations.

Collect the information regarding awareness about health insurance and IRDA among
the common people.
24.11 KEYWORDS
Actuarial Society of India: It means Actuarial Society of India registered under
Societies Registration Act 1860; (21 of 1860).
Authority: It means the Insurance Regulatory and Development Authority established
under sub-section (1) of section 3 of the Insurance Regulatory and Development
Authority Act, 1999 (41 of 1999).
Professional Standard: It means the standard of practice specified, with the 235
concurrence of the Authority, by the Actuarial Society of India by issue of guidance Authority (IRDA)
notes to its members.

1. What are the procedures followed to appoint an actuary?
2. Explain the powers and duties of an actuary.

A person shall be eligible to be appointed as an appointed actuary for an
insurer, if he or she shall be:
1. Ordinarily resident in India;
2. A Fellow Member of the Actuarial Society of India;
3. An employee of the life insurer, in case of life insurance business;
4. An employee of the insurer or a consulting actuary, in case of general
insurance business;
5. A person who has not committed any breach of professional conduct;
6. A person against whom no disciplinary action by the Actuarial Society of
India or any other actuarial professional body is pending;
7. Not an appointed actuary of another insurer;
8. A person who possesses a Certificate of Practice issued by the Actuarial
Society of India; and
9. Not over the age of seventy years.

236
25
SERVICE TAX
CONTENTS
25.1 Introduction
25.2 Objectives of Levying Service Tax
25.3 Chapter V of the Finance Act, 1994
25.4 Definitions
25.5 Charge of Service Tax
25.5.1 Service Tax Chargeable on any Taxable Service
25.5.2 Payment of Service Tax
25.5.3 Registration
25.5.4 Furnishing of Returns
25.6 Value of Taxable Services Escaping Assessment
25.7 Interest on Amount Collected in Excess
25.8 Publication of Information in Respect of Persons in Certain Cases
25.9 Rectification of Mistake
25.10 Interest on Delayed Payment of Service Tax
25.11 Penalty for Failure to Pay Service Tax
25.12 Penalty for Contravention of Any Provision for Which no Penalty is Provided
25.13 Penalty for Suppressing Value of Taxable Service
25.14 Penalty not to be Imposed in Certain Cases
25.15 Let us Sum up
25.17 Keywords

z Get an idea about the Service Tax Act
z Understand about the various services
z Know the different penalties for the contravention
237
25.1 INTRODUCTION Service Tax
This is a tax which is charged on the Services. The Service Tax is collected by the
service provider and charged from the service consumer.
In India, service tax has been introduced as a tax on services and treated as a separate
levy from sales tax on goods. It came into force from 1st July, 1994. Initially three
services i.e. telephone, general insurance and stock broking were made subject of
service tax through the Finance Act, 1994. The Net of service tax kept expanding over
the period of time and now around 121 services are subject to service tax.
At present the levy of service tax extends to the whole of India except the State of
Jammu and Kashmir.
25.2 OBJECTIVES OF LEVYING SERVICE TAX

z The basic objective of levying Service Tax is broadening the tax base,
augmentation of revenue and larger participation of citizens in the economic
development of the nation.
z In India, the service sector contributes to more than 50% of GDP.
Service Tax is a form of indirect tax imposed on specified services called "taxable
services". Service tax cannot be levied on any service which is not included in the list
of taxable services. Over the past few years, service tax been expanded to cover new
services. The intention of the government is to gradually increase the list of taxable
services until most services fall within the scope of service tax.
In the Union Budget of India for the year 2006-2007, service tax has been increased
from 10% to 12%. For the purpose of levying service tax, the value of any taxable
service should be the gross amount charged by the service provider for the service
rendered by him.
In 2005-2006, the services sector is estimated to 54% of GDP. As such, it should
contribute also contribute significantly to the exchequer. To attain this objective, the
Finance Minister has proposed to bring more services under the services tax net. The
new services to be covered include:
z ATM operations, maintenance and management.
z Registrar, share transfer agents and bankers to an issue.
z Sponsorships of events, other than sports events by companies.
z International air travel excluding economy class passengers.
z Container services on rail, excluding the railway freight charges.
z Business support services, auctioneering.
z Recovery agents.
z Ship management agents.
z Travel on cruise ships.
z Public relation management services.
25.3 CHAPTER V OF THE FINANCE ACT, 1994

1. This Chapter extends to the whole of India except the State of Jammu and
Kashmir.
2. It shall come into force on such date as the Central Government may, by
238 3. It shall apply to taxable services provided on or after the commencement of this
Act.
25.4 DEFINITIONS
z "air travel agent" means any person engaged in providing any service connected
with the booking of passage for travel by air;
z "architect" means any person whose name is, for the time being, entered in the
register of architects maintained under section 23 of the Architect Act,1972 (20 of
1972) and also includes any person engaged in any manner, whether directly or
indirectly, in rendering services in the field of architecture;
z "assessee" means a person liable to pay the service tax and includes his agent;
z “auction of property” includes calling the auction or providing a facility,
advertising or illustrating services, pre-auction price estimates, short-term storage
services, repair or restoration services in relation to auction of property;
z "authorized service station" means any service station or centre, authorized by any
motor vehicle manufacturer, to carry out any service, repair, reconditioning or
restoration of any motor car or two wheeled motor vehicle manufactured by such
manufacturer;
z “automated teller machine” means an interactive automatic machine designed to
dispense cash, accept deposit of cash, transfer money between bank accounts and
facilitate other financial transactions;
z “automated teller machine operations, maintenance or management service”
means any service provided in relation to automated teller machines and includes
site selection, contracting of location, acquisition, financing, installation,
certification, connection, maintenance, transaction processing, cash forecasting,
replenishment, reconciliation and value-added services;
z "banking" shall have the meanings assigned to it in clauses (b) of section 5 of the
Banking Regulation Act, 1949 (10 of 1949).
z "broadcasting" has the meaning assigned to it in clause (c) of section 2 of the
Prasar Bharati (Broadcasting Corporation of India) Act, 1990 (25 of 1990) and
also includes programme selection, scheduling or presentation of sound or visual
matter on a radio or a television channel that is intended for public listening or
viewing, as the case may be; and in the case of a broadcasting agency or
organisation, having its head office situated in any place outside India, includes
the activity of selling of time slots or obtaining sponsorships for broadcasting of
any programme or collecting the broadcasting charges or permitting the rights to
receive any form of communication like sign, signal, writing, picture, image and
sounds of all kinds by transmission of electro-magnetic waves through space or
through cables, direct to home signals or by any other means to cable operator
including multisystem operator or any other person on behalf of the said agency
or organisation, by its branch office or subsidiary or representative in India or any
agent appointed in India or by any person who acts on its behalf in any manner;
z "broadcasting agency or organization" means any agency or organization engaged
in providing service in relating to broadcasting in any manner and, in the case of a
broadcasting agency or organization, having its head office situated in any place
outside India, includes its branch office or subsidiary or representative in India or
any agent appointed in India or any person who acts on its behalf in any manner,
engaged in the activity of selling of time slots for broadcasting of any programme
or obtaining sponsorships for programme or collecting the broadcasting charges or
permitting the rights to receive any form of communication like sign, signal,
writing, picture, image and sounds of all kinds by transmission of electro-
magnetic waves through space or through cables, direct to home signals or by any 239
other means to cable operator including multisystem operator or any other person Service Tax
on behalf of the said agency or organisation;

z “beauty treatment” includes hair cutting, hair dyeing, hair dressing, face and
beauty treatment, cosmetic treatment, manicure, pedicure or counseling services
on beauty, face care or make-up or such other similar services;
z "beauty parlour" means any establishment providing beauty treatment services;
z “information technology service” means any service in relation to designing, or
developing of computer software or system networking, or any other service
primarily in relation to operation of computer systems;
z "cable operator" shall have the meaning assigned to it in clause (aa) of section 2
of the Cable Television Networks (Regulation) Act, 1995 (7 of 1995);
z "cable service" shall have the meaning assigned to it in clause (b) of section 2 of
the Cable Television Networks (Regulation) Act, 1995 (7 of 1995);
z "cargo handling service" means loading, unloading, packing or unpacking of
cargo and includes cargo handling services provided for freight in special
containers or for non-containerized freight, services provided by a container
freight terminal or nay other freight terminal, for all modes of transport and cargo
handling services incidental to freight, but does not include handling of export
cargo or passenger baggage or mere transportation of goods;
z "caterer" means any person who supplies, either directly or indirectly, any food,
edible preparations, alcoholic or non-alcoholic beverages or crockery and similar
articles or accoutrements for any purpose of occasion;
z “cleaning activity” means cleaning, including specialised cleaning services such
as disinfecting, exterminating or sterilising of objects or premises, of:
(i) commercial or industrial buildings and premises thereof; or
(ii) factory, plant or machinery, tank or reservoir of such commercial or industrial
buildings and premises thereof, but does not include such services in relation
to agriculture, horticulture, animal husbandry or dairying;
z "clearing and forwarding agent" means any person who is engaged in providing
any service, either directly or indirectly, connected with the clearing and
forwarding operations in any manner to any other person and includes a
consignment agent;
z “club or association” means any person or body of persons providing services,
facilities or advantages, for a subscription or any other amount, to its members,
but does not include:
(i) any body established or constituted by or under any law for the time being in
force; or
(ii) any person or body of persons engaged in the activities of trade unions,
promotion of agriculture, horticulture or animal husbandry; or
(iii) any person or body of persons engaged in any activity having objectives
which are in the nature of public service and are of a charitable, religious or
political nature; or
(iv) any person or body of persons associated with press or media;
z “commercial or industrial construction service” means:
(a) construction of a new building or a civil structure or a part thereof; or
(b) construction of pipeline or conduit; or
240 (c) completion and finishing services such as glazing, plastering, painting, floor
and wall tiling, wall covering and wall papering, wood and metal joinery and
carpentry, fencing and railing, construction of swimming pools, acoustic
applications or fittings and other similar services, in relation to building or
civil structure; or
(d) repair, alteration, renovation or restoration of, or similar services in relation
to, building or civil structure, pipeline or conduit, which is:
(i) used, or to be used, primarily for; or
(ii) occupied, or to be occupied, primarily with; or
(iii) engaged, or to be engaged, primarily in,
commerce or industry, or work intended for commerce or industry, but does not
include such services provided in respect of roads, airports, railways, transport
terminals, bridges, tunnels and dams;
z "commercial training or coaching centre" means any institute or establishment
providing commercial training or coaching for imparting skill or knowledge or
lessons on any subject or field other than the sports, with or without issuance of a
certificate and includes coaching or tutorial classes but does not include preschool
coaching and training centre or any institute or establishment which issues any
certificate or diploma or degree or any educational qualification recognised by
law for the time being in force;
z "commissioning and installation agency" means any agency providing service in
relation to erection, commissioning or installation;
z "computer network" has the meaning assigned to it in clause (j) of sub-section (1)
of section 2 of the Information Technology Act, 2000 (21 of 2000);
z "consulting engineer" means any professionally qualified engineer or any body
corporate or any other firm who, either directly or indirectly, renders any advice,
consultancy or technical assistance in any manner to a client in one or more
disciplines of engineering;
z "credit rating agency" means any person engaged in the business of credit rating
of any debt obligation or of any project or programme requiring finance, whether
in the form of debt or otherwise, and includes credit rating of any financial
obligation, instrument or security, which has the purpose of providing a potential
investor or any other person any information pertaining to the relative safety of
timely payment of interest or principal;
z "dry cleaning" includes dry cleaning of apparels, garments or other textile, fur or
leather articles;
z "fashion designing" includes any activity relating to conceptualizing, outlining,
creating the designs and preparing patterns for costumes, apparels, garments,
clothing accessories, jewellery or any other articles intended to be worn by human
beings and any other service incidental thereto;
z "fashion designer" means any person engaged in providing service in relation to
fashion designing;
z “franchise” means an agreement by which the franchisee is granted
representational right to sell or manufacture goods or to provide service or
undertake any process identified with franchisor, whether or not a trade mark,
service mark, trade name or logo or any such symbol, as the case may be, is
involved;
z "general insurance business" has the meaning assigned to it in clause (g) of
section 3 of General Insurance Business (Nationalisation) Act, 1972 (57 of 1972);
z “goods transport agency” means any person who provides service in relation to 241
transport of goods by road and issues consignment note, by whatever name called; Service Tax
z "health club and fitness service" means service for physical well-being such as,
sauna and steam bath, Turkish bath, solarium, spas, reducing or slimming salons,
gymnasium, yoga, meditation, massage (excluding therapeutic massage)or any
other like service;
z "health club and fitness centre" means any establishment, including a hotel or
resort, providing health and fitness service;
z "internet cafe" means a commercial establishment providing facility for assessing
internet;
z “manpower recruitment or supply agency” means any person engaged in
providing any service, directly or indirectly, in any manner for recruitment or
supply of manpower, temporarily or otherwise, to a client;
z "market research agency" means any person engaged in conducting market
research in any manner, in relation to any product, service or utility, including all
types of customized and syndicated research services;
z “passenger” means any person boarding, at any customs airport, an aircraft for
performing an international journey, but does not include:
(i) a person who has arrived at such customs airport from a place outside India
and is in transit through India, provided that he does not pass through
immigration and does not leave customs area and continues his journey to a
place outside India; and
(ii) a person employed or engaged by the aircraft operator in any capacity on
board the aircraft;’
z "photography" includes still photography, motion picture photography, laser
photography, aerial photography and fluorescent photography;
z "port service" means any service rendered by a port or any person authorized by
the port, in any manner, in relation to a vessel or goods;
z "practising chartered accountant" means a person who is a member of the Institute
of Chartered Accountants of India and is holding a certificate of practice granted
under the provision of the Chartered Accountants Act, 1949 (84)
z "practicing cost accountant" means a person who is member of the Institute of
Cost and Works Accountants of India and is holding a certificate of practice
granted under the provisions of the Cost and Works Accountants Act, 1959 (23 of
1959) and includes any concern engaged in rendering services in the field of cost
accountancy;
z "practicing company secretary" means a person who is a member of the Institute
of company Secretaries of India and is holding a certificate of practice granted
under the provisions of the Company Secretaries Act, 1980 (56 of 1980) and
includes any concern engaged in rendering services in the field of company
secretaryship;
z "rail travel agent" means any person engaged in providing any service connected
with booking of passage for travel by rail;
z "real estate agent" means a person who is engaged in rendering any service in
relation to sale, purchase, leasing or renting of real estate and includes a real estate
consultant;
z "scientific or technical consultancy" means any advice, consultancy or scientific
or technical assistance rendered in any manner, either directly or indirectly, by a
242 scientist or a technocrat or any science or technology institution or organization,
to a client, in one or more disciplines of science or technology;
z "service tax" means tax leviable under the provisions of this Chapter;
z “ship management service” includes:
(i) the supervision of the maintenance, survey and repair of ship;
(ii) engagement or providing of crews;
(iii) receiving the hire or freight charges on behalf of the owner;
(iv) arrangements for loading and unloading;
(v) providing for victualling or storing of ship;
(vi) negotiating contracts for bunker fuel and lubricating oil;
(vii) payment, on behalf of the owner, of expenses incurred in providing services
or in relation to the management of ship;
(viii) the entry of ship in a protection or indemnity association;
(ix) dealing with insurance, salvage and other claims; and
(x) arranging of insurance in relation to ship;
z "technical testing and analysis agency" means any agency or person engaged in
providing service in relation to technical testing and analysis;
z "technical inspection and certification" means inspection or examination of goods
or process or material or any immovable property to certify that such goods or
process or material or immovable property qualifies or maintains the specified
standards, including functionality or utility or quality or safety or any other
characteristic or parameters, but does not include any service in relation to
inspection and certification of pollution levels;
z “telecommunication service” means service of any description provided by means
of any transmission, emission or reception of signs, signals, writing, images and
sounds or intelligence or information of any nature, by wire, radio, optical, visual
or other electro-magnetic means or systems, including the related transfer or
assignment of the right to use capacity for such transmission, emission or
reception by a person who has been granted a license under the first proviso to
sub-section (1) of section 4 of the Indian Telegraph Act, 1885 and includes:
(i) voice mail, data services, audio tax services, video tax services, radio
paging;
(ii) fixed telephone services including provision of access to and use of the
public switched telephone network for the transmission and switching of
voice, data and video, inbound and outbound telephone service to and from
national and international destinations;
(iii) cellular mobile telephone services including provision of access to and use
of switched or non-switched networks for the transmission of voice, data
and video, inbound and outbound roaming service to and from national and
international destinations;
(iv) carrier services including provision of wired or wireless facilities to
originate, terminate or transit calls, charging for interconnection, settlement
or termination of domestic or international calls, charging for jointly used
facilities including pole attachments, charging for the exclusive use of
circuits, a leased circuit or a dedicated link including a speech circuit, data
circuit or a telegraph circuit;
(v) provision of call management services for a fee including call waiting, call 243
forwarding, caller identification, three-way calling, call display, call return, Service Tax
call screen, call blocking, automatic call-back, call answer, voice mail,
voice menus and video conferencing;
(vi) private network services including provision of wired or wireless
telecommunication link between specified points for the exclusive use of
the client;
(vii) data transmission services including provision of access to wired or wireless
facilities and services specifically designed for efficient transmission of
data; and
(viii) communication through facsimile, pager, telegraph and telex, but does not
include service provided by:
(a) any person in relation to on-line information and database access or
retrieval or both referred to in sub-clause (zh) of clause (105);
(b) a broadcasting agency or organisation in relation to broadcasting
referred to in sub-clause (zk) of clause (105); and
(c) any person in relation to internet telephony referred to in sub-clause
(zzzu) of clause (105);
z “travel agent” means any person engaged in providing any service connected with
booking of passage for travel, but does not include air travel agent and rail travel
agent.
25.5 CHARGE OF SERVICE TAX

There shall be levied a tax (hereinafter referred to as the service tax) at the rate of
twelve per cent of the value of taxable services.
25.5.1 Service Tax Chargeable on any Taxable Service

1. Service tax chargeable on any taxable service with reference to its value shall:
(i) in a case where the provision of service is for a consideration in money, be the
gross amount charged by the service provider for such service provided or to
be provided by him;
(ii) in a case where the provision of service is for a consideration not wholly or
partly consisting of money, be such amount in money, with the addition of
service tax charged, is equivalent to the consideration;
(iii) in a case where the provision of service is for a consideration which is not
ascertainable, be the amount as may be determined in the prescribed manner.
2. Where the gross amount charged by a service provider, for the service provided or
to be provided is inclusive of service tax payable, the value of such taxable
service shall be such amount as, with the addition of tax payable, is equal to the
gross amount charged.
3. The gross amount charged for the taxable service shall include any amount
received towards the taxable service before, during or after provision of such
service.
4. Subject to the provisions of sub-sections (1), (2) and (3), the value shall be
determined in such manner as may be prescribed.
25.5.2 Payment of Service Tax

1. Every person providing taxable service to any person shall pay service tax at the
rate specified in section 66 in such manner and within such period as may be
prescribed.
244 2. Notwithstanding anything contained in sub-section (1), in respect of any taxable
service notified by the Central Government in the Official Gazette, the service tax
thereon shall be paid by such person and in such manner as may be prescribed at
the rate specified in section 66 and all the provisions of this chapter shall apply to
such person as if he is the person liable for paying the service tax in relation to
such service.
25.5.3 Registration
1. Every person liable to pay the service tax under this chapter or the rules made
there under shall, within such time and in such manner and in such form as may
be prescribed, make an application for registration to the Superintendent of
Central Excise.
2. The Central Government may, by notification in the Official Gazette, specify such
other person or class of persons, who shall make an application for registration
within such time and in such manner and in such form as may be prescribed.
25.5.4 Furnishing of Returns

1. Every person liable to pay the service tax shall himself assess the tax due on the
services provided by him and shall furnish to the Superintendent of Central
Excise, a return in such form and in such manner and at such frequency (and with
such late fee not exceeding two thousand rupees, for delayed furnishing of return,
as may be prescribed)
2. The person or class of persons notified under sub-section (2) of section 69, shall
furnish to the Superintendent of Central Excise, a return in such form and in such
manner and at such frequency as may be prescribed.
25.6 VALUE OF TAXABLE SERVICES ESCAPING

ASSESSMENT
Where any service tax has not been levied or paid or has been short-levied or short-
paid or erroneously refunded, the Central Excise Officer may, within one year from
the relevant date, serve notice on the person chargeable with the service tax which has
not been levied or paid or which has been short-levied or short-paid or the person to
whom such tax refund has erroneously been made, requiring him to show cause why
he should not pay the amount specified in the notice:
Provided that where any service tax has not been levied or paid or has been short-
levied or short-paid or erroneously refunded by reason of:
a) fraud; or
b) collusion; or
c) wilful mis-statement; or
d) suppression of facts; or
e) contravention of any of the provisions of this Chapter or of the Rules made there-
under with intent to evade payment of service tax, by the person chargeable with
the service tax or his agent, the provisions of this sub-section shall have effect, as
if, for the words “one year”, the words “five years” had been substituted.
25.7 INTEREST ON AMOUNT COLLECTED IN EXCESS

Where an amount has been collected in excess of the tax assessed or determined and
paid for any taxable service under this Chapter or the Rules made thereunder from the
recipient of such service, the person who is liable to pay such amount as determined
under sub-section (4) of section 73A, shall, in addition to the amount, be liable to pay 245
interest at such rate not below ten per cent. and not exceeding twenty-four per cent. Service Tax
per annum, as is for the time being fixed by the Central Government, by notification
in the Official Gazette, from the first day of the month succeeding the month in which
the amount ought to have been paid under this Chapter, but for the provisions
contained in sub-section (4) of section 73A, till the date of payment of such amount.
Provided that in such cases where the amount becomes payable consequent to issue of
an order, instruction or direction by the Board under section 37B of the Central Excise
Act, 1944, and such amount payable is voluntarily paid in full, without reserving any
right to appeal against such payment at any subsequent stage, within forty-five days
from the date of issue of such order, instruction or direction, as the case may be, no
interest shall be payable and in other cases, the interest shall be payable on the whole
amount, including the amount already paid.
25.8 PUBLICATION OF INFORMATION IN RESPECT OF

PERSONS IN CERTAIN CASES
1. If the Central Government is of the opinion that it is necessary or expedient in the
public interest to publish the name of any person and any other particulars relating
to any proceedings under this Chapter in respect of such person, it may cause to
be published such names and particulars in such manner as may be prescribed.
2. No publication under this section shall be made in relation to any penalty imposed
under this Chapter until the time for presenting an appeal to the Commissioner
(Appeals) under section 85 or the Appellate Tribunal under section 86, as the case
may be, has expired without an appeal having been presented or the appeal, if
presented, has been disposed of.
Explanation: In the case of a firm, company or other association of persons, the
names of the partners of the firm, directors, managing agents, secretaries and
treasurers or managers of the company, or the members of the association, as the case
may be, shall also be published if, in the opinion of the Central Government,
circumstances of the case justify it.
25.9 RECTIFICATION OF MISTAKE

1. With a view to rectifying any mistake apparent from the record, the Central
Excise Officer who passed any order under the provisions of this Chapter may,
within two years of the date on which such order was passed, amend the order.
2. Where any matter has been considered and decided in any proceeding by way of
appeal or revision relating to an order referred to in sub-section (1), the Central
Excise Officer passing such order may, notwithstanding anything contained in any
law for the time being in force, amend the order under that sub-section in relation
to any matter other than the matter which has been so considered and decided.
3. Subject to the other provisions of this section, the Central Excise Officer
concerned:
(a) may make an amendment under sub-section (1) of his own motion; or
(b) shall make such amendment if any mistake is brought to his notice by the
assessee or the [Commissioner] of Central Excise or the [Commissioner] of
Central Excise (Appeals).
4. An amendment, which has the effect of enhancing the liability of the assessee or
reducing a refund, shall not be made under this section unless the Central Excise
Officer concerned has given notice to the assessee of his intention so to do and
has allowed the assessee a reasonable opportunity of being heard.
246 5. Where an amendment is made under this section, an order shall be passed in
writing by the Central Excise Officer concerned.
6. Subject to the other provisions of this Chapter where any such amendment has the
effect of reducing the liability of the assessee or increasing the refund, the Central
Excise Officer shall make any refund which may be due to such assessee.
7. Where any such amendment has the effect of enhancing the liability of the
assessee or reducing the refund already made, the Central Excise Officer shall
make an order specifying the sum payable by the assessee and the provisions of
this Chapter shall apply accordingly.
25.10 INTEREST ON DELAYED PAYMENT OF

SERVICE TAX
Every person, liable to pay the tax in accordance with the provisions of section 68 or
rules made thereunder, who fails to credit the tax or any part thereof to the account of
the Central Government within the period prescribed, shall pay simple interest at such
rate not below ten per cent and not exceeding thirty-six per cent per annum as is for
the time being fixed by the Central Government, by Notification in the Official
Gazette for the period by which such crediting of the tax or any part thereof is
delayed.
Check Your Progress
Fill in the blanks:
1. Service tax is come under …………… .
2. There shall be levied a tax at the rate of …………… per cent. of the value
of taxable services.
25.11 PENALTY FOR FAILURE TO PAY SERVICE TAX

Any person, liable to pay service tax in accordance with the provisions of section 68
or the rules made under this Chapter, who fails to pay such tax, shall pay, in addition
to such tax and the interest on that tax amount in accordance with the provisions of
section 75, a penalty which shall not be less than two hundred rupees for every day
during which such failure continues or at the rate of two per cent. of such tax, per
month, whichever is higher, starting with the first day after the due date till the date of
actual payment of the outstanding amount of service tax:
Provided that the total amount of the penalty payable in terms of this section shall not
exceed the service tax payable.
25.12 PENALTY FOR CONTRAVENTION OF ANY

PROVISION FOR WHICH NO PENALTY IS
PROVIDED
Whoever contravenes any of the provisions of this Chapter or any rule made there
under for which no penalty is separately provided in this Chapter, shall be liable to a
penalty which may extend to an amount not exceeding one thousand rupees.
25.13 PENALTY FOR SUPPRESSING VALUE OF

TAXABLE SERVICE
Where any service tax has not been levied or paid or has been short-levied or short-
paid or erroneously refunded, by reason of:
a) fraud; or 247
Service Tax
b) collusion; or
c) wilful mis-statement; or
d) suppression of facts; or
e) contravention of any of the provisions of this Chapter or of the rules made there
under with intent to evade payment of service tax, the person, liable to pay such
service tax or erroneous refund, as determined under sub-section (2) of section 73,
shall also be liable to pay a penalty, in addition to such service tax and interest
thereon, if any, payable by him, which shall not be less than, but which shall not
exceed twice, the amount of service tax so not levied or paid or short-levied or
short-paid or erroneously refunded.
25.14 PENALTY NOT TO BE IMPOSED IN

CERTAIN CASES
Notwithstanding anything contained in the provisions of section 76, section 77 or
section 78, no penalty shall be imposable on the assessee for any failure referred to in
said provisions, if the assessee proves that there was reasonable cause for the said
failure.
25.15 LET US SUM UP

Service Tax is a form of indirect tax imposed on specified services called "taxable
services". Service tax cannot be levied on any service which is not included in the list
of taxable services. Over the past few years, service tax been expanded to cover new
services. The intention of the government is to gradually increase the list of taxable
services until most services fall within the scope of service tax. This act highlighted
Furnishing of returns, interest on amount collected in excess, publication of
information in respect of persons in certain cases, interest on delayed payment of
service tax 15 penalty for failure to pay service tax , Penalty for contravention of any
provision, penalty is provided, penalty not to be imposed in certain cases.

Discuss how the service tax is valued on various services.
25.17 KEYWORDS
Information technology service: It means any service in relation to designing, or
developing of computer software or system networking, or any other service primarily
in relation to operation of computer systems;
Clearing and forwarding agent: It means any person who is engaged in providing
any service, either directly or indirectly, connected with the clearing and forwarding
operations in any manner to any other person and includes a consignment agent.
Club or association: It means any person or body of persons providing services,
facilities or advantages, for a subscription or any other amount, to its members.

1. Explain about the service tax in detail.
2. Explain the valuation of service tax
3. Explain the different penalties of contravention.
1. The Finance Act, 1994.
2. 12%.

LESSON UNIT III 251
Health Care Delivery System
26
HEALTH CARE DELIVERY SYSTEM
CONTENTS
26.1 Introduction
26.2 Health Care Delivery System – Overview
26.3 History of Hospitals
26.3.1 Hospitals in Ancient Times
26.3.2 Hospitals in Middle Ages
26.3.3 Hospitals in 19th Century
26.3.4 Development of Modern Hospitals
26.4 Changing Concept of Hospitals
26.5 Growth of Hospitals in India
26.6 The Modern Hospital – A Complex Entity
26.7 Let us Sum up
26.9 Keywords

z Know about the health care delivery system
z Understand the history of hospitals
z Explain the growth and development of hospitals
26.1 INTRODUCTION
Health care problems have haunted human society since time immemorial. Social and
economic gains of society have direct bearing on the status of the people. Cultural
progress depends upon the recognition and elimination of health problems. Health
therefore is a major ingredient of public welfare. Health is wealth.
Good health in any community is possible only when sufficient infrastructure health
care facilities and patient care services are ensured. This process entails the provision
of necessary educational and research opportunities in medical fields as well as
adequate treatment and service facilities. Well-equipped medical educational
complexes and health care institutions become complementary.
252
Health Laws and Policies 26.2 HEALTH CARE DELIVERY SYSTEM – OVERVIEW
The health care delivery system is the organization of all health care facilities,
providers, and ancillary services that are necessary to serve patients. Health is not
merely the absence of disease but also protection from factors, which predispose to
disease. The World Health Organization has defined health as the status of complete
physical, mental, and social well-being.
Modern definitions of health care are influenced by many factors such as the advances
in medical sciences, new technology, increased life spans, and societal expectations.
The patient of today expects personal attention, explanations of problems, assurances
of relief, and satisfaction of complaints. The health care delivery system does not have
the resources or the capabilities to meet the expectations of every patient served. With
serious consequences for the health of any nation.
There are three major components that make up the Healthcare Delivery System:
z Facilities
z Practitioners
z Entities
Hospitals may provide different levels of care:
z Acute care for critically ill patients.
z Tertiary care is a designation given to hospitals that provide medical education
and handle complex care.
z Primary care is provided by most hospitals.
z Sub-acute care for patients requiring hospitalization, but not in a life-threatening
condition.
z Swing-bed care for patients requiring skilled nursing when no skilled facility.
What are the three components of health care delivery system?
………………………………………………………………………………….
………………………………………………………………………………….
26.3 HISTORY OF HOSPITALS

26.3.1 Hospitals in Ancient Times
z Pre-christian Era: Medical treatment was identified was identified as part of
organized religions as early as 4000 BC. During the Pre-Christian, Era, hospitals
were established in Greece, Egypt and India. Greek temples, as early as in 1134
BC, served as resting places for patients under observation. Greek medicine
reached its zenith during the golden age of Greece. Hippocrates the most
prominent Greek physician, was instrumental in separating medicine from religion
and philosophy. Medical training gained importance in this era. The first hospitals
possessing modern features were found in ancient Egypt and India. Between 273
and 232 BC, hospitals were called Chikistaslayas. Indian Hindu physicians who
initiated surgery built these. Chikistas were noted for their cleanliness. Care was
provided by attendants.
z Mohammedan Hospitals: In Baghdad, Cordova, Cairo, etc. Mohammedans
provided luxurious hospital accommodations. During 786-809, Harun-al-Rashid
built a great system of hospitals. They were probably the first people who used
intestines of sheep for suturing and who cleaned wounds with alcohol.
26.3.2 Hospitals in Middle Ages 253
Health Care Delivery System
z Christian Era: The word hospital comes from the Latin word ‘hospet’, which
means guest or host. The Christian hospitals were much like hotels or hostels.
This era stressed on humanitarianism. These hospitals were built adjacent to
churches, so that the priests could conveniently care for the patients. By 500 AD
almost every city in old Roman Empire had church related hospitals. In 13th
Century, in Cairo, Almunsur Hospital had separate wards for serious disease, out
patient clinics and home for convalescence.
z Hospitals of Renaissance: Scientific medicine was rediscovered during the
Renaissance. During the 14th century medicine was increasingly separated from
religion. During 16th and 17th centuries, European religious brotherhoods
established hospitals in the western world for the sick who were homeless and
poor. The first hospital constructed solely for sick and injured persons is
Pennsylvania Hospital, founded in Philadelphia in 1751. This event was to mark
the beginning of our present day voluntary hospitals. The second voluntary
institution was Network Hospital in 1773 followed by Massachusetts General
Hospital in 1861 and New Heaven Hospital in 1826. It has been estimated that by
1840, there were about 50 permanent hospitals in the United States, most of which
were of the voluntary type.
26.3.3 Hospitals in 19th Century

During 19th century, functions of hospitals underwent radical changes. Emphasis was
laid on medical, surgical and nursing care. Hospitals continued to offer free services
for the indigent and began to establish differential-pricing policies based on their
economic capabilities. The practice of deficit financing became a well-established
pattern which has persisted to the present. This was a significant period in evolution of
modern Nursing Practice. Nursing care was significantly influenced by theories and
principles of Florence Nightingale. Significant development of the late 1800s was the
establishment of numerous church related hospitals.
26.3.4 Development of Modern Hospitals

The 20th century has been a period during which hospitals have been called on to
provide an ever increasing number of services to the patients, resources for the
education of physicians, nurses and other members of the health team and facilities for
medical research, in recent decades, significant contributions to the improvement of
hospital care have come form professional nursing leaders. American Hospital
Association emerged in 1907 to provide leadership in the field of hospital
administration. The development of medical science from symptom centered to
people-centered.
26.4 CHANGING CONCEPT OF HOSPITALS

The history of hospitals is an indication of its future. There have been accelerating
changes in the environment in which hospitals function, resulting in accelerating
changes in management of hospitals. It is important, therefore, to look at the evolution
of hospitals within the environment on which it is dependent.
The major changes in concept of hospitals can be divided into different periods such
as: (1) Trusteeship Period (2) Physician Period (3) Administration Period.
z Trusteeship Period: This period began with the origin of hospitals. Most hospitals
were funded by trustees. In addition, they were frequently in-charge of religious
orders. Other hospitals were started by philanthropists, and physicians usually on
proprietary basis to provide bed services for their patients. The technology of this
period, which lasted until about the 1920s, was minimal. In 1910, the Flexner
254 Report signaled reforms in medical education leading towards scientific medicine.
The economic and political environment had little influence on hospitals in
Trusteeship Period. Hospital employees, such as nurses received primarily
humanitarian rather than financial rewards. During this period, hospital objectives
were to comfort the poor and dying who could not be cared for at home.
z Physician Period: During this period physicians became more involved in
utilizing hospitals for practice of medicine. In 1930s, therapy progressed.
Laboratory medicine developed in 1940s and 1950s. Physician practice moving
from patients home and away from physicians’ clinics to hospitals. Ancillary
hospital services were provided. The economic and political environment bean to
effect hospitals. Labour unions gained power. Rural hospitals were established.
Social attitudes during the period changed. No longer was the hospital service
viewed as a charitable service. Hospitals survive and succeed not through cost
control but through increased income.
z Administration and team periods: During the previous two periods, the physician
practiced as an individual in the hospital. Afterwards hospital service becomes a
team effort. Nurses and other health professionals have come to be viewed more
as colleagues than as subordinates. The economic and political environment has
changed more rapidly. In the light of these changes the scope of hospital services
expanded due to increased sophistication, volume, income and facilities with
excessive capacity. Many hospitals adopted aggressive marketing strategy to meet
the competition. Hospital technology became far advance. Management became
the source of information. The hospitals also became more sophisticated in
applying modern managerial techniques such as accounting, finance, etc.
26.5 GROWTH OF HOSPITALS IN INDIA

In India, the history of medicine and surgeons dates back to the earliest of the ages.
But hospitals as institutions to which a sick person could be brought for treatment
were of a much later origin. The brilliantly planned cities Mohenzodaro and Harappa
are good examples of cities with sophisticated drainage system and importance of
environmental sanitation for good health. The ayurvedic System of medicine was
developed in India after the Aryan invasion of the Indus Valley. In primitive days
religion, art and medicine were combined. People looked to the priests to cure them
from sin and disease. As evolution progressed these became more distinct.
In sixth century BC, during the time of the Buddha there were a number of hospitals
to look after the crippled and the poor. More such hospitals were started by Buddha’s
devotees. Ashoka was responsible for spread of social medicine. The outstanding
hospitals in India at that time were those built be King Ashoka. In those days, Charaka
and Sushruta of ancient India were famous physicians. The Upakalpa Niyam
Adhyayam gives specifications for hospital buildings, rooms and wards. The
qualifications for hospital attendants and nurses as well as specifications for
equipment, death particulars have also been given. There is evidence to show that
there were many hospitals in South India, as observed in Chola and Malkapuram
edicts. We find from the books written by Arabian and European travelers (about 600
AD) that the study of medicine in India was in its boom. In those days every major
city had medical school. The decline of Indian medicine started with the invasion of
foreigners in 10th century AD. That was a period of unrest. During Muslim rule,
physicians trained in Unani System of medicine. The use of Allopathic System of
medicine commenced in 16th century with the arrival of European missionaries in
South India. The first hospital in India was probably built in Goal. The first hospital in
Madras was opened in 1664. The establishment of a hospital in Mumbai was in 1676.
The earliest hospital in Calcutta was built in 1707-08 and in Delhi in 1874.
In 17th century, the European doctors employed by the East India Company played an 255
important role in introducing of modern medicine in India. At that time, Sir Thomas Health Care Delivery System
Roe introduced modern medicine in the court of Jahangir the Moghul Emperor. But
after that in 17th and 18th centuries, there was slow but steady progress in the growth
of modern system of medical practice in India and the indigenous system was pushed
to the background. During the last decades of 18th century, western medicine was
introduced to serve their armed forces. 80 to 90% of population realized the value of
medical practitioners and hospitals. Britishers introduced medical care system to cover
the army, to cover money spent on them, In the 19th century, modern medicine took
firm root. Allopathic Medicine became dominant. It competed with Homeopathy,
Osteopathy and others. Scientific development took place in microbiology and
surgery. In 1835, in India there were 1250 hospitals and dispensaries, which
constitutes 6 % of 192 million population. In 1857, three universities started medical
education in a formal way. Between 1800-1916, 17 medical schools/colleges were
started in various cities.
In late 1907, survey teams were sent by world council of churches to survey Christian
medical work in India. By 1920. Foundation has been laid for contemporary hospital
system and the following 30 years brought refinement and consolidation. The increase
in the average size of hospitals probably improved the comprehensiveness and the
quality of care. In this era, various committees were appointed to improve healthcare
all over the country. By 1960, like industrial organizations, health institutions too have
become more complex systems needing special skills to manage them. Since 1960s,
hospital management has come to be recognized. A survey of hospitals by Dr. Mc.
Gibony and Christian Medical Commission in 1968, pointed to a paradox of large
sums of money invested in buildings and equipments and for training and healthcare
administration. A study was conducted by Dr. Mc. Gibony of United States Public
Health Services who came to India as an advisor in hospital administration during
1959-60. This study stresses the need for organized education for hospital
administration in India. The first attempt to fill this growing need was a seminar on
hospital administration sponsored by technical co-operative mission in 1961 followed
by orientation course in Hospital Administration at Govind Vallabha Pant Hospital.
The National Institute of Health Administration and Education was established at New
Delhi, 1964. In 1966, first Master’s Degree in hospital administration course was set
up at All India Institute of Medical Sciences, New Delhi.
26.6 THE MODERN HOSPITAL – A COMPLEX ENTITY

That the modern hospital is an extremely complex organization is evident from the
fact that it provides essential services, which must be available 24 hours a day.
Obviously, the hospitals differ from other organizations in that they deal continuously
with the problems of life and death. The hospital is faced by a unique set of issues and
characteristics. These characteristics in Indian context can be summed up thus:
a) Hospitals are operated continuously. This leads to high cost and causes personnel
and scheduling problems.
b) There is wide diversity of objectives and goals among the individuals,
professional groups and various sub-systems. Hospital components are
responsible for/or participate inpatient care, education, research, prevention of
prospective ailments, accommodation and intricate medical and surgical
procedures. These activities are generally conflicting. Effective co-ordination is
becoming difficult in minimizing this conflict and obtaining the maximum support
in achieving hospital mission.
c) Hospital personnel range from highly skilled and educated to unskilled and
uneducated employees. The major responsibility of the hospital manager is to get
256 work from these diversified groups. Unionization among personnel complicates
human resource management in hospitals.
d) Many components of hospital operation have dual lines of authority. Physicians
are responsible for patient care, education and research. This necessitates unique
skills and special working relationships.
e) Hospitals deal with the problems of life and death. This puts significant
psychological and physical stress on all the personnel. The setting and outcome
may cause consumers and their families to be hypercritical.
f) It is difficult to determine and measuring the quality of patient care. There has
been progress in determining what quality is, but many questions were
unanswered and there is disagreement among experts as to how and what should
be measured.
g) One major characteristic of hospital management is the over emphasis on medical
care and the overriding of financial aspects of hospital operations. This results in
distortion of management principles and their application to hospitals as compared
with other undertakings.
h) The complexity of a hospital is characterized not only by its diversified activities
but also by the personalized nature of its services. Each is a special product.
Advances in technology, economic, political pressures and consumer demands add
complexity and problems to hospital management at the rate equal to or greater than
the rate at which managers solve them.
Fill in the blanks:
1. Between 273 and 232 BC, hospitals were called …………….. .
2. The major changes in concept of hospitals can be divided into different
periods such as …………….., …………….. and …………….. .
26.7 LET US SUM UP

The health care delivery system is the organization of all health care facilities,
providers, and ancillary services that are necessary to serve patients. Health is not
merely the absence of disease but also protection from factors, which predispose to
disease. The World Health Organization has defined health as the status of complete
physical, mental, and social well-being. There are three major components that make
up the Healthcare Delivery System:
z Facilities
z Practitioners
z Entities
Hospitals may provide different levels of care:
z Acute care for critically ill patients
z Tertiary care is a designation given to hospitals that provide medical education
and handle complex care.
z Primary care is provided by most hospitals.
z Sub acute care for patients requiring hospitalization, but not in a life-threatening
condition.
z Swing-bed care for patients requiring skilled nursing when no skilled facility.
The term “hospital” means an establishment for temporary occupation by the sick and 257
the injured. The history of hospitals starts from Pre-Christian era the different time Health Care Delivery System
periods are highlighted. To conclude, there should be a team approach to meet the
community needs and to manage institutional services. We call this Team Period,
where influence need to be shared among trustees, physicians, administrators, nursing,
other personnel and Governments who fund hospitals.

Compare different types of famous hospitals history and development which is in your
city.
26.9 KEYWORDS
Health: The World Health Organization has defined health as the status of complete
physical, mental, and social well-being.
Hospital: It provides essential services, which must be available 24 hours a day.
Obviously, the hospitals differ from other organizations in that they deal continuously
with the problems of life and death.

1. Explain the health care delivery system.
2. Evolution of hospital services and different time periods.
3. Elaborate the growth and development of hospitals in India.

CYP 1
There are three major components that make up the Healthcare Delivery
System:
z Facilities
z Practitioners
z Entities
CYP 2
1. Chikistaslayas-Chikistas
2. Trusteeship period, Physician period and Administration periods.

Talluru Sreenivas, “Management of Hospitals”, A.P.H. Publishing Corporation, New Delhi.
Goyal, R.C, “Hospital Administration and Human Resource Management”, Prentice Hall of
India (P) Ltd., New Delhi, 4th Edition, 2006.
George, M.A, “The Hospital Administrator,” Jay Pee Brothers Medical Publishers (P) Ltd.,
New Delhi, 2003.
258
27
NATIONAL HEALTH COMMITTEES
CONTENTS
27.1 Introduction
27.2 Bhore Committee, 1946
27.3 Chopra Committee
27.4 Mudaliar Committee, 1962
27.5 Chadha Committee, 1963
27.6 Mukherjee Committee, 1965
27.7 Mukherjee Committee, 1966
27.8 Jungalwall Committee, 1967
27.9 Kartar Singh Committee, 1973
27.10 Shrivatsava Committee, 1975
27.11 Bajaj Committee, 1986
27.12 Let us Sum up
27.14 Keywords

z Explain about the purpose of various committees
z Understand the recommendations of various committees
27.1 INTRODUCTION
After India attained freedom, there was rapid industrialization in the country, but at
the same time there was continuous growth of population, which caused a number of
medical and health problems. Special efforts were therefore made to solve those
health problems and various committees are set up from time to time to render advice
about different health problems. The reports of these committees have formed and
important basis of health planning in India. Major recommendations of some
important committees are given below.
27.2 BHORE COMMITTEE, 1946

This Committee, known as the Health Survey and Development Committee, was
appointed in 1943 with Sir Joseph Bhore as its Chairman. It made comprehensive
recommendations for remodeling of health services in India. It laid emphasis on 259
integration of curative and preventive medicine at all levels and recommended and National Health Committees
network of primary health centers.

One Primary Health Centre was suggested for a population of 40,000. Each PHC was
to be manned by two doctors, one nurse, four public health nurses, four midwives,
four-trained dais, two sanitary inspectors, two health assistants, one pharmacist and
fifteen other class IV employees. Secondary Health Centers were also envisaged to
provide support to PHCs and to coordinate and supervise their functioning.
27.3 CHOPRA COMMITTEE

To the uninitiated it must come as a surprise that the government is only now, after
half a century of independence, working on a plan to involve the vast numbers of
traditional medicine practitioners and their well-entrenched infrastructure in the public
health system. Often there has been a deliberate attempt to relegate such efforts to the
sidelines; more frequently, the attempts have failed because they have not been based
on realities, nor had proper ground been prepared for such change.
One of the earliest such “models” is to be found in a document forgotten by everyone
except health researchers, known as the Chopra Committee report, published around
the same time as the Bhore Committee report which drew the grid-lines for the current
health infrastructure. The Chopra Report had drawn an elaborate plan for integrating
the several systems of medicine with the allopathic system, even going to the extent of
suggesting the manner in which an integrated system of medical education could be
evolved. Had the system been put in place the traditional systems today may not have
remained in isolation, and the integrated system may well have been in the forefront
of medical developments. A little later, perhaps in the early 1960s, yet another
initiative began, under the auspices of the Banaras Hindu University where several
systems shared diagnostic facilities and offered patients a choice of treatment.
Although the experiment was quite successful to begin with, the early enthusiasm
petered out in the face of heavy criticism form purists on both sides of the fence.
There have been similar local level initiatives, many very successful, though the
government’s mindless incorporation of traditional medical systems in the from of a
non-allopathic doctor at the PHC level ahs failed miserably, remaining a cosmetic
feature.
The current plan of the government to include traditional systems and to
systematically workout a list of 10 to 15 diseases for which there could be a choice of
therapies, while commendable, requires a lot more groundwork than there seems to be
comprehension about. For one, a critically important factor is the system of
registration of practitioners. If these systems are to become effectively accessible to
people there is a need to revamp some of these institutions and revitalize them. The
search for ‘old’, ‘native’, ‘traditional’, remedies, on for some time, is gathering rapid
momentum in the increasingly competitive world of pharmaceuticals. This means that
these systems need to be studied, adequately documented and protected both through
wide usage and necessary patenting.
27.4 MUDALIAR COMMITTEE, 1962

This Committee, known as the “Health Survey and Planning Committee”, headed by
Dr. A.L. Mudaliar, was appointed by the Government in 1962 to assess the
performance in health sector since the submission of the Bhore Committee report.
This Committee found the conditions in the PHCs to be unsatisfactory and suggested
that the PHCs already established should be strengthened before new ones are opened.
Strengthening of sub divisional and district hospitals was also advised. It was
emphasised that a PHC should not be made to cater to more than 40,000 population
260 and that the curative, preventive and promotive services should be all provided at the
PHC. The Mudaliar Committee also recommended that an All India Health Service
should be created to replace the erstwhile Indian Medical Service.
27.5 CHADHA COMMITTEE, 1963

This Committee was appointed under the Chairmanship of Dr. M S Chadha, the then
Director General of Health Services, to advise about the necessary arrangements for
the maintenance phase of National Malaria Eradication Programme. The Committee
suggested that the vigilance activity in the NMEP should be carried out by basic
health workers (one per 10,000 population), who would function as multipurpose
workers and would perform, in addition to malaria work, the duties of family planning
and vital statistics data collection under supervision of family planning health
assistants.
27.6 MUKHERJEE COMMITTEE, 1965

The recommendations of the Chadha Committee, when implemented, were found to
be impracticable because the basic health workers, with their multiple functions could
do justice neither to malaria work nor-to family planning work. The Mukherjee
Committee headed by the Secretary of Health, was appointed to review the
performance in the area of family planning. The Committee suggested that basic
health workers should no be given family planning work and that the family planning
health assistant should devote their time entirely to family planning.
27.7 MUKHERJEE COMMITTEE, 1966

Multiple activities of the mass programs like family planning, smallpox, leprosy,
trachoma, NMEP (maintenance phase), etc. Were making it difficult for the states to
undertake these effectively because of shortage of funds. A committee of state health
secretaries, headed by the Union Health Secretary, Shri Mukherjee, was set up to look
into this problem. The Committee recommended and worked out the details of a basic
health service to be provided at the block level.
27.8 JUNGALWALL COMMITTEE, 1967

This Committee, known as the “Committee on Integration of Health Services” was
set-up in 1964 under the Chairmanship of Dr. N. Jungalwalla, the then Director of
National Institute of Health Administration and Education (currently, NIHFW). It was
asked to look into various problems related to integration of health services, abolition
of private practice by doctors in government service, and the service conditions of
doctors. The Committee stated that an integrated health service should have two
characteristics:
1. Different problems should be approached in a unified manner rather than different
approaches for different problems.
2. Public health programs and medical care should be put under charge of a single
administrator at all levels of hierarchy.
The Committee recommended integration at all levels of health organization in the
country. The followings steps were recommended for such integration:
a) Unified cadre
b) Common seniority
c) Recognition of extra qualifications
d) Equal pay for equal work
e) Special pay for special work 261
National Health Committees
f) Abolition of private practice by government doctors
g) Improvement in their service conditions.
27.9 KARTAR SINGH COMMITTEE, 1973

This Committee, headed by the Additional Secretary of Health and titled the
“Committee on Multipurpose Workers under Health and Family Planning” was
constituted to form a framework for integration of health and medical services at
peripheral and supervisory levels. Its main recommendations were as follows:
Various categories of peripheral workers should be amalgamated into a single cadre of
multipurpose workers (male and female). The erstwhile auxiliary nurse midwives
were to be converted into MPW (M). The work of 3-4 male and female MPWs was to
be converted into female health supervisors.
One Primary Health Center should cover a population of 50,000. It should be divided
into 16 sub-centers (one for 3000-3500 population) each to be staffed by a male and a
female health worker.
Check Your Progress
Fill in the blanks:
1. Bhore Committee is known as the …………… .
2. Mudaliar Committee, 1962 is known as the …………… .
3. Jungalwall Committee, 1967 is known as the …………… .
27.10 SHRIVATSAVA COMMITTEE, 1975

This Committee was set up in 1974 as “Group on Medical Education and Support
Manpower” to determine the steps needed to: (i) reorient medical education in
accordance with national needs and priorities, and (ii) develop a curriculum for health
assistants who were to function as a link between medical officers and multipurpose
health workers and who were supposed to provide health care family welfare and
nutritional services.
The main recommendations of the committee were as follows:
a) A cadre of semiprofessional village level health workers should be developed
within the community. These workers should be recruited form amongst the
community itself (e.g. school teachers, postmasters, gram sewaks, social workers,
etc.) and should look after the primary health needs of the community. They
would serve as a link between the community and the primary health center.
b) Within the PHC system, the multipurpose health workers should be the link
persons between the village level health worker and the PHC. The work of 2 male
and 2 female health workers should be supervised by one male and one female
health assistants respectively. These health assistants should be located at the sub-
center and not at the PHC.
c) Steps should be taken to develop a referral system form PHC to hospitals at tehsil,
district and regional levels and the medical colleges.
d) A medical and health education commission on the lines of the University Grants
Commission should be established.
Acceptance of the recommendations of the Shrivastava Committee in 1977 led to the
launching of the Rural Health Scheme. The details of this scheme are given in the next
lesson.
262
Health Laws and Policies 27.11 BAJAJ COMMITTEE, 1986
An “Expert Committee for Health Manpower Planning, Production and Management.
Was constituted by the Ministry of Health and Family Welfare, Government of India,
in 1985 under the Chairmanship of Dr. J.S. Bajaj Member (Health), Planning
Commission. The major recommendations of the Committee are listed below:
1. Formulation of national medical and health education policy.
2. Formulation of national health manpower policy.
3. Establishment of an educational commission for health sciences (ECHS) on the
lines of UGC.
4. Establishment of health science universities in various state and union territories.
5. Establishment of health manpower cells at center and in the states.
6. Vocationalization of education at 10 + 2 levels as regards health related fields
with appropriate incentives, so that good quality paramedical personnel may be
available in adequate numbers.
7. Carrying out a realistic health manpower survey.
Sl.No Name of Committees Chairman Year Purpose Recommendations

1 2 3 4 5 6
1. Bhore Committee Joseph Bhore 1943 To study then (a) No individual shall fail
Existing health to secure adequate medical
conditions and to care because of inability to
make pay for it.
recommendations
for the future (b) Special emphasis on
development preventive work.
(c) Provision of medical
relief and preventive
healthcare to rural
population.
(d) Heath services should
be placed as close to the
people as possible to
ensure maximum profit to
the community.
(e) It is essential to secure
the active co-operation of
the people in the
development of health
programme.
(f) Three month training
recommended for
preventive and social
medicine workers.
(g) In long-term
programme, a primary
health unit for a population
of 20,000 and second unit
for a population of 6 lakhs
are earmarked. In short-
term programme a primary
unit for a population of
40,000 and secondary unit
for a population of one and
half million are
recommended.
Contd….
2. Mudaliar Committee Mudaliar 1961 To survey the (a) Consolidation of 263
progress made in advances, efforts and National Health Committees
the field of health achievements made in First
and medical relief and Second Year Plans.
since submission
of Bhore (b) Equipping district
Committee’s hospitals with specialized
Report and to services.
make (c) Need of
recommendations regionalization of health
for the future services.
development.
(d) Fixed upper limit for
each PHC is 40,000.
(e) Constitution of all
India Health Services on the
patient of Indian
Administrative Services.
3. Chaddah Committee Dr. Chadah, M.S. 1963 To study the (a) The vigilance
arrangements for operation of the national
the maintenance Malaria eradication
phase of National programme should be
Malaria under control of PHC.
Eradication
Programme. (b) Vigilance operations
through monthly home
visits should be
implemented through basic
health workers.
(c) The norm of basic
health worker per 10,000
populations was
recommended.
(d) The general health
services at district, level
should undertake the
responsibility for the
maintenance phase.
4. Mukerjee Committee S.H.B. Mukerjee 1965 To review the (a) Recommended
strategy for separate staff for Family
Family Planning Planning Programme.
Programme.
(b) Recommended not to
use health workers for
family planning.
(c) Recommended
separation of Malaria
Eradication Programme and
Family Planning
programme.
5. Mukerjee Committee Mukerjee 1966 To work out the Recommended the staff
details of the pattern for various agencies
basic health administering health
service and to services in the country i.e.
recommend for for primary health center,
consequential district health organization,
strengthening of district hospital, and urban
administration areas.
6. Junganwala Committee Dr. N. 1967 To integrate Integration of oragnisation
Junganwala health services. and personnel and health
from the highest and lowest
level in the service.
Contd….
264
7. Karthar Singh Sri Karthar Singh 1973 To develop (a) The structure for
Committee multipurpose integrated service was
workers under recommended.
Health and
Family Planning. (b) Given
recommendations on
training requirements.
(c) Given steps for
utilization of mobile service
units under Family
Planning Programme.
(d) Recommended for
provision of a primary
health center for a
population of 50,000.
8. Srivastava Group Dr. J.V. 1975 To improve (a) Recommended for a
Srivastava medical nation-wide network of
education and effective services suitable
support man to Indian conditions.
power.
(b) Steps should be taken
to create bands of
paraprofessional or semi-
professional health workers
form the community.
(c) Recommended for the
primary health center with
additional doctor and nurse.
(d) Recommended for
constituting an act of the
Parliament for co-
ordination and maintaining
standards in medical and
health education.
27.12 LET US SUM UP

The reports of these committees have formed and important basis of health planning
in India. Major recommendations of some important committees are:
Bhore Committee 1943, No individual shall fail to secure adequate medical care
because of inability to pay for it. Special emphasis on preventive work. Provision of
medical relief and preventive healthcare to rural population. Heath services should be
placed as close to the people as possible to ensure maximum profit to the community.
Mudaliar Committee 1961, Consolidation of advances, efforts and achievements made
in First and Second Year Plans. Equipping district hospitals with specialized services.
Need of regionalization of health services.
Chaddah Committee 1963, The vigilance operation of the national Malaria eradication
programme should be under control of PHC. Vigilance operations through monthly
home visits should be implemented through basic health workers
Mukerjee Committee 1965, Recommended separate staff for Family Planning
Programme. Recommended not to use health workers for family planning.
Mukerjee Committee 1966, Recommended the staff pattern for various agencies
administering health services in the country i.e. for primary health center, district
health organization, district hospital, and urban areas Junganwala Committee 1967-
Integration of oragnisation and personnel and health from the highest and lowest level
in the service.
Karthar Singh Committee 1973, The structure for integrated service was 265
recommended. Given recommendations on training requirements. National Health Committees
Srivastava Group 1975, Recommended for a nation-wide network of effective services

suitable to Indian conditions. Steps should be taken to create bands of
paraprofessional or semi-professional health workers form the community.

Try to know the committee which is activating currently and their recommendations.
27.14 KEYWORDS
Bhore committee: This Committee, known as the Health Survey and Development
Committee, was appointed in 1943 with Sir Joseph Bhore as its Chairman.
Mudaliar committee: This Committee, known as the “Health Survey and Planning
Committee”, headed by Dr. AL Mudaliar, was appointed by the Government in 1962
to assess the performance in health sector since the submission of the Bhore
Committee report.
Chaddah committee: This Committee was appointed under the Chairmanship of
Dr. MS Chadha, the then Director General of Health Services, to advise about the
necessary arrangements for the maintenance phase of National Malaria Eradication
Programme.
Junganwala committee: This Committee, known as the “Committee on Integration of
Health Services” was set-up in 1964 under the Chairmanship of Dr. N. Jungalwalla,
the then Director of National Institute of Health A Administration and Education
(currently, NIHFW).
Karthar Singh committee: This Committee, headed by the Additional Secretary of
Health and titled the “Committee on Multipurpose Workers under Health and Family
Planning” was constituted to form a framework for integration of health and medical
services at peripheral and supervisory levels.

1. Explain the national health committees.

1. Health Survey and Development Committee.
2. Health Survey and Planning Committee.
3. Committee on Integration of Health Services.

Goyal, R.C, “Hospital Administration and Human Resource Management”, Prentice Hall of
India (P) Ltd., New Delhi, 4th Edition, 2006.
George, M.A, “The Hospital Administrator,” Jay Pee Brothers Medical Publishers (P) Ltd.,
New Delhi, 2003.
266
28
HEALTH CARE INFRASTRUCTURE
CONTENTS
28.1 Introduction
28.2 Health Administration – National Level
28.2.1 Role of the Union Government
28.2.2 Structural Growth and Existing Set-up
28.2.3 Functions of the Union Ministry of Health and Family Welfare
28.2.4 Functions of the Family Welfare Department
28.3 Health Administration – State Level
28.3.1 Organisation of State Health Department
28.4 Health Administration – District Level
28.4.1 District Hospital Administration
28.4.2 Nature of Existence
28.4.3 Functions
28.4.4 Indices for Measuring the Efficiently of a Hospital
28.4.5 Aspects of Hospital Services
28.4.6 Staff Function
28.5 Health Administration – Community Health Centres
28.5.1 Organisation Structure of Community Health Centre
28.5.2 Functions of Community Health Centre
28.6 Health Care Administration – Primary Health Centre
28.6.1 Rationale and Philosophy
28.6.2 Genesis and Growth
28.6.3 Strengthening of Infrastructure
28.6.4 Functions of PHC
28.6.5 Role of PHC, Secondary and Tertiary Hospitals
28.6.6 Organizational Structure of PHC
28.6.7 Problems Situations
28.6.8 Suggestions
28.7 Health Administration – Sub-Centre Level
28.8 Health Administration – Village Level
28.8.1 Criteria for CHW
28.8.2 Activities of Village Health Guide Scheme
28.9 Let us Sum up
28.11 Keywords
267
28.0 AIMS AND OBJECTIVES Health Care Infrastructure

z The Health care infrastructure at national level
z The Health care infrastructure at state level
z The Health care infrastructure at district level
z The Health care infrastructure at community level
z The Health care infrastructure at primary health care level
z The Health care infrastructure at village level
28.1 INTRODUCTION
The concern for better Public Health care is universal. Promotion of health is basic to
national progress. Nothing could be of greater significance than the health of the
people in terms of resources of socio-economic development. Administration can
provide the means whereby the most effective use can be made of the knowledge and
skills of the personnel responsible for the health care delivery system.
28.2 HEALTH ADMINISTRATION – NATIONAL LEVEL

Health and Human development form integral components of overall socio-economic
development of nation. Good health and economic prosperity tend to support each
other. Healthy people can more easily earn an income, and people with higher income
can more easily seek medical care, have better nutrition and have the freedom to lead
healthier lives.
28.2.1 Role of the Union Government

According to the Constitution, the Central Government is concerned only with
international health matters, assisting and coordinating State activities, establishing
standards and promoting research and professional education. Most other health
matters are thus reserved for the States and their health departments, though a few,
such as mental health, food adulteration, drugs and vital statistics are on the
concurrent list. The 42nd Amendment to the constitution has made “Population
Control and family Planning” a concurrent subject and this provision has been made
effective from January 1977, the two Health survey committees (Bhore and Mudaliar)
reporting in 1946 and 1961, did not recommend an amendment to the Constitution
although it was stressed that the Central Government should have greater powers to
coordinate the activities of the State authorities dealing with health. Many persons
from time to time have stressed that the Ministry of Health should be given more
powers to deal with health matters. Pt. Jawaharlal Nehru said:
“The Central Health Ministry is the pivot round which all the major schemes for
improving the standards of health of the nation revolve. All major schemes have
necessarily to be sponsored and encouraged by the Central Ministry”.
The Ministry of Health and Family Welfare plays a vital role in the national efforts to
enable the citizens to lead a healthy and happy life. Under the Indian Constitution, the
items of public health, sanitation, hospitals and dispensaries fall in the State list. Items
alike population control and family planning, medical education, adulteration of
foodstuffs and other goods, drugs and poisons, medical professions, vital statistics
including registration of births and deaths and lunacy and mental deficiency find a
place in the concurrent list.
The Ministry of Health and Family Welfare at the centre is responsible for
implementation of numerous programmes of national importance like family welfare,
268 primary health care, prevention and control of major diseases, etc. Which form the
main plank of our development efforts. The Ministry has several centrally sponsored
schemes which are implemented through the States. At the same time, it also
implements various central sector schemes. All these schemes aim at fulfilling our
national commitment to attain the goal of Health for All by 2000 AD in accordance
with Alma-Ata Declaration of September 1978 to which India is also a signatory.
28.2.2 Structural Growth and Existing Set-up

Before 1947, the medical and health services at the centre were administered by the
two separate departments, one under the Director General of IMS and the other under
the Commissioner of Public Health. After independence, these two offices were
amalgamated under the Director-General of Health services and the post of
Commissioner of Public Health was abolished. The Union Ministry of Health was
vested with several additional responsibilities, namely, family planning, works and
Housing and Urban Development were transferred from this ministry. Family
planning was raised to the status of a full-fledged department in 1966, and the
Ministry was designated as the Ministry of Health and Family Planning. It is known at
present as “Ministry of Health and Family Welfare”.
The Union Ministry of Health and Family Welfare is headed by a Cabinet Minister
with a Minister of State to assist him.
The Union Ministry of Health and Family Welfare comprises of the following:
z Department of Health
z Department of Family Welfare
z Department of Indian systems of Medicine and Homeopathy.
z Department of Health: The Department of Health deals with medical and public
health matters including drugs control and prevention of food adulteration. It is
headed by a Secretary to the Government of India, Who is supported by two
Additional Secretaries.
z Department of Family Welfare: The Secretary overseen the implementation of
the programmes concerning family welfare and mental and child health in the
states and Union territories and coordinates the activities and functions of the
Technical Divisions and Secretariat side.
On the Technical side, the following Divisions are functioning in the Department of
Family Welfare:
z Programme appraisal and special schemes
z Technical operations
z Maternal and Child Health
z Evaluation and Intelligence
z Nirodh marketing supply/distribution
z Transport
z Universal Immunization programme
z Area project
z Mass Education and media
National Level 269
Ministry of Health and Family Welfarwe Health Care Infrastructure
States (25) and U.Ts. (2)

Department of Health Family Welfare
District Health Organisation and

Basic Specialisties Hospital, Districts (431)
Community Health Centres 1,80,000 to 120,000

(2424) (Being Converted Into) Sub District Taluka Hospital
Selected Specialities
Primary Health Centres (21305)

1,100.000 (Old PHC)
1,00.000 (New PHC)
Sub Centres (132727)
H. Workers (M)
H. Workers(F) 1,5000 to 1,000.0
Villages 5,75.936
Health Guide 1,1000
Trained OAI
People 844 Million

(Provisional)
Census 1991
Figure 28.1: Health System in India

z Department of Indian Systems of Medicine and Homoeopathy: It was
established in March 1995 and had continued to make steady progress. Emphasis
was on implementation of the various schemes introduced around the thrust areas
identified by the Department. The thrust areas are education, standardization of
drugs, enhancement of availability of raw materials, research and development,
information, education and communication and involvement of ISM and H in
National Health Care.
Ministry of Health and Family Welfare
Cabinet Minister
Minister of State
Deputy Minister
Department of Department of
Department of Health Family Welfare Indian System of Medicine and Homeopathy
Secretary Health Secretary Secretary
Additional Secretary
Chief Director Joint Director Director Ayurvedia JS
(1) (2) and Sidhi (ISH)
Joint Secretary
Director General of
Health Services
Additional Director Generals (1)
Figure 28.2: Organisation Structure - National Level

270 28.2.3 Functions of the Union Ministry of Health and Family Welfare
z Maintenance of international health relations, Administration of port health and
quarantine laws.
z Administration of Central Health Institutions, training colleges, laboratories and
hospitals.
z Promotions and maintenance of appropriate standards of education in medicine,
nursing, dental, pharmaceutical and of ancillary health personnel through statutory
bodies and coordination and collaboration with various national association in
health programmes.
z Promotion of medical and public health researches through the Indian council of
Medical Research and other research institutions, each of which is headed by a
secretary to the Government of India:
z Regulation and development of medical, dental, nursing and pharmaceutical
professions in consultation with the state governments.
z Establishment and maintenance of drug standards and of control over the
manufacture and sale of drugs and biological products.
z Collection of information regarding development in the medical and health
services in India and abroad to be made available to all State Governments
through the Central Bureau of Health Intelligence.
z Maintenance of a Central Medical library.
z Promotion and coordination of health activities through the central council of
health.
z Establishment of close contact with other Ministries in respect of health measures.
z Coordination of various activities through consultative committees of the
parliament, statutory bodies, committees and associations.
z Negotiations with International bilateral agencies.
z Planning and organization of health activities throughout the country in
collaboration with the State Government and the planning commission.
z Evaluation of health schemes organized in the country.
z Assessment of health conditions in the country through health morbidity surveys
and by regular collection of vital and health statistics and spreading of the
information throughout the country.
z Promulgations of Central enactments on health matters as may be provided by the
Constitution of India.
z Organisation and maintenance of a central health service.
z Establishment of total medical care programmes for the Central Government
employees.
z Carrying out the functions of health services in the centrally administered areas.
z Power to lay down and enforce minimum standards of health administration for
these services which are within the immediate control of other departments, e.g.,
Railways, Prisons, etc.
28.2.4 Functions of the Family Welfare Department

z To organize family welfare programmes through family welfare centres
throughout the country.
z To create an atmosphere of social acceptance of the programme and to support all
voluntary organizations interested in the programme.
z To educate every individual to develop a conviction that a small family size is 271
valuable for him or her, and to popularize every known, appropriate and Health Care Infrastructure
acceptable method of family planning and to leave the choice of method to the
individual couple.
z To disseminate the knowledge on the practice of family planning as widely as
possible through all available publicity and educational measures, and to provide
service agencies nearest to the community.
z To organize basic research of human fertility, genetics and population dynamics
and on the evolution of easy and more reliable method of contraception.
z To study the social factors that affect fertility and to take such steps as will reduce
the number of children in a family. e.g. raising the age of marriage, education and
employment of women etc.
z To coordinate the family planning programme with the child welfare and maternal
health services throughout the country.
z To organize production of contraceptive devices in adequate quantities to
maintain the supply at all levels preferably free or at a minimum cost.
z India system of medicine and Homoeopathy helps to promote /ISM in the country
training, research and use.
28.3 HEALTH ADMINISTRATION – STATE LEVEL

Health, according to the Constitution of India, is a state subject. The main
responsibility for providing health services to all people lies with the State Health
Department with the assistance of local health organizations wherever these exist, e.g.,
Corporations, Municipalities, Panchayati Raj, ad hoc statutory bodies like the Mines
Board of Health, Employees State Insurance corporation and soon.
The Executive machinery of the government at the State level is headed by the
Governor. Article 163 of the Constitution provides for a council of Ministers with the
Chief Minister as its head to aid and advise the Governor. The business of the
government of the State is allocated by the Governor amongst the Ministers in
accordance with the provisions contained in Article 166(3) of the Constitution.
28.3.1 Organisation of State Health Department

z Political Head: The Health Minister has to perform both types of activities viz.,
political as well as administrative. These can be broadly discussed as follows:
(i) As a member of the State Legislature, it is his duty to support and safeguard
the total policies of the Government because of the collective responsibility of
the cabinet.
(ii) As a member of the ministry, he brings all the bills pertaining to his
Department for the approval of the legislature.
(iii) As political head of the Health Department, he acts as an executive and
administrator. He has to see that the policies approved by the legislature are
faithfully implemented.
(iv) He is the custodian of the interests of the people in general and of his
constituency in particular.
(v) As a member of the Government, he performs ceremonial duties.
272
Minister Incharge of Health and Family
Health Laws and Policies Welfare Portfolio in the State
Secretary or Commissioner Department

of Health and Family Welfare
Director Director
Health FW Director Medical Education Director ISM
and Research and Homeopathy
Services Services
Additional/Deputy Joint Principal Deans of

Directors of Health Services Medical College
(Dealing with One or More
Programmes
Assistant Directors
Health Services Divisional set up
(Dealing with one or more in Some States
Programmes)
District Health
Organisation
Taluka Health
Organisation
Block Level Health

Organisation
Figure 28.3: Organisation of State Health Department

z Administrative Head: In order to keep a record of the policies framed by the
political heads and to watch over their implementation and execution, the State
administration has to take the help of an office which is known as the state
secretariat. The word ‘Secretariat’ refers to the complex of departments which
vary from state to state.
The main duties and responsibilities of the health department are:
1. Assisting the Minister in policy-making, in modifying policies from time to
time and in the discharge of his legislative responsibilities,
2. Framing draft legislation and rules and regulations,
3. Coordination of policies and programmes, supervision and control over their
execution and review of results,
4. Budgeting and control of expenditure,
5. Maintaining contact with the Government of India and other State
Governments, and
6. Overseeing the smooth and efficient running of administrative machinery and 273
initiating measures designed to develop greater personnel and organizational Health Care Infrastructure
competence.
z Technical Head: Below the State Secretariat, there are Executive Departments.
These Departments are headed mostly by the specialists and are concerned with
the supervision, coordination and control of the policy framed by the State
Government. Based on our personal observation and discussion, it was revealed
that notwithstanding the apparently clear demarcation of functions as between the
secretariat and the Executive Department a lot of duplication and overlapping still
persists between the Secretariat and the Executive Department. This results in too
much interference in the day-to-day functioning of the Executive Department. As
a matter of policy the Secretariat should restrict its activities only to policy
making.
28.4 HEALTH ADMINISTRATION – DISTRICT LEVEL

The district is the most/crucial level in the administration and implementation of
medical/health services. At the district level there is a District Medical and Health
Officer (DMHO) or Chief Medical Officer who is overall responsible for the
administration of Medical and Health services in the entire district and for the
implementation of all the national health and family welfare programmes. He is
assisted by the Additional District Medical and Health Officers or Deputy District
Medical and Health officers along with other district officers for various national
health programmes in the district. Their number varies from state to state.
Each district has been divided into two or more sub-revenue divisions. In each sub-
division, there is a Senior Medical officer who is overall in-charge and is responsible
for supervising the activities of all health and family welfare programmes in
dispensaries and Taluka Hospitals of the sub-division. He is assisted by Health
Supervisors and Health Education Officer.
28.4.1 District Hospital Administration

A district level health center is a hospital complex mainly engaged in curative services
for the population of the district. The size of the hospital varies form the 500 beds
depending upon the size and population of the district. Most of district hospitals are
housed in old buildings while new buildings have been constructed in the new districts
or upgraded the existing civil hospitals. However, old buildings have been renovated
with extensions of OPD, wards and other facilities.
274
District Health and Family Welfare Officer
Dy. CMO/ Assistant Assistant District Senior Senior District District

Medical District District Malaria Malaria Medical Leprosy Health
Officer Health & Health & Officer Officer Superin- Officer Education
(FW & MCH) Welfare Family tendent Officer
Officer Welfare DMEIO
(H.O.) Officer
Sub. Division
Level/
Dy. CMOs)
Medical Officers of
Dt. General Hospital and other Govt.
Hospitals
Medical District District Gazetted Assistant Service

Officer Tubeculosis Nursing Assistant Statistical Engineer
(District Officer Supervisor Officer (Mobile
Lab.) (T.B. Centre) Workshop)
Lady Medical
Medical Officers MD of
Officers of
Primary Health
Primary Health
Centres
Centres
(Co-ordinators at
PHD Level)
Figure 28.4: Organisation Structure – District Level
28.4.2 Nature of Existence

The medical superintendent/SMO head the district hospital. Each unit is under the
charge of a senior specialist who is assisted by junior specialists and general duty
medical offices and almost works as independent units without even essential
knowledge linkages.
Presently, the district hospital provides for both ambulatory (OPD) and in-patient care
in most of the general specialties like medicine, surgery, orthopedics, ENT,
ophthalmology, skin and STD, Pediatrics, emergency and dental care, etc. The
districts where there are no separate women’s hospitals also have obstetrics and
gynecology units as well. Most of the district hospitals have a post mortem center as
well. The beds are allocated to each specialty but there is no rational system fox its
distribution.
The typical district hospital totally lacks modern diagnostic and therapeutic facilities,
equipments, adequate emergency care facilities, intensive care units, drugs and
supplies, referral support and resources. The management and provision of even other
supportive and ancillary services in these hospitals like medical records, deity,
contract laundry, housekeeping and nursing care services are totally in adequate and
ineffective. The central sterile stores department does not exist. The units have their
own autoclaves for the purpose. Many district hospitals do not even have qualified
anesthetist on their roles.
There is no trained staff for hospital management or for the management of other 275
supportive or ancillary services as they have undergone only professional course. Health Care Infrastructure
They find difficulty in managing resources men, money and inter leading to a number
of problems. High infection rates and death rates are common.
These district hospitals further are divorced from the responsibility of coordinating the
basic specialty care provided by the CHCs and utilizing them for follow up services of
rural patients after being discharged from the hospital inpatient care. The linkage and
supervision by district senior specialists of the CHCs, which are so bedded hospitals,
is very essential to import professional training.
28.4.3 Functions
a) Patient Care: The first and foremost function of a hospital is to give care to the
sick and injured and restore the health of diseased persons and to all without
discrimination of social, economic or racial nature.
b) Training: The education and training of doctors and nurses have traditionally
been carried out is hospitals. These activities are today the vital support to the
specialist whether he is the surgeon, physician, diagnostician or therapeutics.
These people are and indispensable for the all round excellence of are specialist
work.
c) Medical Research: The third important function of hospital is to give support to
medical research, which is at present non-existent. A good hospital, where the
quality of professional work is excellent is an ideal ground for medical research.
d) Health Education: The fourth and final object is to support and assist all
activities carried out by various public health and voluntary agencies to prevent
disease and promote positive health attitudes in the community through health
education.
The District Hospital is Supposed to Ensure the Following:

z Provide curative services to any person approaching directly or through referral
system.
z Provide guidance, support, and supervision to PHCs and CHCs so that there may
not be unnecessary rush.
z Provide in-service training to personnel from CHC, PHC and sub-center and its
own staff.
z To act as a referral system both to patients and the personnel working in PHC and
CHC.
z Providing technological support to different levels of health care system.
z Extending specialists services to out reach areas.
z To act as a center for immunization programme.
z It should support promotive, preventive, rehabilitative serves.
z It should keep a continuous track on surveillance of diseases and keeping the
CHC, PHC and sub-center well informed in this aspect.
28.4.4 Indices for Measuring the Efficiently of a Hospital

Research institutions and the universities have formulated and helped the hospital
management to improve their services. Some commonly used measures to check the
efficiency of hospitals are:
Number of patient day During the year
1. Bed occupancy = u 100
Number of bed days during the year
276 The Number of patient day During the year
Health Laws and Policies 2. Average duration of illness = u 100
Total Number of in-patient admissions during the year
The total vacant bed days During the year

3. Turn Over Internal =
Total Number of in-patient admissions during the year
The total number of out patents during the year
4. The average out-patient admission =
Total Number of out-patients admissions during the year
The total number of new out patients admission during the year
5. Average daily out-patient admissions =
Total Number of working days during the year
The expenditure on diet during the year

6. Cost of daily diet =
Total Number of inpatients days
Total cost of medicines for the patients for the year
7. Average cost of Medicine = u 100
Total Number of inpatients admissions
Number of inpatient's details during a specified period

8. Fatality rate =
Number of discharges during the same period
Number of autopsies performed

9. Autopay rate = u 100
Number of inpatients deaths
28.4.5 Aspects of Hospital Services

Generally the services are categorized as:
z Line services
z Staff services
z Auxiliary services
z Line Services
(i) Emergency services
(ii) Outpatient services
(iii) In-patient services
(iv) Intensive care unit
(v) Operation theatre
z Support Services
(i) Central sterile supply service management.
(ii) Diet management.
(iii) Pharmaceutical services management.
(iv) Laundry.
(v) Laboratory and X-ray facilities.
(vi) Nursing services.
z Auxiliary Services
(i) Registration and Indoor case records.
(ii) Stores.
(iii) Transport.
(iv) Mortuary.
28.4.6 Staff Function 277
Health Care Infrastructure
Supportive services
CSSD Lab Blood Bank Nursing Pharma X-ray
Out Door In Door
Patient
Line Functions
Operation ICU Emergency
Stores Registration of in & out patient’s Mortuary

case records
Figure 28.5: House Keeping Services
28.5 HEALTH ADMINISTRATION – COMMUNITY

HEALTH CENTRES
WHO defines Community Health Centre as Reference Health Centre. “The Reference
health centre differs from the generic health centre in that it is a functional concept
that can be realized by strengthening one or more health centres to improve referral
within the health system in rural areas. Thus, in addition to its generic health centre
functions, it provides essential surgical, maternity and medical care, as well as
carrying out preventive and promotive activities in the neighbourhood it serves. The
reference health centre lightens the burden of the first referral hospital by taking over
certain routine interventions, at the same time bringing appropriate care closer to the
population at only a fraction of the cost of similar operations performed in local
hospitals. Health centres, including reference health centres and hospitals, are
components of a health care system, each playing a different but complementary
role”.
28.5.1 Organisation Structure of Community Health Centre

The CHC is headed by Senior Medical Officer (SMO) who is generally a medical
officer with 20-25 years of experience. He is the chief executive and has to ensure the
smooth functioning of CHC. The other staff in CHC is a given below:
1. Medical officer 4
2. Nurse Mid-wives 7
3. Dresser 1
4. Pharmacist/Compounder 1
Contd….
278
5. Laboratory Technician 2
6. Radiographer 1
7. Ward Boys 2
8. Dhobi 1
9. Sweepers 2
10. Mali 1
11. Chowkidar 1
12. Aya 1
13. Peon 1
25
28.5.2 Functions of Community Health Centre

z It acts as referral centre. All those who are referred from PHC or sub-centre are
attended here with more facilities and by qualified personnel. It provides good
examination facilities or gets it done from district hospital at higher level.
z It serves as a part of district health system, thereby getting the benefits of
exchange of services.
z It should be an integral part of the primary health care and should support all
activities of primary health centres and sub-centres.
z It should provide training to its staff to make them more and more professional
and dynamic
z It should have intimate contact with the people, the communities and involve
them in their own health promotion.
28.6 HEALTH CARE ADMINISTRATION – PRIMARY

HEALTH CENTRE
28.6.1 Rationale and Philosophy
z WHO has defined the health center as that which covers all health facilities other
than hospitals. It is usually the facility at the first contact level and has a unique
potential, as well as responsibility, for increasing people’s ability to solve their
own problems with confidence.
z It provides a full range of health promotion and preventive services, as well as
curative care limited mainly to ambulatory patients. It has multi-disciplinary team
capable of providing the range of services.
z The concept of the PHC as an institution to provide both curative and preventive
services can be traced to the report of the consultative council on Medical and
Allied Services, held in 1920, in England under the chairmanship of Lord Dawson
of Pen.
z One of the fathers of the health center movement during this period was John
Grant of the Rock Feller Foundation.
z Another expert of PHC was Andarija Stampar of Yugoslavia.
z In the district health system, each health center should be responsible for a defined
population so that no groups or families are left without a health team to provide
care. The care should include accountability for essential public health and
clinical services. In most countries this population will reside is a geographically 279
defined area. Health Care Infrastructure

The Bhore Committee (1946) recommended that a PHC should be set up to serve as
the focal point for providing comprehensive, curative and preventive health services
in the rural areas. The report, in its long-term programme, recommended a primary
health unit for a population of 20,000, a secondary unit for a population of 6,00,000
and a district headquarters’ organization for a population of three million. The
committee in its short-term programme recommended a primary unit for a population
of 40,000, a secondary unit for a population of one and a half million, and a district
headquarters’ organization for a population of three million. To improve the operation
of primary health centers, this committee recommended a reduction in the population
covered by them, expansion and strengthening of district hospitals, and introduction of
mobile teams of specialists to provide necessary supervisory and consultancy services
to the periphery.
28.6.3 Strengthening of Infrastructure

1. The rural health infrastructure was to be further strengthened in the sixth Plan to
achieve the objective of Health for all by 2000 A.D. The norms envisaged were:
One community health volunteers for every village for a population of 1000
chosen by the community to form the base unit.
One sub-center for a population of 5000in the plains 3000 is the hilly &
tribals.
One PHC for 30,000 population in the plains and 20,000 is the hilly and tribal
areas.
One CHC for a population of one lakh or one community development block.
2. Health infrastructure in rural areas is of prime importance for realization of the
objectives set forth in the National Health Policy and for attaining the goal of
“Health for all by 2000 A.D”.
3. Co-coordinated efforts under various Rural Health Programmes are essential to
provide effective and efficient services to the people in the rural areas.
4. Numerous programmes and schemes are being implemental under the Minimum
Needs Programme to provide PHC are relevant to the actual needs of the
community in the rural areas. The states of establishment of the sub-centers, PHCs
& CHC under the minimum needs Programme, has been of great significance.
This development is in consonance with the thrust of all plans for Rural
Development.
28.6.4 Functions of PHC

z To provide preventive, promotive, curative and rehabilitative services with
emphasis on preventive health care.
z To meet local needs based on largely local resources.
z To function as a unit for the promotion of positive health and not merely serve as
dispensary.
z To ensure equitable and qualitative services and not merely as a rudimentary and
traditional services.
z To join with other sectors of socio-economic development to optimize benefit for
the promotion of health services.
z To make frequent visits to the community in order and people needing their help.
280 z To arrange exhibitions to make people aware of health developments.
z To provide training to workers in the center.
z To keep in constant touch with district, state and central health authorities, health
research institutions to get advice and guidance.
z To develop teamwork.
z To encourage community leaders to support health development activities of
health centers.
z Health centers should empower community to take decisions with the support of
PHC.
28.6.5 Role of PHC, Secondary and Tertiary Hospitals

z Primary Health Care: Primary health care is the first level of contact below the
individual and the health system where essential health care is provided. A
majority of prevailing health complaints and problems can be satisfactorily dealt
with at this level. This level of care is closet to the people. This care is provided
by the primary health centres, with community participation.
z Secondary Health Care: Secondary health care deals with more complex
problems. This comprises essentially curative services and is provided by district
hospitals, sub-divisional hospitals, area hospitals and CHCs. This level serves as
the first referral level in the health system as the patients are referred to such
medical institutes from the Primary Health Centre.
z Tertiary Health Care: Tertiary health care offers super specialist care. This care
is provided by regional / central hospitals, teaching hospitals and super specialty
hospitals. This institutions provide not only highly specialized care, but also
planning and managerial skills and teaching for specialized staff.
28.6.6 Organizational Structure of PHC

The PHC functions with a medical officer of Health or Administrative Medical
Officer as the chief of the PHC and a Lady Medical Officer as the second medical
officer. One Block Extension Educator, one pharmacist, a para-medical worker and
two senior health Assistants (a male and a female) function under the Medical
officer’s supervision. Seven male multipurpose workers are under the supervision of
the Senior Health Assistant (male) and Seven female multipurpose workers work
under the supervision of the Senior Health Assistant (female).
Medical Officer Incharge 281
Lady Medical Officer Medical Officer
Block extension educator
Health supervisor (Male) Health supervisor (Female)

Erstwhile Categories of health Erstwhile Category
inspector and sanitary inspectors of lady health visitor
1:3 - 4 MPSO 1:4 MPSO
Multi-Purpose Health Worker Multi-Purpose Health Worker

(Male) Erstwhile Categories (Female) Erstwhile Categories
of FPFWs. BHWs & of ANMs
Vaccinators
Dispensers (2), Dresser (1),

1-6000-8000 Nurse, dai (2), Laboratory Tech/ 1-3000-4000
Population Lab: Assistant (1), Clerk (1), Population
Computer In-Charge (1t.b.Worker (1)),
Driver (1) and Class IV Staff.
Figure 28.6: Organisation Structure – Primary Health Care
T.B.A.
T.B.A. VHG T.B.A.
VHG VHG
T.B.A.
T.B.A.
VHG
VHG
Covers
1,000 Population
Sub
Covers 5,000 Population Centre
Covers 30,000 Population
Sub Sub
Centre Centre
Primary
Sub Health
Centre
Centre
Sub Sub
Centre Centre
Covers 1,00,000 Population Primary Health

Centre
Primary Community Primary

Health Health Health
Centre Centre Centre
Chief District Health

Executive Zilla
and Parishad
Officer Family Welfare
Figure 28.7: Primary Health Care Infrastructure – District Level

282 28.6.7 Problems Situations
1. Lack of coordination among the Developmental Agencies.
2. Absence of Organized Structure for People’s participation.
3. Poor Quality of Service.
4. Absence of Linkages with Cultural, Social and Religious Institutions.
5. Absence of Political Will and Direction.
6. Absence of Missionary Spirit among the Health Personnel.
7. Non-involvement of the universities in the programme and implementation of the
programme.
8. Absence of Informal Supervision through Medical Colleges/Institutes.
9. Absence of Research in the Flora and Fauna of the area.
28.6.8 Suggestions
z Inadequate PHC Buildings.
z Public Health Facilities.
z Medicines and equipment.
z Health Education.
z Indoor beds.
z Location not ideal.
z Administrative Powers of Medical Officers-Not sufficient.
z Linkage between Community and PHC.
z Vacant Posts need to be filled.
28.7 HEALTH ADMINISTRATION – SUB-CENTRE LEVEL

Sub-centre is the most important institution in providing health care. The success or
failure of health care depends upon the attitudes, perception and ethos of health
workers and volunteers working in sub-centers. It is a matter of great dis-satisfaction
that health centres are not ding well and are showing poor performance. This may be
attributed to lack of interest about them among union, state and district level health
functionaries. Sub-centres are the pivot around which all important schemes revolve.
At present, workers in these centres are highly dis-satisfied resulting in bad delivery
of primary health care services. Health centres can really communicate effectively
with community, volunteers and the people.
In the new millennium, we must strengthen the health centres to reap the benefits of
health care. WHO also recommended it.
The first line health workers are the major work force at the primary level. They
provide a substantial part of the promotive and preventive components of the essential
health care package. They also identify and refer complicated cases and emergencies.
However, there are marked variations in their level of training among member states,
with some workers being trained for only one and a half months. Appropriate training,
proper deployment, and basic supplies and logistic support for the first line health
workers are important for the delivery of essential health care.
The staffing pattern in peripheral health units is an important indicator of the effective
functioning of PHC in basic health units, and shortages of personnel are reported from
several countries. In the majority of countries of the region, auxiliary health workers
are the main providers of care at the first level static health facilities. Medical officers 283
are not usually posted to this level. Health Care Infrastructure
To overcome the problem of limited access to static health facilities in some areas,
many countries have organized outreach services through which health workers
regularly visit communities to provide health care. Services commonly provided are
immunizations, family planning, health education, growth monitoring and advice on
nutrition, basic maternal care, vitamin A distribution, and treatment of common
ailments such as diarrhea and acute respiratory infection. Data on disease incidence
and vital statistics are also collected during outreach visits in some countries.
28.8 HEALTH ADMINISTRATION – VILLAGE LEVEL

It has been realized that health status of the rural population can be improved not
merely by increasing the number of doctors or increasing the availability of
medicines, but by making each individual realize and appreciate the need of simple
steps in sanitation, preventive, promotive and rehabilitative health activities. The
Government’s new health policy aims at providing adequate medical care, where such
care is needed and to educate the people in the matter of preventive and promotive
health.
In pursuance of the decision of the government of India to devote special attention to
the health needs of the rural population and to ensure people’s participation in their
own health activities, a number of measures have been taken, the most important of
which is the launching of a new scheme, namely, the Health Guides Scheme, in
October 1997. Under this scheme, every village or community with a population of
1000 selects one person from among its residents, who is willing to serve the
community and enjoys its confidence.
28.8.1 Criteria for CHW

The following criteria is to be observed while selecting community /village health
workers:
z CHW may be of either sex.
z The person selected must be a permanent resident of that village itself and may be
from any vocation.
z He may even be a practitioner of one of the systems of medicine, residing in his
village.
z He should be able to read and write. However, since with higher level of
education, better quality of service would be available the person to be selected
should have had formal education up to the sixth standard.
z He should be social service minded and be able to spare 2-3 hours every day for
community health activities.
z He should be physically active and willing to serve at least for 3 hours as
community health worker.
z He should be acceptable to all sections of the community.
z He should not belong to any group, faction or political organization of the village
which may limit his acceptability.
With these guidelines the village community is requested to recommend 2-3 persons
considered suitable by them to be health guides. The final selection may be made by
the Medical Officers of Primary health centre jointly after consulting the Block
Development officer and the field staff of various government organizations. The
Health guide is given training in simple and basic health services for three months at
284 the primary health centre to which he belongs. After training the health guide goes
back to the village to serve the community. He is provided with a kit containing
medicines and also a manual. During the period of training he is paid a stipend of
Rs.200 per month for three months. After training he is given an honorarium of Rs.50
per month for working with the community and also Rs.50 worth of medicines per
month.
28.8.2 Activities of Village Health Guide Scheme

z Malaria eradication.
z Prevention and control of communicable diseases.
z Environmental sanitation and personal Hygiene.
z Immunization programmes for diphtheria, whooping cough, tetanus, smallpox,
tuberculosis, poliomyelitis, cholera and typhoid.
z Family planning.
z Maternal and child care.
z Nutrition.
z Reports of vital events.
z First Aid in emergencies.
z Treatment and minor ailments.
z Mental Health.
Check Your Progress
1. Who is in charge at district level?
…………………………………..………………………………………….
…………………………………..………………………………………….
2. What is bed occupancy ratio?
…………………………………..………………………………………….
…………………………………..………………………………………….
3. What are the different aspects of hospital services?
…………………………………..………………………………………….
…………………………………..………………………………………….
28.9 LET US SUM UP

The Ministry of Health and Family Welfare at the centre is responsible for
implementation of numerous programmes of national importance like family welfare,
primary health care, prevention and control of major diseases, etc. Which form the
main plank of our development efforts. The Ministry has several centrally sponsored
schemes which are implemented through the States. At a the same time, it also
implements various central sector schemes. All these schemes aim at fulfilling our
national commitment to attain the goal of Health for All by 2000 AD in accordance
with Alma-Ata Declaration of September 1978 to which India is also a signatory.
The Union Ministry of Health and Family Welfare comprises of the following:
z Department of Health
z Department of Family Welfare
z Department of Indian systems of Medicine and Homeopathy. 285
The executive machinery of the Government at the State level is headed by the
Governor. Article 163 of the Constitution provides for a council of Ministers with the
Chief Minister as its head to aid and advise the Governor. The business of the
government of the State is allocated by the Governor amongst the Ministers in
accordance with the provisions contained in Article 166(3) of the Constitution Each
district has been divided into two or more sub-revenue divisions. In each sub-division,
there is a Senior Medical officer who is overall in-charge and is responsible for
supervising the activities of all health and family welfare programmes in dispensaries
and Taluka Hospitals of the sub-division. He is assisted by Health Supervisors and
Health Education Officer The medical superintendent/SMO head the district hospital.
Each unit is under the charge of a senior specialist who is assisted by junior specialists
and general duty medical offices and almost works as independent units without even
essential knowledge linkages.
Generally the services are:
z Line services
z Staff services
z Auxiliary services
WHO defines Community Health Centre as Reference Health Centre. “The Reference
health centre differs from the generic health centre in that it is a functional concept
that can be realized by strengthening one or more health centres to improve referral
within the health system in rural areas. Primary Health care is the first level of contact
below the individual and the health system where essential health care is provided. A
majority of prevailing health complaints and problems can be satisfactorily dealt with
at this level. This level of care is closet to the people. This care is provided by the
primary health centres, with community participation Secondary health Care deals
with more complex problems. This comprises essentially curative services and is
provided by district hospitals, sub-divisional hospitals, area hospitals and CHCs. This
level serves as the first referral level in the health system as the patients are referred to
such medical institutes from the Primary Health Centre Tertiary health care offers
super specialist care. This care is provided by regional / central hospitals, teaching
hospitals and super specialty hospitals. This institutions provide not only highly
specialized care, but also planning and managerial skills and teaching for specialized
staff.

Try to verify the health care infrastructure in your place.
28.11 KEYWORDS
Department of Health: It deals with medical and public health matters including
drugs control and prevention of food adulteration.
Chief Medical Officer (CFO): This responsible for the administration of Medical and
Health services in the entire district and for the implementation of all the national
health and family welfare programmes.
Reference Health Centre: In addition to its generic health centre functions, it
provides essential surgical, maternity and medical care, as well as carrying out
preventive and promotive activities in the neighbourhood it serves.
Health Centres: Health centres, including reference health centres and hospitals, are
components of a health care system, each playing a different but complementary role.
286
Health Laws and Policies 28.12 QUESTIONS FOR DISCUSSION
1. Explain the organization structure of Ministry of Family Health and Welfare with
its function.
2. Explain the health infrastructure at State level and its function.
3. Explain the District Level Hospital Administration with its structure and its
function.
4. What are the indices used to measure the efficiency of hospitals?
5. Explain the Administration of health at community health centres.
6. Explain the PHC with its function.
7. What is village guide scheme? Explain.

1. At the district level there is a District Medical and Health Officer
(DMHO) or Chief Medical officer who is overall responsible for the
administration of Medical and Health services in the entire district.
Number of patient day during the year
2. Bed occupancy = u 100
Number of bed days during the year
3. Different Hospital services are:
Line services.
Staff services.
Auxiliary services

Goel, S.L., “Health Care Organisation and structure’, Deep & Deep Publications Pvt., Ltd.,
New Delhi.
287
LESSON Private and Voluntary Health
Organizations
29
PRIVATE AND VOLUNTARY HEALTH ORGANIZATIONS
CONTENTS
29.1 Introduction
29.2 Meaning and Definition
29.3 Functions of Voluntary Health Agencies
29.4 Contributions to PHC
29.5 Critical Appraisal of the Voluntary Health Agencies
29.6 Areas to give Greater Attention
29.7 Let us Sum up
29.9 Keyword

z Get an idea about voluntary health agencies
z Know about the functions of voluntary health agencies
29.1 INTRODUCTION
Voluntary action is the soul of democracy as this medium secures the active
involvement of the people from policy-making to implementation of social services.
It is the life and blood of democracy. Their programme covers a diverse range of
functions embracing human welfare in the field of health.
The work of voluntary organizations influence the functioning of total health care
administration is a country.
29.2 MEANING AND DEFINITION

A voluntary health agency may be defined as; “An Organization that is administered
by an autonomous board which holds meetings, collects funds for its support, chiefly
from private sources and expends money, whether with or without paid workers, in
conducting a programme directed primarily to furthering the public health be
providing health services or health education or by advancing research or legislation
for health, or by a combination of these activities”.
288
Health Laws and Policies 29.3 FUNCTIONS OF VOLUNTARY HEALTH AGENCIES
z Participation of beneficiaries.
z Creating a sense of responsibility through direct involvement.
z Rectification of planner’s misconception.
z Greater understanding and positive attitude among the beneficiaries.
z Effective policy formulation through interpretation of public opinion.
z Flexibility and experimentation.
z Initiative and leadership.
z Channel sing human resources.
z Advancing health legislation.
z Supplement the efforts of the Government.
z Helping in efficient programme implementation.
29.4 CONTRIBUTIONS TO PHC

1. Provides assistance to develop and strengthen the local NGOs capabilities.
2. Conducts reviews and assessment of existing health and development
programmes.
3. Develop innovative programmes placing PHC is the context of comprehensive
human development.
4. Ensure that existing programmes and new initiatives promote fall participation by
individuals and communities.
5. Expanding the training efforts to respond to need of PHC programmes.
6. Extend the efforts to develop locally sustainable and appropriate health
technologies and use of resources.
7. Contribute to the creation of new and effective methods of health education to
assume greater responsibility (both individuals and communities).
8. Recognize the essential role of women in health promotion.
9. Extend the capacity to work with poor, disadvantaged and remote populations,
enabling them to break the cycle of deprivation.
29.5 CRITICAL APPRAISAL OF THE VOLUNTARY

HEALTH AGENCIES
1. Lack of effective coloration among the voluntary agencies themselves,
Suggestions to improve the inter-agency relationships:
Representation at each other’s meetings on all appropriate occasions.
Early consultation when one organization felt that the other might be
interested or involved in an activity.
Creation of standing or ‘adhoc’ joint committees whenever circumstances
warrant.
Full and continuous personal contacts among be official of allied voluntary
agencies.
Housing all the offices at various levels in the same building.
Exchanging information on a regular basis. 289
Private and Voluntary Health
2. Governmental Interference. Organizations
3. Lack of Competence to Develop Integrated Area Plans.

4. Lack of Identity with the Programmes among the personnel of the Voluntary
Agencies.
5. Ornamental Membership of the Non-officials in the Governing Bodies.
6. Poor Linkages with the Beneficiaries.
7. Voluntary Agencies Not Action – Oriented.
8. Absence of Controlled and Regulated Growth.
9. Not Properly Equipped and Staffed.
10. Absence of Systems Mechanism to Coordinate the Functioning of Allied
Agencies in a geographical/Functional area.
11. Lack of interest among the Intellectual Elite.
12. Misappropriation and Improper Utilization of Funds.
13. Absence of Sound administrative set-up to deal with social work.
Check Your Progress
Define voluntary health agency.
……………………………………….…………………………………………
……………………………………….…………………………………………
29.6 AREAS TO GIVE GREATER ATTENTION

1. Voluntary organizations need to develop a reasonable personnel policy to attract
qualified and staff personnel implement their programmes.
2. They need to evaluate their programmes and performance as to improve the
quality of services.
3. They need to develop a sound accounting system, which not only meets their
demands but also the demands of the Government and the community.
4. Voluntary agencies should play an increasing supportive role to Government
programmes and complement the Government’s efforts.
5. Voluntary organizations at present are too much programme oriented; they should
develop a broader perspective of the field in which they are working.
6. There is a need for them to work in the area of social action and there by facilitate
social change.
7. The majority of voluntary agencies are concentrated in the urban areas and there
is an urgent need to expand their work in rural areas.
29.7 LET US SUM UP

A voluntary health agency may be defined as: An Organization that is administered by
an autonomous board which holds meetings, collects funds for its support, chiefly
from private sources and expends money, whether with or without paid workers, in
conducting a programme directed primarily to furthering the public health be
providing health services or health education or by advancing research or legislation
for health, or by a combination of these activities. Some of the functions of voluntary
health agencies are; Participation of beneficiaries; Creating a sense of responsibility
290 through direct involvement; Rectification of planner’s misconception; Greater
understanding and positive attitude among the beneficiaries; Effective policy
formulation through interpretation of public opinion; Flexibility and experimentation;
Initiative and leadership; Channel sing human resources etc., This lesson also
emphasized critical appraisal of the functioning of the voluntary health agencies.

Do you know any Health Care Agency in your city. If so, what are their function?
29.9 KEYWORD
Voluntary Health Agency: An Organization that is administered by an autonomous
board which holds meetings, collects funds for its support, chiefly from private
sources and expends money, whether with or without paid workers, in conducting a
programme directed primarily to furthering the public health be providing health
services or health education or by advancing research or legislation for health, or by a
combination of these activities.

1. Define voluntary health agencies. Explain the functions of health care agencies.
2. Explain the contributions to PHC by voluntary organizations.
3. Critically analyze the functioning of the voluntary health agencies.
4. In which areas voluntary agencies have to give greater attention?

A voluntary health agency may be defined as: “An Organization that is
administered by an autonomous board which holds meetings, collects funds
for its support, chiefly from private sources and expends money, whether with
or without paid workers, in conducting a programme directed primarily to
furthering the public health be providing health services or health education or
by advancing research or legislation for health, or by a combination of these
activities”.

LESSON UNIT IV 293
Indian and International
Voluntary Health Agencies
30
INDIAN AND INTERNATIONAL VOLUNTARY
HEALTH AGENCIES
CONTENTS
30.1 Introduction
30.2 Voluntary Health Agencies in India
30.2.1 Important Voluntary Agencies
30.3 Professional Bodies
30.4 International Agencies
30.5 Semi Official Organizations
30.7 Let us Sum up
30.9 Keywords

z Get an idea about voluntary health agencies
z Know the voluntary health agencies in India and international
30.1 INTRODUCTION
An organization that is administered by an autonomous board which holds meetings,
collects funds for its support, chiefly from private sources and expends money,
whether with or without paid workers, in conducting a programme directed primarily
to furthering the public health be providing health services or health education or by
advancing research or legislation for health, or by a combination of these activities are
known as voluntary health agencies. Many voluntary organizations at national level
are linked with international federations or associations. There are many which though
not involved directly in health care administration, as human development cannot be
fragmented.
30.2 VOLUNTARY HEALTH AGENCIES IN INDIA

z In India, voluntary action by individuals, communities and organizations has
existed from ancient days.
z India being a big country, only governmental effort alone may not be able to meet
the health needs of its large population and hence involvement of voluntary
organization is not only welcomed but also essential and describable.
294 30.2.1 Important Voluntary Agencies
Some of the important voluntary agencies engaged in the fields of health care
administration are:
z The Indian Red Cross Society: Established in 1920 and works in co-operation
with national and international agencies. The headquarters of the society is in
New Delhi and branches in the states and union territories.
z Tuberculosis Association of India: Formed in 1939 and coordinates in
standardizing the methods, promoting consultation and conferences, stats model
institutions, trains TB workers etc.
z The Hind Kusht Nivaran Sangh: Founded in 1950 and renders assistance to
various leprosy homes and clinics.
z Indian Council For Child Welfare: Established in 1952 and is affiliated to
International Union for Child Welfare. It is to develop the children, physically,
mentally, morally, spatially and socially in a healthy and normal manner.
z The Acc-India Blind Relief Society: Established in 1946 to coordinate the
activities of different organization for the blind.
z Family Planning Association of India: Established in 1949, that provides
supports to the Family Welfare Planning Programme of the Government of India.
30.3 PROFESSIONAL BODIES

Professional organizations includes:
z IMA – Indian Medical Association
z Indian Public Health Association
z Trained Nurses Association of India
z All India Dental Association
Making substantial contribution to the health programmes of the country.
30.4 INTERNATIONAL AGENCIES

It includes:
z Rockefeller Foundation
z Ford Foundation
30.5 SEMI OFFICIAL ORGANIZATIONS

z Medical Council of India.
z Indian Nursing Council.
z Dental Council of India.
z The Central Social Welfare Board.
Check Your Progress
1. Name some professional bodies in India.
…………………………………..………………………………………….
…………………………………..………………………………………….
2. List out the semi official organizations.
…………………………………..………………………………………….
…………………………………..………………………………………….
295
30.7 LET US SUM UP Indian and International
India being a big country, only governmental effort alone may not be able to meet the
health needs of its large population and hence involvement of voluntary organization
is not only welcomed but also essential and describable some of the important
voluntary agencies in India are : the Indian red cross society, tuberculosis association
of India.
The hind kusht nivaran sangh, Indian council for child welfare, the acc-India blind
relief society, family planning association of India etc., international agencies
includes, Rockefeller foundation, Ford foundation etc.

Is there any other professional bodies comes under voluntary health care agencies?
Verify.
30.9 KEYWORDS
Indian Red Cross Society: Established in 1920 and works in co-operation with
national and international agencies.
Hind Kusht Nivaran Sangh: Founded in 1950 and renders assistance to various
leprosy homes and clinics.
Family Planning Association of India: Established in 1949, that provides supports to
the Family Welfare Planning Programme of the Government of India.

Explain the voluntary health agencies in India.

1. Professional organizations includes:
IMA – Indian Medical Association.
Indian Public Health Association
Trained Nurses Association of India
All India Dental Association
2. Semi official organizations are:
Medical Council of India.
Indian Nursing Council.
Dental Council of India.
The Central Social Welfare Board.

296
31
VOLUNTARY HEALTH AGENCIES IN INDIA
CONTENTS
31.1 Introduction
31.2 Indian Red Cross Society
31.3 Bharat Sevak Samaj
31.3.1 Objectives
31.3.2 Aim
31.3.3 Membership
31.3.4 Functions
31.3.5 Achievement
31.3.6 Activities
31.3.7 Problems
31.3.8 Future Programme
31.4 Central Social Welfare Board
31.4.1 General Body
31.4.2 Executive Committee
31.4.3 Programmes of the Board
31.5 Indian Council for Child Welfare
31.5.1 Guiding Values and Principles
31.5.2 ICCW Mission
31.5.3 ICC-TN Programmes
31.6 Family Planning Association of India
31.6.1 Vision
31.6.2 Mission
31.6.3 What We are and What We do?
31.6.4 FPA India is Contributing Towards
31.6.5 Activities
31.6.6 Branches Manager
31.6.7 Supported By
31.6.8 Capacity Building
31.6.9 Medical Training Courses
31.6.10 Specialized Training Programmes
31.6.11 Developing and Implementing Need based Reproductive and Child
Health Interventions and Programmes
31.6.12 Influencing Government Policies
31.6.13 FPA India Services
Contd….
31.7 National Tuberculosis Control Programme 297
31.7.1 Directly Observe Treatment, Short-Course (DOTS) in India
31.7.2 DOTS is a Systematic Strategy having Five Components

31.7.3 Extent of the Programme
31.7.4 Objectives of the Programme
31.7.5 Essentials of RNTCP
31.7.6 Suggestions for the Success of the Programme
31.8 National Programme for Control of Blindness
31.8.1 Need for the Programme
31.8.2 Magnitude of the Problem of Blindness
31.8.4 Strategy
31.8.5 Infrastructure Development
31.8.6 District Blindness Control Societies
31.8.7 Issues and Problems
31.8.8 Suggestions
31.8.9 Programme Priorities during 9th Plan
31.9 All India Women’s Conference (AIWC)
31.9.1 About
31.9.2 At the International Level, AIWC has
31.9.3 Important Issues Addressed by AIWC over the Years are
31.9.4 Issues through Various Activities and Programmes
31.9.5 Activities
31.9.6 Platinum Jubilee Celebration
31.10 Hind Kusht Nivaran Sangh
31.10.1 Objectives
31.10.2 How we have Fulfilled these Objectives
31.11 Let us Sum up
31.13 Keywords

z Know about various voluntary health agencies in India
z Get an idea about the different voluntary health agencies activities
z Understand their origination and the executive members
298
Health Laws and Policies 31.1 INTRODUCTION
Many voluntary organizations are functioning at national level. There are directly and
indirectly involved in health care administration, for the human development in our
nation.
31.2 INDIAN RED CROSS SOCIETY

Since its inception in 1920, Indian Red Cross Society has been doing commendable
work towards alleviation of human suffering. The Indian Red Cross Society is a
national federation of over 650 branches spread throughout the country, at State/
Union Territory, Regional, District and Sub-Division levels. The Indian Red Cross
Branches, through volunteers and field workers provide a disciplined and organised
network of humanitarian service throughout the country. It contributes towards the
creation of a better society where the vulnerable people and communities can lead a
life of social and economic security and human dignity. The primary activities of the
Indian Red Cross Society are – Disaster Relief, Promotion of Voluntary Blood
Donation and Collection of Blood for Transfusion, Hospital Services, Maternity &
Child and Junior Red Cross. Some of the Indian Red Cross Service Institutions being
run by the Society through its branches are as under:
z Health & Medical Services: Mobile Medical Units 33, Static Medical Unit 94,
General Hospitals 2, T.B. Hospital 2, Poly Clinic 15.
z Services for the Children: Children’s Home 11, Crèches & Nursery Schools 115,
Home for the Healthy Children of Leprosy patients 1.
z Maternity & Child Welfare: Maternity Hospital/Home 35, Maternity Centers &
Sub-centers 338.
z Services for Servicemen: Home for the Disabled 1, Maintenance of Diversional
Therapy, library and other welfare & recreational facilities in the service hospitals
48.
z Blood Donation Services: Blood Banks 75, Motivation, Education & Information
Centers 135.
z General Welfare Services: Dormitories for attendants of the hospitalized patients
7, Drug Stores 57, Mobile Libraries 2.
z Service for the Handicapped: Hospital Home for the Disabled 2, Physiotherapy
and Vocational Training Centers 12, Centers/Schools for mentally handicapped
and for deaf 4, Home Schools & Workshops for the Visually Handicapped 9.
z Socio Economic Services for Women: Craft/Vocational Training Centres 54,
Working Women’s Hostel 9, Senior Citizen’s Homes 6.
z Disaster Preparedness Services: Warehouses 25, Training Institute for Disaster
Management 1, Static & Mobile Dispensaries 32 (included under health services),
Cyclone Shelters 227.
Providing immediate relief to the victims of disaster such as flood, cyclone,
earthquake, drought, epidemic etc, is one of the important activities of the Indian Red
Cross Society. During the period under review the society rendered such relief
services in support of nearly half a million beneficiaries and distributed relief
materials to the victims in the States of Assam, Bihar, Punjab, Uttar Pradesh and West
Bengal. This was over and above the relief distributed by the local branches from their
own resources.
In June 1998, a powerful cyclone hit coastal Gujarat affecting the people and property
in the coastal districts. Red Cross relief teams with relief items rushed to the
devastated area and provided assistance to the people affected by the catastrophe.
Soup kitchens were run and food grain & vegetables were supplied for a period of
three weeks. Five thousand most vulnerable families received a kit of essential items 299
so that they could start their life again. in India
The Society provides items of general amenity like toiletry, bedspreads, table cloths,
items of indoor games, library services and musical instruments to the inmates of
Armed Forces Hospital. Diversional Therapy stores are also provided to big hospitals
where Red Cross Welfare Officers are attached. During the year, the Society provided
general amenity stores worth Rs. 2.50 lakh, DT Stores Rs. 1 lakh and library services
worth Rs. 1.5 lakh.
Permanently disabled ex-serviceman numbering 11 are being looked after at the
Bangalore Home for disabled ex-personnel of the Society. Sick and ailing ex-service
personnel suffering from tuberculosis, leprosy and other serious disorders are
provided grants to take care of their disease. During this year, 75 old and new patients
received assistance. The society also provided grants-in-aid to a British ex-service
personnel residing in India.
A rehabilitation programme started in 1997 for leprosy patients in Orissa is running
successfully. Many patients are getting vocational training along with regular medical
care at the center.
In the gas-affected areas of Bhopal in the State of Madhya Pradesh, mild distribution
programme has been strengthened. Distribution of milk has been completed and some
medical and welfare activities have been started.
In the gas affected, areas of Bhopal in the State of Madhya Pradesh, milk distribution
programme has been strengthened. Distribution of milk has been continuing
satisfactorily.
Between April and November 1998, five workshops on Disaster Management have
been organised at regional level to familiarize Red Cross workers with the subject.
There are plans to hold many more workshops during the next year for the benefit of
the Red Cross Workers.
Between 1st January to 12th November 1998, a total of 43,001 units of blood were
collected from voluntary and replacement donors. Fresh blood along with blood
products were issued to the hospitals and patients by the blood bank situated at the
national headquarters. The Society held 225 blood camps during this period.
31.3 BHARAT SEVAK SAMAJ

BHARAT SEVAK SAMAJ is a Non-political, Non-official and an All India
Voluntary Organization. Late Pt. Jawaharlal Nehru, the First Prime Minister of India,
founded the Samaj on 12th August 1952 to mobilize people’s participation and
cooperation in national developmental activities as well as moral regeneration of the
people for all round prosperity. Shri Gulzari Lal Nanda, the Former Union Home
Minister was the main architect of this great organization.
They were assisted by a team of eminent social leaders. Presently, a veteran freedom
fighter and eminent social and political leader Shri Ram Niwas Mirdha is the Present
and Swami Harinarayan Nanda is the Chairman of central Bharat Sewak Samaj.
The Samaj has given a new direction to the countrymen for Shramdan (Voluntary
labour) and was able to utilize the voluntary services of millions of people including
students, young men and women for large-scale execution of developmental activities
in rural areas.
31.3.1 Objectives
z Find and develop avenues of voluntary service for the citizens of India.
z Promote national sufficiency and build up the economic strength of the country.
300 z Promote the social well being of the community and to mitigate hardship of its
less favored sections.
z Draw out the available unused time, energy and other resources of the people, and
direct them into various fields of social and economic activity.
z Take all steps which are necessary for the fulfillment of the aforesaid objects.
31.3.2 Aim
The Samaj primarily aimed at people’s participation and cooperation in National
Developmental activities both in social and economic sphere as well as moral
regeneration of the people for all round prosperity. It has been inspired by the ideal of
true service to the needy people without transcending the man-made barriers and keen
to relieve distress and come to the help of suffering mankind whether such sufferings
are due to man made calamities or the result of natural disaster.
The aim is also to fight against the forces of corruption in public life, communalism
and to organize welfare activities in sensitive areas with focus to help weaker section
of the society especially children and women. Pradesh Branches were set up all over
the country.
First State BSS Unit

Delhi Pradesh BSS has the distinct honor of being the first state unit to open in 1952
with Smt. Indira Gandhi as its Chairperson. Bharat Sewak Samaj, Delhi Pradesh, has
always been in the forefront in the matters of social welfare work, ever since its
inception.
The founder president and founder chairman had already laid before the Samaj a
program to identify and develop avenues of voluntary service for the citizens of India,
in order to promote national sufficiency and promote economic stability and social
well being of the people of the country. The Samaj has been trying its best for the last
about fifty years to keep marching on the path thus indicated.
For the purpose of organizing welfare activities better functioning Delhi Pradesh has
been divided into seven zones with zonal chairman as their head. These zones have
further been divided into districts, each district Chairman, who is assisted by an
Administrative Committee, constituted from amongst the local active workers of the
Samaj.
In spite of acute financial difficulties, which BSS Delhi Pradesh has been facing for
quite a number of years its endeavor in the field of service to the poor and under
privileged people living in various parts of the capital, continue unabated.
31.3.3 Membership
Any person who attains the age of 18 years, signs membership pledge and offers to
devote at least two hours a week voluntarily to the activities of the Samaj and pays an
annual membership fee can enroll himself as a member of the Bharat Sewak Samaj.
Active member has to devote at least four hours a week for any specified item(s) of
program. The BSS also enrolls helpers who promise to give financial assistance to
BSS and believe in its aim and objectives.
31.3.4 Functions
z Children’s Day: November 14th has a special significance for our educational
centers. A common function is held at which the children and teachers of al
centers assemble and present cultural programs, the central theme of which is
national integration. The day coinciding as it does with the birthday of Chacha
Nehru reminds us all of the high ideals, which the great leader had put before us
and for which he worked all his life.
z Nutritional Services Program: Samaj had also opened four centers under the
Nutritional Service Program aided by the Delhi social welfare Advisory board. At
these centers milk, bread and other nutritive food is distributed among needy 301
children who cannot afford a balanced diet. About 500 children were served daily in India
at these centers.
The centers have since been closed for stoppage of supply by the Government:
z Education Centers: Trained nursery teachers manage the balwaris and balwari-
cum-primary schools of the Samaj and some have even trained graduates. Due to
paucity of funds the Samaj cannot afford to pay the teachers and other members of
the staff adequately, but that has not dampened the spirit of service and devotion
of the workers. As a result, the quality of instruction imparted to children at these
centers compares very well with other schools, which have ample funds at their
disposal. Our schools give due attention to cultural and extra curriculum activities
also. The above mentioned welfare centers are located in Delhi Gate, Nabikarim
(Paharganj), Manakpura, North Avenue, Nauroji Nagar, Sarojini Nagar and
Seelampur.
z Women Crafts Centers: The Women crafts centers of the Samaj impart training in
sewing, cutting, stitching and needle work, thus enabling the trainees, who are
housewives, or would-be-brides, to be efficient in their role and augment their
family income or effect saving on stitching of family garments. The Samaj intends
to convert these training centers into training-cum-production centers so hat order
work may be secured for the trained ladies of the area. But the implementation of
this proposal has to wait till the Samaj is out of financial difficulties it is presently
confronted with.
z Night Shelters or Rain Baseras: BSS had five night shelters, Apna Ghar, or Rain
Baseras as they are popularly known and were located in Delhi gate, Nabikarim,
Paharganj, Shadipur, Motinagar, Manakpura, North Avenue, Panchkuian Road
and Nauroji Nagar. These have been closed since government and local bodies
have opened night shelters and BSS has constraints of fund.
z Legal Aid and Advice Bureau: The legal aid and advice bureau of Bharat Sewak
Samaj has rendered yeomen service to the poor and needy litigants. The bureau
has been able to do its little it by preventing eviction of slum dwellers, securing
compensation awards in accident cases, getting reinstatement of discharged
workmen, getting relief to the windows and destitute women, legal separation and
or restitution of conjugal right and defending divorce proceedings, applications
for the grant of succession certificates. So far about 4000 persons have sought its
help in their various legal problems.
31.3.5 Achievement
Delhi Pradesh has many achievements to its credit under the inspiring leadership of
Bhai Ji, Kumari Surendar Saini, and present Chairman of Pradesh.
Many of its projects were innovative for example pioneering work in the field of
improvement of slums (Gandi Basti) located in walled city, Rain Baseras (Night
Shelter) for pavement dwellers. Legal Aid for weaker section, Yoga Asan Classes,
technical education for boys and girls. Adult Education Classes Balwaris Creches
Women Welfare and Craft Centers. Relief and assistance to victims of floods,
earthquakes and other natural calamities. Form time to time Youth Camps attended by
a large number of College-School students and others who through Shramdan made
significant contribution in the construction of Marjina Yamunal Bund. During Chinese
aggression and war with Pakistan Canteens for Army Jawans were opened at the
Railway Station, New Delhi, Milk distribution Centers with the help of CARE, was
opened in Labor Camps of undernourished children and expectant mothers. Water
taps as well as water hydrants were also installed in these camps.
302 31.3.6 Activities
BSS established the following welfare centers in its units at various parts of India-
Nursery School and Bal Kendra or Pre-primary/Primary School, Women Craft
Centers, Condensed course classes of education for girls, Adult Education-Classes,
Legal Aid & Advice, Relief & Aid, Family Counselling Centre, Creches, General
awareness for education and national integration.
In addition to aforesaid regular activities the Pradesh have been organizing family
welfare camps, prohibition camps sponsored by prohibition Council, study
programmes of high-risk families sponsored by ICMR and also holding corner
meetings, Seminars to give well publicity to the Govt. welfare programmes. Legal
literacy training camps are organized.
31.3.7 Problems
The Financial Constraints is holding expansion of activities, strengthening of existing
programme and improvement of service condition of the centers, offices and the staff.
So we earnestly appeal to generous people, civic authorities and the government for
adequate financial assistance to give a push to out social welfare programmes for the
benefit of weaker sections of the society as well as poor, needy, sick and the aged.
Donation to BSS Delhi Pradesh are exempted under (80G) of Income-tax Act, 1961.
31.3.8 Future Programme

The Samaj is planning to start more Adult Education classes in labour / Jhuggi-Jhopri
Camps, activate free-Legal Aid and Family Counseling Bureaus and also to work for
National Integration promotion of Communal Harmony and to fight against the forces
of corruption in public life by holding frequent corner meetings besides helping the
people in distress.
31.4 CENTRAL SOCIAL WELFARE BOARD

Central Social Welfare Board (CSWB) was conceived as an institution to be
instrumental in bringing the neglected, weak, handicapped and backward sections of
society into the national mainstream. Established in August 1953, the Board initiated
several programmes of delivering welfare services to the most backward,
marginalized and deserving sections of society. As a follow up, the State Social
Welfare Advisory Boards were set up with the task of implementing and monitoring
of different programmes but has also moved in policy approach form welfare to
development to empowerment. Today it is the pioneering national level organization
in the field of development and empowerment of women in the country.
The CSWB was also envisaged as an interface between the Government and the
voluntary sector for social development in the country. It has made a signal
contribution in encouraging, assisting and promoting the growth of nearly twenty five
thousand voluntary organizations for reaching the neglected women and children of
the country.
31.4.1 General Body

z All chairpersons of State Social Welfare Advisory Boards (30).
z Representatives from the Parliament: Lok Sabha 2 & Rajya Sabha 1.
z 5 Professionals (one each from Law, Medicine, Social Work, Education and
Social Development).
z 3 Eminent persons with extensive experience in social work.
z Representatives form Ministries / Departments / Govt. of India Department of 303
Women & Child Development, Department of Rural Development, Department of in India
Education, Planning Commission, Ministry of Labour, Ministry of Social Justice
and Empowerment, Department of Family Welfare.
z Executive Director, CSWB.
31.4.2 Executive Committee

z Chairpersons of State Social Welfare Advisory Boards: 5 by rotation.
z Representatives form Ministries / Departments of the Govt. of India Department
of Women & Alleviation, Dept. of Education and Ministry of Social Justice &
Empowerment.
z Two professionals.
z Executive Director, CSWB.
31.4.3 Programmes of the Board

The Board is running a number of programmes for the development of women and
children. All these programmes are fully funded by the Department.
Awareness Generation Programme for Rural and Poor Women

The scheme of Awareness Generation Programme provides a platform for the rural
and poor women to come together, exchange their experience, ideas and in the
process.
Develop an understanding of reality and also they way to tackle their problems and
fulfill their needs. The programme also enables women to organize themselves and
strengthen their participation in decision making in the family and in the society and
to deal with social issues including atrocities on women and children.
Condensed Courses of Education for Women

The Scheme of Condensed Course of Education for Women were started by the
Central Social Welfare Board during the year 1958 with the objective of providing
education to those women who for various social and economic reasons dropped out
for school and could not pursue their studies. The scheme was designed particularly to
benefit women like young widow, women deserted by their husbands and those
belonging to economically backward classes.
Under this Scheme, grant is given to Voluntary Organizations to conduct two types of
courses, one of two years duration for preparing women candidates for Primary /
Middle/Matric Examination and the other of one year duration for Matric failed
candidates. Girls and women of 15 years plus age groups are entitled to avail the
benefit of the scheme.
Vocational Training for Women

The Central Social Welfare Board had started the scheme of Vocational Training
Programme during the year 1975 to train women in the trades which are marketable
and also to upgrade their skills in order to meet the demands of changing work
environment. Main objective of training interventions is to enable and empower
women to access remunerative employment opportunities, which will instill self-
confidence and enhance their self-esteem.
From the year 1997-98, funds for Vocational Training are being provided under
NORAD assisted scheme on Training and Employment of Women. The main
emphasis of the programme is training and skill up gradation of women for their
employment and self-employment on a sustainable basis. In view of a similar
304 programme implemented by the Department through the Women Development
Corporations of the States, CSWB concentrates mainly on the seven North Eastern
States and Sikkim from where adequate number of proposals are not received through
the State Governments. The network of State Social Welfare Advisory Boards and the
voluntary organizations provide very useful support for running this programme.
Socio-Economic Programme
The Socio-Economic Programme of the Central Social Welfare Board endeavours to
provide employment opportunities on full or part time basis to destitute women,
widows, deserted and the physically handicapped, to supplement their meager family
income. Besides, women entrepreneurs are encouraged to exhibit and sell their
products through Exhibition-cum-Melas organised by State Boards at Distt. Level.
The Central Social Welfare has two different types of schemes of assistance under this
Programme.
Agro-based Units
The Board assists voluntary organizations for setting up agro-based units like dairy,
poultry, piggery, goatery etc. For poor and needy women. However, for the past few
years proposals for Agro-based Units are not being considered since another
Programme of the Department of Women and Child Development, namely Support
for Training and Employment of Women (STEP) is taking care of these sectors.
Production Units
Voluntary organizations are encouraged to set up Production Units, which can provide
employment on full or part time basis to women. Project proposals are examined by
District Industrial Centres, KVICs etc. Who look into viability of the projects. A grant
is provided by the Board to facilitate setting up a Production Unit by the
grantee institution. The grant is finalized on a case-to-case basis subject to a limit of
Rs. 3 lakhs.
Creche Programme
This programme has been in operation since 1975 the scheme provides for day care
services to children in the age group of 0 - 5 years. The facilities are provided to the
children of workingwomen belonging to economically backward sections of casual,
agricultural and construction labour in remote, rural and urban slum areas. Children of
sick women also get the benefit of this programme. The schematic provision for
recurring grant is Rs.18,480/- per annum per Creche Unit of 25 children of the age
group of 0-5 years.
Working Women’s Hostels

Under this scheme the Board provides a maintenance grant to voluntary organizations
for providing safe accommodation to workingwomen whose salary does not exceed
Rs.16,000/- p.m. so that they are not exposed to undesirable and anti-social elements.
The following types of maintenance expenses are covered under the scheme:
1. Salary of Matron and Chowkidar,
2. Recreation facilities,
3. Difference of Rent of the Hostel Building, and
4. Maintenance of Hostel building,
A minimum grant of Rs. 40,000/- and maximum grant of Rs. 50, 000/- is sanctioned to
an institution in a year keeping in view the class or category of the city.
Family Counselling Centres 305
The objective of the Family Counseling Centres is to provide preventive and in India
rehabilitative services to women and children who are victims of atrocities and family
maladjustments. The Scheme is being implemented since 1984 through voluntary
agencies. It was evaluated through NIPCCD during the year 1990-91 and a revised
scheme is in force since 1992-93. Under the revised scheme, a maximum of Rs.1 lakh
per center per annum is given for continuation of existing FCCs while Rs.1.15 lakh is
given for new FCCs. The salaries of two counselors who are either Post Graduate in
Social Work or Psychology and Rs.15000/- for recurring items are borne fully the
board while the institution is required to contribute 20 % towards other recurring
expenditure.
Short Stay Home Programme

The scheme of Short Stay Home was launched by the Govt. of India in 1969 to
provide temporary shelter to women and girls:
z Promotion of in-country adoption and advocacy of adoption as a rehabilitation
measure for destitute and abandoned children.
z Recreational programmes including holiday camps, cultural programmes like folk
art and dances, competitions, etc. for children at out centers.
Children’s Disaster Relief Fund

Indian Council for Child Welfare has set up a CHILDREN’S DISASTER RELIEF
FUND to help children affected by the disaster. It has four phases such as:
z Phase I: Immediate Relief of clothes, medicines, bedding, cooking vessels and
basic needs is being distributed.
z Phase II: The Children’s Relief Fund will be using Rs.1000/- (US $ 22 approx) to
buy sets of uniform, Scholl books, bag and other requisites per child to get them
back to school.
z Phase III: Sponsorship assistance of Rs.4000/- per child per year will be given to
children who have lost a parent or wage earner of whose family is incapacitated in
some way due to calamity.
z Phase IV: The Government is setting up temporary children’s homes in each of
the Districts (Three) to care for total orphans.
Central Advisory Board on Child Labour

The Central Advisory Board on Child Labour was constituted on March 4, 1981. the
following are the terms of reference of the Board:
z Review the implementation of the existing legislation administered by the Central
Government.
z Suggest legislative measures as well as welfare measures for the welfare or
working children.
z Review the progress of welfare measures for working children.
z Recommend the industries and areas where there must be a progressive
elimination of child labour.
31.5 INDIAN COUNCIL FOR CHILD WELFARE

The Indian Council for Child Welfare, Tamil Nadu (ICCW, TN) is a non-profit, non-
governmental organization committed to the cause of deprived, neglected and
exploited children.
306 The ICCW, TN was started in 1953 in the state of Tamil Nadu in South India and is
affiliated to the Indian Council for Child Welfare (National), New Delhi. It has a
branch in each District of the State of Tamil Nadu. The Council is registered as a
voluntary organization under the Societies Registration Act.
Each District has District Council for Chile Welfare with the Collector as Chairman
and Non-official and Official members.
It has various programmes in the districts such as crèches for children of
workingwomen, Programmes for Child Labour, Prevention of Female Infanticide and
Girl Child Development Pogrammes etc.
31.5.1 Guiding Values and Principles

The UN Convention of the Rights of the Child (UN CRC) provides a guiding
framework and it emphasis on:
z A need for a holistic development of children.
z Interests and rights should be considered and given priority in policy planning
both by Federal and State Governments and that the ICCW, TN has a role in
protecting the interests of child.
z Harmonious development of his/her personality can best take place in a family
environment.
z That education is the fundamental right of every child.
z That the Girl child needs special attention to ensure her rights to Survival,
Development and Protection.
z That we need to work at the macro-level to influence policy, change social
attitudes and network with appropriate authorities, media, NGOs, the public and
children themselves.
31.5.2 ICCW Mission

z To ensure the basic human rights to survival, physical, mental and social
development.
z To protect the child against neglect, abuse and exploitation.
z Betterment of families and communities to enhance the quality of life for children.
z To undertake aid directly or through District Councils of Institutional Members
and initiate schemes for enhancement of Child Welfare / Development in
Tamilnadu.
z Dissemination of Information and education of public on Child Welfare /
Development on a scientific basis.
z Enactment of legislation-related matters concerning children and their welfare and
implementation of the same.
31.5.3 ICC-TN Programmes

1. Developmental Programmes
Mother and Child Welfare Project-Usilampatti
Street and working Children
Project for Prevention of Child Beggary
School Enrichment Programmes
Transit Schools
2. Residential Care Programmes: Residential rehabilitation and educational 307
facilities for children affected by polio from remote villages of Tamil Nadu. in India
3. Training Programmes: The Council lays great importance on the training of
grass – root level child-care workers. The training programmes run by ICC-TN
are:
Child Care Workers Training
Middle Level Tanning Center
Non-Institutional Programmes
The projects undertaken include:
1. 110 day care centers for the children of working mothers, situated in urban slums
and also in remote villages.
2. Financial assistance to handicapped as well as academically bright children from
the below the poverty line to meet their educational and vocational training needs.
3. Counselling, guidance and referral services for handicapped children and their
parents.
4. Supplementary schools, where children – especially first generation learners – are
given free tuitions.
31.6 FAMILY PLANNING ASSOCIATION OF INDIA

31.6.1 Vision
FPA India envisions health, particularly sexual and reproductive health for all,
especially marginalized young people, in the broad context of sustainable
development leading towards the alleviation of poverty, stabilization of population,
gender equality, and human rights.
31.6.2 Mission
FPA India strengthens a voluntary and non-government commitment to promote
sexual and reproductive health and rights including family planning. It supports the
rights of individuals to reproductive choices, include legal and safe abortion; works
towards reducing the spread and the impact of STIs / HIV / AIDS and increasing
access to gender sensitive SRH information, education and services to all especially
the young and marginalized eliminating violence, discrimination, and abuse.
31.6.3 What We are and What We do?

Established in 1949, FPA India has been recognized as India’s leading and largest
reproductive and sexual he organization. It provides information on sexually
education and family life and wide range of services in sex and reproductive health
including family planning, bringing health and happiness to millions.
FPA India works closely with NGOs and the Government.
31.6.4 FPA India is Contributing Towards

z Population Stabilization
z Prevention of Unsafe Abortion and Sex Selective Abortions
z Reduction in Infant Mortality Rate
z Reduction in Maternal Mortality Rate
z Reduction in Reproductive Morbidity of Men and Women
308 z Reduction in Sexually Transmitted Infections including HIV
z Gender Equity and Gender Equality
z Meeting the SRH Needs of Youth.
31.6.5 Activities
FPA India works through 40 Branches and special projects spread across the country
assisted by national/international funding.
Strategic Plan (2005-2009)-5 Action Areas: 5 A’s

I. Access
Situation
Men and women have low sexual reproductive health status.
There are huge geographical, socio-cultural and religious diversities.
There is a need to meet the special needs of groups such as persons living
with disabilities, persons living HIV / AIDS, persons with sexual
orientation.
Goal: All people particularly the poor, marginalized, the socially excluded
and underserved are able to exercise that rights, to make free and informed
choices about their sexual and reproductive health, and have access to SRH
information, sexuality education and high quality services including family
planning.
Strategic Direciton: By removing socio-cultural barriers and promoting
people’s participation and services to marginalize and poverty affected
population.
Objective
To empower 50% of marginalized and poverty stricken women.
To improve access of 30% marginalized and poverty effected population
to high quality SRH information services using rights based approach.
Major Activities
Implementing need based sexual and reproductive health care.
Developing and implementing behaviour change communication
strategies.
Providing sexual and reproductive health care through clinical and non-
clinical outlets.
Maintaining essential standards and adopting quality of care approach.
Involving men in women’s health care.
Addressing men’s reproductive health concerns.
Addressing women’s concerns – gender based violence, increasing self-
esteem through skills development income generating activities.
Increasing the perception of the value of the girl child.
II. Advocacy
Situation
The global agenda with the MDGs dissipated the ICPD agenda.
Population stabilization is still a distant cry.
Recession, global gag rule, change in donor perspective – led to reduced 309
funding in India
0.6% spent on health of country’s budget in spite of high demand.
Intrusion of the rights based approach with introduction of two-child
norm among legislators.
Goal: Strong public, political and financial commitment and support from
sexual and reproductive health and rights national and international levels.
Strategic Direction: By associating communities and policy makers for
promoting SRH&R and enlist their support for resource generation.
Objective: To achieve greater public support for government commitment and
accountability for SRH.
Major Activities
Developing networks at the grassroots level with NGOs/CBOs
Establishing partnerships with government functionaries at the Panchayat,
District, State and National level.
Establishing strategic partnerships with NGOs, research agencies, donor
agencies and other institutions.
Involving the media for advocating sexual and reproductive health and
rights.
Publishing information material on sexual and reproductive health and
rights for mobilizing public support.
Influencing decision making at policy level for inclusion of sexual and
reproductive health and rights in a areas of development.
III. Adolescents
Situation
Highly vulnerable group
Lack of knowledge and understanding of SRH
Not empowered group
Early marriage and childbirth – related complications
High instances of gender based violence and sexual abuse
Half of young girls suffer from RH problems
About half of all HIV infections occur among them.
Goal: All adolescents and young people are aware of their sexual and
reproductive rights, are empowered to make informed choices and decisions
regarding SRH; and are able to act on them.
Strategic Direction: By building partnerships with municipal and government
schools to provide SRH education and services to going adolescents (10-16
years).
Major Activities
Providing age-linked critical information on human sexuality,
relationships etc.
Building the capacity of adolescents to provide sexuality education to
their peers and to provide basic counseling.
310 Encouraging adolescents to participate at decision-making levels for
providing adolescent friendly informatics and services.
Developing culture-sensitive human sexuality curricula for
implementation at schools.
IV. AIDS
Situation
5.1 million persons infected with HIV.

0.9 population of India
Increase in incidence among women & young people
In high prevalence states
Over 1% among antenatal women-adds to PTC transmission
5% in STD clinics
Gender roles, inequities and power relations-increases vulnerability of
women and girls.
Denial, stigma and discrimination still very high.
Goal: Reduction in the incidence of HIV / AIDS and the full protection of the
rights of people infected and affected by HIV / AIDS.
Strategic Direction: By integrating gender sensitive programmes for
HIV/AIDS prevention and management with on going SRH including FP
services, in high prone areas served by the MA.
Objective
To increase access to interventions for the prevention of sexually
transmitted infection STIs/ HIV/AIDS integrate SRH & FP programs
50% service delivery points.
To reach out to 50% of population in HIV prone areas to reduce social,
religious, cultural, economic, leg political barriers that make people
vulnerable to HIV / AIDS.
Major Activities
Upgrading clinics to provide STI management and voluntary counseling
and testing.
Promoting condom use for dual purpose
Providing antenatal care services with voluntary counseling and testing
services
Empowering women to negotiate safe sex.
V. Abortion
Situation
Lack of information on legal status of abortion.
Socio-cultural barriers and provider bias.
High incidence of sex selective abortions.
High number of illegal abortions leading to morbidity and mortality.
Unmet need for FP leading to abortions.
Lack of facilities for legal and safe abortion
Dependency on medical methods. 311
Goal: A universal recognition of a woman’s right to choose and have access in India
to safe abortion, and a reduction in the incidence of unsafe abortion.
Strategic Direction: By lobbying and advocating for a women’s right to safe
abortion, forging partnership with the government an upgrading facilities in
the SDPs for prevention of unsafe as well as sex selective abortions.
Major Activities
Promoting the right to choose safe abortion.
Generating awareness on prevention of abortion and the implications of
unsafe abortions
Generating awareness on the implications of sex selective abortions
Effecting the enforcement of the PC/PNDY Act.
Promoting newer methods of abortion such as MVA and medical
abortion.
Supporting Strategies
Leadership & Governance
To invoke the commitment of voluntary leadership to mobilize public,
political and financial support SRHR a provide good governance.
31.6.6 Branches Manager

z 37 Reproductive Health and Family Planning Centres
z 24 Urban Family Welfare Centres
z 15 Outreach Service Units
z 25 Sexuality Education, Counselling, Research, Training / Therapy Centres
31.6.7 Supported By
z 2,019 Community Based Distributors
z 2,266 Local Voluntary Groups
z 3,000 Peer educators
z 41,225 Grass-root level volunteers
z Serves over 7,00,000 clients
31.6.8 Capacity Building

Provides training in the area of SRH medical care, counseling skills, and sexuality
education to:
z Medical / Paramedical persons
z Teacher / Educators
z NGOs
z Youth leaders/ Community leaders
z Grassroots workers/Community
z Health workers
z Field workers
z Dais
312 z Practitioners of Indian Systems of Medicine and Homeopathy.
FPA India started providing training to health care providers are early as 1952 in the
sphere of family planning services including sterilization, training doctors both from
the public and private sectors.
31.6.9 Medical Training Courses

A team of experts on the FPA India Medical Advisory Panel along with other eminent
doctors on the FPA India team has devised and conducted the following courses on:
z Laparoscopic sterilization
z Medical Termination of Pregnancy
z Contraceptive methods
z Non-scalpel vasectomy
z Microsurgery for fallopian tubes and vas recannalisation
z Reproductive health services
z Sexual health services
z Male reproductive health services
31.6.10 Specialized Training Programmes

z Community mobilization
z Monitoring and evaluation of NGOs
z Gender issues
z Project proposal development
z Needs assessment methodologies.
31.6.11 Developing and Implementing Need based Reproductive and

Child Health Interventions and Programmes
z Adolescent reproductive health
z Male reproductive health
z Safe motherhood and child survival
z HIV/AIDS prevention interventions
z Human sexuality
z Quality of care in reproductive health
z Counseling training
z Communication skills for service providers
z Clinical service planning and provision
z Training methodologies for trainers
z Effective presentation and public speaking skills.
FPAI develops tailor-made, comprehensive training packages for all reproductive and
sexual health related programmes for all levels of providers, planners and policy
makers.
31.6.12 Influencing Government Policies

z Bringing sexuality education into the school curriculum.
z Demonstrating that reproductive health care can gain acceptance through NGOs. 313
z Operating government-funded Urban Family Welfare Centres at the Branch level. in India
Stimulating community participation in sexual and reproductive health and a rights

based approach through gender sensitive developmental activities.
Offering consultancy services and assisting other voluntary organizations to link
reproductive and child health activities with their ongoing work.
As a National NGO FPA India supports FNGOs under the Government MNGO
scheme. Provides six FPA in Branches Ahmedabad, Madurai, Manipur, Mohali,
Lucknow and Trivandrum have been accorded Mothe NGO status.
31.6.13 FPA India Services

z Contraceptives (for men and women)
z Abortion (medical and surgical)
z Emergency contraception
z Maternal health care
z Child health care
z Diagnosis and treatment of reproductive tract infections and sexually transmitted
infection and other reproductive health care (for men and women)
z Infertility
z Adolescent sexual and reproductive health care
z Counseling
z Prevention and management of HIV / AIDS
z Pathological / diagnostic facilities
31.7 NATIONAL TUBERCULOSIS CONTROL

PROGRAMME
(TB) Tuberculosis is an infectious disease caused by a bacterium, mycobacterium
tuberculosis. It spread through the air by a person suffering from TB. A single TB
patient can infect 10 or more people in a year.
Nearly 8 out of 10 patients diagnosed in the programme since 1993 were cured; this
rate is more than double that of the previous programme.
31.7.1 Directly Observe Treatment, Short-Course (DOTS)

DOTS, known as the Revised National TB Control Programme (RNTCP) in India, is a
comprehensive strategy for TB control. DOTS are the only strategy, which has proven
effective in controlling TB on mass basics.
India has adapted and tested DOTS in various parts of the country since 1993, with
excellent results and the RNTCP now covers more than 120 million population.
31.7.2 DOTS is a Systematic Strategy having Five Components

z Political and Administrative Commitment.
z Good quality diagnosis.
z Good quality drugs.
z The Right Treatment, given in the Right Way.
314 z Systematic Monitoring and Accountability.
31.7.3 Extent of the Programme

It is estimated that 14 million people are suffering from active tuberculosis in India of
which 3-3-5 million are highly infections cases.
31.7.4 Objectives of the Programme

1. To provide facilities for diagnosis of TB patients through integrated general health
services.
2. To provide optimum treatment near to the residence of the patients.
3. To prevent infection, immunization is done by doing BCG vaccination.
4. Health education to encourage patients through health workers, their relatives and
village leaders to take full course of treatment.
5. Detection of New TB Cases (Sputum positive, X-Ray suspects and extra
pulmonary cases).
31.7.5 Essentials of RNTCP

Good quality diagnosis, Good quality drugs; the right treatment, given in the right
way; systematic monitoring and accountability.
31.7.6 Suggestions for the Success of the Programme

While treating TB, we have to consider that:
1. TB has a cure, and treatment is inexpensive.
2. TB control is a very cost-effective health intervention.
3. Successful treatment requires 6-8 months of consistent uninterrupted medication.
4. Successful treatment demands education and follow up.
5. The best way to prevent TB is to cure infections cases in their early stages to
prevent transmission.
(i) Early Detection and Action.
(ii) Emphasis on Research.
(iii) Holistic Approach.
(iv) Ambulatory treatment based on good on good supervision.
(v) Combat TB along with other communicable diseases.
31.8 NATIONAL PROGRAMME FOR CONTROL OF

BLINDNESS
31.8.1 Need for the Programme
z It is self-evident that eye-sight is an essential function for carrying out the
majority of human functions any impairment of the functions creates chaos in the
life of the persons affected. However most of the today’s blindness is totally
preventable. There are many diseases that can lead to loss of sight, but the most
important are trachoma, Xeropthalnea, cataract and on choccriases (river
blindness) which are all preventable or curable.
z Two of the commonest problems encountered in developing countries are poverty
and ignorance and both of these have a direct being on the burden of blindness.
Poverty may sometimes be the reason for a family not seeking early treatment for
trachoma, or for an elderly person not having a cat rout operated on, but more 315
often lack of information, awareness and motivation is the underlying reason. in India
31.8.2 Magnitude of the Problem of Blindness

z Of the total estimated 38 million blind persons in the world, 6 million are in India.
Two major surveys were conducted to find out prevalence of blindness in the
country.
z The first survey was done by ICMR in 1974 and found as 1.38% prevalence rate.
The second survey was done by NPCB / WHO in 1986-89 and as per that the
prevalence rat is increased to 1.49%.

z Nation Programme for control of Blindness was launched in the year 1976 and it
is a 100% centrally sponsored programme.
z Various activities in the programme include establishment of Regional Institute of
Ophthalmology, up gradation of medical colleges and district hospitals and block
level PHCs, development of mobile units and recruitment of required ophthalmic
manpower in eye care units for provision of various ophthalmic services.
31.8.4 Strategy
The four-pronged strategy of the programme is:
z Strengthening service delivery.
z Developing human resources for eye care.
z Promoting outreach activities and public awareness and
z Developing institutional capacity.
31.8.5 Infrastructure Development

z At the tertiary level of ophthalmic care, there are II Regional Institutes of
ophthalmology.
z These centers have been established as centers of excellence in the field of eye
care.
z Regional Institutes of ophthalmology – 11
z Upgraded Medical colleges - 82
z PMOA training centers –39
z Eye banks –166
(PMOA – Para Medical Ophthalmic Assistance).
31.8.6 District Blindness Control Societies

z District hospital equipped – 445
z DBCSs formed – 510
(DBCS – District Blindness Control Society).
PHCs are the basic units in the rural areas. Till date 5440 PHC have been provided
with ophthalmic equipments and Para-Medical ophthalmic assistants, have been
posted.
316 31.8.7 Issues and Problems
z Lack of education among the masses about the excising facilities: Need of wide
publicity.
z Shortage of quality equipment and medicine: Need of strict control to maintain
quality.
z Apathy and indifference on the part of health personnel: Need of change of
attitudes.
z Lack of adequate referral services to take care of complications: Need of
designing referral services.
31.8.8 Suggestions
1. Integrate Eye Care as Part of PHC.
2. Involvement of NGO’s.
3. Train Ophthalmic Medical Assistants.
4. Provide Low Cost spectacles.
5. Correction of Chronic Vitamin-A Deficiency.
31.8.9 Programme Priorities during 9th Plan

z To improve the quality of cataract surgery, clear the backlog of cataract cases.
z To improve quality of case by skill up gradation of eye care personnel.
z To improve service delivery through NGO and public sector collaboration.
z Increase coverage of eye care delivery among underprivileged population.
31.9 ALL INDIA WOMEN’S CONFERENCE (AIWC)

31.9.1 About
AIWC was founded in 1927 “to function as an organization dedicated to the
upliftment and betterment of women and children”. The organization is continuing its
mission.
The initial objective of its founders Margaret Cousins, Sarojini Naidu, Anne Besant
and other sits for Women Education, AIWC has since diversified into various social
and economic issues concerning women.
AIWC today has over 1,56,000 members in more than 500 branches of AIWC across
the country. It is recognized as a premier organization working for women’s
development and empowerment.
AIWC was registered in 1930 under Societies Registration Act, XXI of 1860 (No.558
of 1930).
The main objectives of the organization are:
z To work for a society based on the principle of social justice, personal integrity
and equal right and opportunities for all.
z To secure recognition of the inherent right of every human being to work and to
achieve the essentials of life, which should not be determined by accident of birth
or sex but by planned social distribution.
z To support the claim of every citizen to the right to enjoy basic civil liberties.
z To stand against all separatist tendencies and to promote greater national 317
integration and unity. in India
z To work actively for the general progress and welfare of women and children and
to help women utilize to the fullest, the Fundamental Right conferred on them by
the Constitution of India.
z To work for permanent international amity and world peace.
Eminent women who guided and led the organization include:
1. Margaret Cousins, Sarojini Naidu, Annie Besant, Raj
2. Kumari Amrit Kaur, Vijayalakshmi Pandit, Muthulakshmy
3. Reddy, Kamala Devi Chattopadhyaya, Lakshmi N. Menon
4. Masuma Begum, Lakshmi Raghuramaiah,
In the 80th year of service to the nations, AIWC has:
z Over 530 branches grouped into nine zones and
z More than One Lakh Fifty-six Thousand members
31.9.2 At the International Level, AIWC has

z Consultative status with the United Nations (ECOSOC)
z Membership of UNICEF Executive committee for 10 years
z Membership of CONGO, elected as Vice-President of CONGO for two terms.
z A National Focal Point for International Networking for Sustainable Energy
(InforSE)
z Membership of the World Renewable Energy Network (WREN)
z Membership of ENERGIA International Network on Gender and Energy
z Global Village Energy Partnership
z Membership of World Water Partnership
z Affiliated member of the International Alliance for Women (IAW)
z Affiliated to the Pan Pacific South-East Asian Women’s Association
(PPSEAWA)
z Affiliated to NIMROO Education Center, Japan
31.9.3 Important Issues Addressed by AIWC over the Years are

z Education
z Economic empowerment through poverty alleviation programmes among women
through micro-credit programmes
z Health care: STIs & HIV / AIDS
z Legal reforms
z Violence against women
z Women’s human rights
z Environment conservation and preservation
z Gender discrimination
318 z Women in distress
z Non-conventional sources of energy and renewable energy and technology.
The All India Women’s Conference addresses the above.
31.9.4 Issues through Various Activities and Programmes

z Literacy and Education
z Health and Family Welfare
z Socio Economic Programs
z Legislation
z Economic Empowerment and Micro Credit
z Computer Training Programmes
z Textile Printing
z Non-conventional & Renewable Energy
z Consumer Awareness
z Research Programmes
z Rural Sanitation, Water and Waste Management
z Instuitional Care:
Short Stay Homes
Old Age Homes
z Single Working Women Hostel
31.9.5 Activities
z Education: Literacy and Education: One of the main objectives of AIWC was
woman education and it remains a primary concern even today. The literacy
campaign was intensified in 1996 by initiating non-formal education programmes
for school drop out and literacy programmes for adult woman with craft training
through its branches.
z Socio Economic Activities: The Socio-Economic Programme: AIWC started
programmes for capacity building and skill development by giving financial
support for entrepreneurial endeavours such as processing solar drying etc.
z Health Family Welfare and Population Management: AIWC is actively
involved in organizing health comps, awareness programmes, antenatal, care, and
immunization of programmes though its branches all over he country. AIWC
conducted “Training of trainers” programmes for prevention of and protection
from prevention of and protection from STIs, HIV/AIDS among woman in low-
risk groups for members of its branches. The Outreach programme for awareness
has become a very important part of the AIWC health programme.
z Legal Awareness: AIWC has been represented on committees set up for legal
reforms and amendments framed for women’s welfare. The Legal Cell helps
women who are victims of social and domestic violence. Free legal advice is
provided and counseling for women in distress helps women. Consultant to
national Commission for Women for legal issues.
Work with Leprosy Affected People (CRECHE)

z Creche for Children in Tahirpur Leprosy colony. Tahirpur colony was started
with the active cooperation of ITC Ladies Welfare.
Association for the children in the age group of 3-6 years. Children in the crèche 319
have play activities and are served mid-day meals. in India
Manual water filter has been installed in the crèche for supply of clean drinking
water to the children.
z Rural Energy: AIWC was identified as a Nodal Agency by the Ministry of non-
conventional energy resources in 1989 to Improved the Improved Chullah
program and biogas development programme. AIWC conducts programmes on
renewable among woman at the grassroot level and to also use these technologies
for economic self-sufficiency.
z Other Activities: To generate awareness on various development issues related to
health. AIDS, Family Planning, Foeticide, Education, Legal matters etc., AIWC
organizes Seminar, Workshops, Awareness Programs and group discussion on
regular basis.
31.9.6 Platinum Jubilee Celebration

AIWC in the Platinum Year adopted a village in Haryana. The vision behind this
adoption is to implement the programmes of AIWC on an integrated manner and to
convert the village into an ideal village:
z Research and Documentation Center on Women & Children.
z Children and Adolescent Girls.
z Youth Affairs
z Media Cell
z Deepali Medical Center
z Rural Sanitation, Water & Waste Management
z Disaster Management
31.10 HIND KUSHT NIVARAN SANGH

31.10.1 Objectives
z To control leprosy and provide relief and assistance to the affected person and
their family.
z To collaborate and coordinate with other organizations already working for the
control and elimination of leprosy and also with the organizations working fro
orthopedically handicapped in the National Capital Territory of Delhi.
z To promote social research and also the research into the causes and treatment of
leprosy.
z To devise means whereby the result of such research may be communicated
effectively to the social workers, medical professionals and the public.
z To establish and maintain institutions such as clinics, hospitals, or dispensaries for
the treatment of patients by up-to-date scientific methods, extension of existing
institutions or establishing the new ones wherein cases of leprosy may be treated.
z To educate the public opinion with regards to the disease of leprosy and its control
through latest medicines.
z To establish Children Homes for the Healthy and Non-affected children of the
leprosy affected person.
z To establish residential institutions for the educated Leprosy Cured Aged Persons
on subsidized basis.
320 z To establish training centers for leprosy and Para medical worker.
z To establish centers for Occupational therapy, Physic-Therapy and Meditational
Therapy.
31.10.2 How we have Fulfilled these Objectives

In pursuance of the above objectives the Delhi Branch of the Hind Kusht Nivaran
Sangh established a colony “Anand Gram” comprising of 400 leprosy affected
persons in the year 1961. None of the inmates of this colony liked to go for begging.
The Hind Kusht Nivaran Sangh, Delhi Branch constructed 118 pucca tenements for
the inmates of Anand Gram. To facilitate agriculture and for providing drinking water
a tube well was also installed. Roads and streetlights were provided. With the
collaboration of Late Dr. Mrs. Nelson a medical clinic was also set up to provide
treatment of the inmates.
The following socio-economic rehabilitation programmes were started for cured
leprosy affected persons:
z Production of Handloom cloth
z Physio-therapy unit and plastic surgery
z Poultry farming
z Cultivation of vegetables
z Sewing center
z Farming etc
After 18 years of its establishment Anand Gram was handed over to the Delhi
Government.
There are about 40 lakh leprosy patients in India. The scourge and agony of the
disease is very well known and it is for this reason that the Mass Scale Treatment and
Rehabilitation programme of leprosy affected persons was launched with the
establishment of Hind Kusht Nivaran Sangh, on all India level in the year 1949. It acts
as a useful bridge between the Government and non-governmental organizations
engaged in leprosy elimination, to strengthen collaboration and coordination for a
common goal i.e. prevention and treatment of leprosy and rehabilitation of the cured
person.
At the, National level, Hon’ble President of India is the President of the Sangh and the
Union Minister of Health and Family Welfare is the Chairman.
The Delhi branch of the Hind Kusth Nivaran Sangh was established in 1961 under the
guidance of prominent freedom fighter and social worker Late Dr. Yudhvir Singh.
The Hon’ble Lt. Governor of Delhi is the patron of the Delhi branch of the Sangh and
the Hon’ble Minister for Social Welfare Delhi Government is its Chairman.
Delhi has the unique problem of leprosy. In fact the incidence of leprosy in the
National Capital Territory is almost non-existent, but it attracts the afflicted persons
from all over the country as they find easy avenues for their livelihood in the capital.
The number of identified leprosy affected person in Delhi is estimated to be about
6000. Tahirpur Leprosy Complex, in the Trans-Yamuna area has the population of
about 4000 leprosy affected person, while others are scattered in areas like Lajpat
Nagar, Tilak Nagar, R.K. Puram, Pandav Nagar, Jahangirpuri, Azadpur, Peera Garhi,
Near Gol Dak-Khana, Tuglakabad etc.
With a view to tackling the problem of leprosy in Delhi, the Delhi Pradesh Branch of
Hind Kusth Nivaran was established in the year 1961, as a registered body under the
Societies Act of 1860.
1. What are the important objectives of BSS? in India
…………………………………….………………………………………..
…………………………………….………………………………………..
2. What are the Missions of FPA?
…………………………………….………………………………………..
…………………………………….………………………………………..
3. What is DOTS?
…………………………………….………………………………………..
…………………………………….………………………………………..
4. What is DBCS?
…………………………………….………………………………………..
…………………………………….………………………………………..
31.11 LET US SUM UP

Indian red cross society is a national federation of over 650 branches spread
throughout the country, at state / union territory, regional, district and sub-division
levels. The Indian red cross branches, through volunteers and field workers provide a
disciplined and organized network of humanitarian service throughout the country. It
contributes towards the creation of a better society where the vulnerable people and
communities can lead a life of social and economic security and human dignity. The
primary activities of the Indian red cross society are – disaster relief, promotion of
voluntary blood donation and collection of blood for transfusion, hospital services,
maternity and child and junior red cross. Bharat Sevak Samaj is a nonpolitical, non-
official and an all India voluntary organization. Late Pt. Jawaharlal Nehru, the first
Prime minister of India, founded the samaj on 12th August 1952 to mobilize people’s
participation and cooperation in national developmental activities as well as moral
regeneration of the people for all round prosperity. The aim is also to fight against the
forces of corruption in public life, communalism and to organize welfare activities in
sensitive areas with focus to help weaker section of the society especially children and
women. Pradesh branches were set up all over the country. Central Social Welfare
Board (CSWB) was conceived as an institution to be instrumental in bringing the
neglected, walk, handicapped and backward sections of society into the national
mainstream. Established in August 1953 the board is running a number of
programmes for the development of women and children. All these programmes are
fully funded by the department. The Indian council for child welfare, Tamilnadu is a
non-profit, non-governmental organization committed to the cause of deprived,
neglected and exploited children.
The ICCW, Tamilnadu was started in 1953 in the state of Tamilnadu in south India
and is affiliated to the Indian council for child welfare (national), New Delhi. It has a
branch in each district of the state of Tamilnadu. The council is registered as a
voluntary organization under the societies registration act. Family planning
association of India established in 1949, FPA India has been recognized as India’s
leading and largest reproductive and sexual he organization. It provides information
on sexually education and family life and wide range of services in sex and
reproductive health including family planning, bringing health and happiness to
millions DOTS, known as the Revised National TB Control Programme (RNTCP) in
India, is a comprehensive strategy for TB control. DOTS are the only strategy, which
322 has proven effective in controlling TB on mass basics. DOTS is a systematic strategy
having 5 components.
z Political and Administrative Commitment.
z Good quality diagnosis.
z Good quality drugs.
z The Right Treatment, given in the Right Way.
z Systematic Monitoring & Accountability.
AIWC was founded in 1927 “function as an organization dedicated to the upliftment
and betterment of women and children”. The organization is continuing its mission.
The main objectives of HIND KUSHT NIVARAN SANGH are to control leprosy and
provide relief and assistance to the affected person and their family.
z To collaborate and coordinate with other organizations already working for the
control and elimination of leprosy and also with the organizations working fro
orthopedically handicapped in the National Capital Territory of Delhi.
z To promote social research and also the research into the causes and treatment of
leprosy.

Try to collect the list of more Voluntary Health Care Agencies are activating in India.
31.13 KEYWORDS
Bharat Sevak Samaj: It is a Nonpolitical, Non-official and an All India Voluntary
Organization.
Central Social Welfare Board: It was conceived as an institution to be instrumental in
bringing the neglected, weak, handicapped and backward sections of society into the
national mainstream.
Tuberculosis: Tuberculosis is an infectious disease caused by a bacterium,
mycobacterium tuberculosis.

1. Explain about the Indian red cross society
2. Explain about BSS with its membership, function and activities.
3. Explain about Central Social Welfare board.
4. Explain about the Indian Council for Child Welfare.
5. Explain the objectives and activities of FPA.
6. Explain about national Tuberculosis control programme. And about DOTS.
7. Who is administering National programme for control of Blindness. What are its
functions?
8. What are the important strategies in All India Women’s Conference.
9. What are the main objectives of Hind Kusht Nivaran Sangh. How we have
fulfilled?
1. The Objectives of BSS are: in India
Find and develop avenues of voluntary service for the citizens of

India.
Promote national sufficiency and build up the economic strength of
the country.
Promote the social well being of the community and to mitigate
hardship of its less favored sections.
Draw out the available unused time, energy and other resources of the
people, and direct them into various fields of social and economic
activity.
Take all steps which are necessary for the fulfillment of the aforesaid
objects.
2. FPA India strengthens a voluntary and non-government commitment to
promote sexual and reproductive health and rights including family
planning. It supports the rights of individuals to reproductive choices,
include legal and safe abortion; works towards reducing the spread and
the impact of STIs / HIV / AIDS and increasing access to gender sensitive
SRH information, education and services to all especially the young and
marginalized eliminating violence, discrimination, and abuse.
3. Directly Observe Treatment, Short-Course (DOTS)
4. DBCS – District Blindness Control Society.

324
32
INTERNATIONAL VOLUNTARY HEALTH AGENCIES
CONTENTS
32.1 Introduction
32.2 United Nations Children’s Fund or UNICEF
32.2.1 Priorities
32.2.2 Education, Especially for Girls
32.2.3 Immunization Plus
32.2.4 Child Protection
32.2.5 HIV/AIDS
32.2.6 Early Childhood
32.2.7 Public Perception
32.3 UNDP
32.3.1 Goals of UNDP/Challenges of UNDP
32.3.2 Poverty Reduction and Human Development
32.3.3 Democratic Governance
32.3.4 HIV and Development
32.3.5 Crisis Prevention and Recovery
32.4 World Bank and the Health Sector
32.4.1 A Flawed Strategy
32.4.2 Promoting Privatisation
32.4.3 Infectious Disease Control
32.4.4 World Bank and HIV/AIDS
32.4.5 Nutrition
32.5 CARE
32.5.1 About
32.5.2 Vision
32.5.3 Mission
32.5.4 Core Values
32.5.5 Structure
32.5.6 Care International Secretariat
32.5.7 Care International Members
32.5.8 History
32.5.9 Activities
Contd….
32.5.10 Agriculture and Natural Resources 325
International Voluntary
32.5.11 Education Health Agencies
32.5.12 Health
32.5.13 HIV/AIDS
32.5.14 Nutrition
32.5.15 Economic Development
32.5.16 Water, Sanitation and Environmental Health
32.6 Rockefeller Foundation
32.6.1 History
32.6.2 How we see the World
32.6.3 Activities
32.6.4 Functions
32.7 Colombo Plan
32.7.1 Creation of the Colombo Plan
32.7.2 Purpose
32.7.3 Objectives
32.7.4 Member Countries
32.7.5 Organizational Structure
32.7.6 Funding
32.7.7 Financial Year 2006-2007: US Government Provided Additional
US$ 1.9 Million
32.7.8 Programmes
32.8 Let us Sum up
32.10 Keywords

z Know about the different International health agencies
z Understand about their functions, objectives, strategies and programmes
32.1 INTRODUCTION
International health agencies like UNICEF, UNDP, CARE etc., are involving human
development.
32.2 UNITED NATIONS CHILDREN’S FUND OR UNICEF

UNICEF (Arabic: French: Fonds des Nations Unies pour I’enfance; Spanish: Fondo
de Naciones Unidas para la Infancia) was established by the United Nations General
Assembly on December 11, 1946. In 1953, its name was shortened from United
326 Nations International Children’s Emergency Fund, but is still known by the popular
acronym based on this old name. Headquartered in New York City, UNICEF provides
long-term humanitarian and developmental assistance to children and mothers in
developing countries. A voluntarily funded agency, UNICEF relies on contributions
from governments and private donors. Its programmes emphasise developing
community-level services to promote the health and well being of children. UNICEF
was awarded the Nobel Peace Prize in 1965.
Following the reaching of term limits by Executive Director of UNICEF Carol
Bellamy, former US Secretary of Agriculture Ann Veneman took control of the
organization in May 2005 with an agenda to increase the organization’s focus on the
Millennium Development Goals.
32.2.1 Priorities
UNICEF is currently focused on 5 primary priorities: Young Child Survival and
Development, Primary Education and Gender Equality, Child protection, HIV / AIDS,
and Early childhood. Other priorities include child survival, the child in the family,
and sports for development.
How they work to improve the status of their priorities is though 14 methods ranging
from direct and legal interventions, to education and beyond to research and census
data collection.
32.2.2 Education, especially for Girls

Education is a proven intervention for improving the lives of all people, including
children. Educating young women yields spectacular benefits for the current and
future generations, and specifically affects a range of UNICEF priorities including
child survival, children in family, immunization, and child protection.
UNICEF’s aim is to get more girls into school, ensure that they stay in school and that
they are equipped with the basic tools they need to succeed in later life. As part of its
on-going efforts to ensure every girl and boy their right to an education, UNICEF’s
acceleration strategy is speeding progress in girl’s enrollment in 25 selected countries
during the 2002-2005 period.
32.2.3 Immunization Plus

Immunization is a direct intervention, a method which has made great improvements
in the health of children worldwide over the past 20 years. But every year, more than
2 million children die from diseases that could have been prevented by inexpensive
vaccines.
The plus in the programme is the additional interventions made possible during
interventions. Ranging from client education to nutritional supplements to insecticide-
treated mosquito netting, these life-saving services make immunization programmes a
powerful tool for child health.
32.2.4 Child Protection

Every day children are forced to be soldiers, sex workers, sweatshop workers,
servants. They are abused, exploited, and the subject of violence and the outcomes are
uneducated, unhealthy, and impoverished children. UNICEF works in a variety of
ways to provide protection and support, from child’s rights advocacy to child soldier
demobilization programmes, working with individuals, civic groups, governments,
and the private sector to bring about positive change.
32.2.5 HIV/AIDS 327
15 million children are now orphaned due to AIDS. It is estimated that by the year Health Agencies
2010 in sub-Saharan Africa alone, more than 18 million children, will have lost at
least one parent to AIDS. Half of all new infections are people under the age of 25,
with girls being hit harder and younger than boys. Working to protect and support
orphaned children, to prevent parent-child transmission, and to give young people
gender-sensitive and youth friendly services, UNICEF also advocates for a protective
familial, social and legal environment. UNICEF is also running several programmes
dedicated to controlling both online and offline child pornography. .
32.2.6 Early Childhood

Every child must be ensured the best start in life – their future, and indeed the future
of their communities, nations and the whole world depends on it.
UNICEF applies a holistic, evidence – based approach to Early Childhood, including
the following principles:
z Preventive and curative health care including immunization, adequate nutrition,
and safe water and basic sanitation must be provided for children, their caregivers,
and their communities.
z Children must have birth registration, protection from abuse and neglect, and be
provided with love and psychosocial care as well as support for early education.
z Girls and women, especially, should have good nutrition and health care,
education, family support, and their rights must be respected. They need to be
informed of the health and survival risks, to themselves and their babies,
regarding early repeat pregnancy, as well as breast-feeding. The health and
survival of mothers is directly related to the health and survival of their children.
32.2.7 Public Perception

UNICEF is the world’s leading children’s organization. Over the 60 years of its
history it has become a primary reference for governments and Non-Governmental
Organizations (NGO), collecting and disseminating more research on children than
any other organization, writing position papers on various aspects of the health and
environments of children. UNICEF has also organized worldwide fundraising drives,
to fund interventions, which directly benefit children.
But many groups, governments, and individuals have criticized UNICEF over the
years for failing to meet the needs of their particular group or interest. Recent
examples include criticism of its perceived failure to hold the Government of Sudan
adequately accountable for the practice of slavery in southern Sudan, its policy against
the marketing of breast-mild substitutes in developing world hospitals, and its
adherence to the 1990 Convention on the Rights of the Child, which has been ratified
by every government in the world except the United States and Somalia.
Unlike NGOs, UNICEF is an inter-governmental organization and thus is accountable
to governments. This gives it unique reach and access in every country in the world,
but also sometimes hampers its ability to speak out on rights violations.
UNICEF has also been criticized for having political bias; while UNICEF aims to
fund only non-political organizations, NGO Monitor (published by former Israeli
Ambassador to the UN Dore Gold) criticizes the UNICEF-funded “Palestinian Youth
Association for Leadership and Rights Activation (PYALARA), a student-run
Palestinian NGO, for what NGO Monitor alleges is its covert political agenda
justifying suicide bombings and demonizing Israel. The Catholic Church has also
been critical of UNICEF, with the Vatican even withdrawing donations, because of
reports by the American Life League that parts of the funding pay for sterilizations,
328 abortions, and contraceptives. The cause for this accusations had been that UNICEF
had spread information about possible measure to girls who were in danger of being
raped by soldiers during civil wars as well as education on how to avoid HIV-
infection and how to reduce exorbitant birth rates.
32.3 UNDP
UNDP is the UN’s global development network, and organization advocating for
change and connecting countries to knowledge, experience and resources to help
people build a better life. We are on the ground in 166 countries, working with them
on their own solutions to global and national development challenges. As they
develop local capacity, they draw on the people of UNDP and our wide range of
partners.
32.3.1 Goals of UNDP/Challenges of UNDP

World leaders have pledged to achieve the Millennium Development Goals, including
the overarching goal of cutting poverty in half by 2015. UNDP’s network links and
coordinates global and national efforts to reach these Goals. Our focus is helping
countries build and share solutions to the challenges of:
z Democratic Governance
z Poverty Reduction
z Crisis Prevention and Recovery
z Energy and Environment
z HIV/AIDS
UNDP helps developing countries attract and use aid effectively. In all our activities,
we encourage the protection of human rights and the empowerment of women.
The annual Human Development Report, commissioned by UNDP, focuses the global
debate on key development issues, providing new measurement tools, innovative
analysis and often-controversial policy proposals. The global Report’s analytical
framework and inclusive approach carry over into regional, national and local Human
Development Reports, also supported by UNDP.
In each country office, the UNDP Resident Representative normally also serves as the
Resident Coordinator of development activities for the United Nations system ad a
whole. Through such coordination, UNDP seeks to ensure the most effective use of
UN and international aid resources.
32.3.2 Poverty Reduction and Human Development

Globally, UNDP works to strengthen the capacity of national partners to achieve the
MDGs. UNDP also advocates for human development, the need toe empower women,
equitable growth and sustainability.
Working in partnership with the National Planning Commission and State
Governments, UNDP India has supported the preparation of State (sub-national)
Human Development Reports since 1998. These action-oriented Reposts work as
policy tools, showing the way forward by spurring policy debate and making better
informed decisions about development solutions. To take the process further UNDP is
now supporting State Governments to look at next steps in human development,
engendering the process and taking decentralization a few steps further. By
strengthening the capacity of state planners to enhance the human development
dimension of State plans and of the State statistical departments it improves the
quality of human development data and analysis.
The 2003-07 India Country Programme includes a component on promoting gender 329
equality to support the Government of India’s Ministry of Women and Child Health Agencies
Development in its role of monitoring progress on national commitments to gender
equality and empowerment of women.
UNDP also supports initiatives to develop the capability of people, both in rural and
urban areas, to make a living in a rights-based approach to reducing poverty and
improving their quality of life. For instance, an innovative project on promoting
Endogenous Tourism for Rural Livelihoods is drawing upon India’s cultural heritage
and indigenous tradition to help build alternative models of rural tourism across the
country and seeks to position such models as engines of growth and livelihoods for
the rural poor. Another initiative pilots a franchisee model of public private-
partnership for skills and knowledge to improve livelihoods.
The two main areas of action under Poverty Reduction include:
z Human Development from Analysis to Action.
z Rural and Urban Livelihood for Human Development.
32.3.3 Democratic Governance

More countries than ever before are working to build democratic governance. UNDP
works with countries in bringing government’s closer to people and enabling better
access to justice and public administration. This work supports efforts to develop
greater capacity for the delivery of basic services.
The focus of UNDP’s work in democratic governance in India includes supporting the
Government of India in building capacities of Panchayati Raj Institutions (PRIs) or
the Local Self-Government institutions in rural areas and urban local bodies to support
improvements in service delivery and the achievement of development goals. Other
initiatives in support of local governance include promoting the use of Information
and Communication Technology (ICT) for facilitating citizens’ access to information
and enabling e-governance. Strengthening Access to justice of the poor for poverty
eradication and human development is another key UNDP-supported intervention
under this theme.
32.3.4 HIV and Development

India has low prevalence of HIV but many concentrated epidemics within the country.
In 2007, there were six states and approximately 100 districts with high prevalence of
HIV. Some of these districts are situated in states with low prevalence of HIV.
Recent trends indicate that infections amongst women and youth are increasing and
moving from urban to rural areas. Though 86 percent of infections are due to
unprotected sexual intercourse, there are other factors that increase vulnerability to
HIV such as prevailing gender norms, poverty and migration.
UNDP’s strategy addresses these underlying causes through a multi-dimensional
approach focusing on:
z Addressing the critical nexus between HIV and human development.
z Strengthening the capacity of national authorities to more effectively govern the
AIDS response.
z Promoting human rights and gender equality to reduce vulnerability to HIV.
This will complement direct intervention efforts by other organizations and help in
building a sustainable and long-term response.
330 32.3.5 Crisis Prevention and Recovery
Many countries are increasingly vulnerable to natural disasters that can erase decades
of development and further entrench poverty and inequality. Through its global
network, UNDP seeks out and shares innovative approaches to disaster risk
management and mitigation. With its country-level presence in almost every
developing country, UNDP helps to bridge the gap between emergency relief and
long-term development.
UNDP is working with the Government of India, Ministry of Home Affairs, in setting
up an institutional framework for disaster preparedness, response, prevention and
mitigation. It is working with the Central Government in 169 districts identified as
being prone to multiple hazards, spread across 17 states. The project, a multi-
stakeholder, multi-donor partnership, is supporting preparedness, response and
mitigation plans at all levels of administration, from the state to the village.
32.4 WORLD BANK AND THE HEALTH SECTOR

The World Bank has been, for some time, soliciting comments on its Country Action
Strategy (CAS) for the World Bank Group in India, which is essentially a draft plan
for intervention in India by the World Bank in different sectors from 2005 to 2008. A
careful reading of this paper would be useful, as the Bank’s prescriptions continue to
be lapped up with all seriousness by our bureaucrats and policy makers.
32.4.1 A Flawed Strategy

A close look at the section on health in the CAS brings out the fundamental premises
of the World Bank’s prescription in the Health Care sector. Talking of “Reducing the
Health Risks of the Poor” the document says. “There are a range of health sector
Interventions and services that are critical………. These include accessible and good
quality facilities for safe delivery care for acute respiratory infections and diarrhea in
young children and effective health and nutrition promotion. Improving health
outcomes for the poor will require a concerted effort to improve both the overall
health system of the states – the public and private sector combined….”
The basic approach to health care and health delivery need that the World Bank
proposal needs to be carefully examined. The World Bank continues to emphasise on
(1) Selected Interventions (viz. safe delivery, diarrhoeal disease control; (2) A role for
the private sector. From a public health perspective, both these approaches are deeply
flawed.
A public health approach is premised on the provision of comprehensive health care
services to all by the state. A comprehensive health care system includes all services
at relevant levels of the system, with adequate provisions for human power, resources
and technical know-how. They World Bank’s attempt to reduce this approach to a few
“magic bullets” that target a few interventions, in fact, led to the dilution and
subsequent abandonment of the “Primary Health Care” approach that was fore
grounded in Alma Ata in 1978 – especially given the World Bank’s increasing global
clout in formulation of health policies.
Again, the World Bank’s regular tomtomming of the role for the private sector defies
all conventional logic. Developed countries (and developing countries with strong
health systems lie Cuba) have built their health infrastructure through a public funded
system. Being a “public good” private sector participation in provisioning of health
care is a contradiction in terms. In a country like India – possibly the MOST
privatized system of health care with just 16 per cent public spending on health care –
it is ridiculous to continue to harp on a “role” for the private sector. What we should
be talking about is in fact a much reduced role for the private sector and much greater
regulation of this sector-which in fact is the largest unregulated sector of the Indian
economy.
32.4.2 Promoting Privatisation 331
The Paper goes on to talk of some of the World Bank’s priority areas for intervention, Health Agencies
where it says: “…new projects in these states…would seek to break new ground in
forging public-private partnerships (including through progressive separation of
public health financing from provision), strengthening oversight of private providers,
increasing public expenditure on health, reorienting health facilities to ensure service
for the poor and reducing vulnerability through creation of health insurance schemes”.
What is this “public – private” partnership that the Bank talks about? Is it the
“progressive separation of public health financing form provision.” Or it refers to
“Health Insurance Schemes”. These are all euphemisms for legitimization of the
abandonment of the role of health care provider that the state should play. The key
here is really public health expenditure. At 0.9 per cent of the GDP India’s public
Health expenditure is one of the lowest in the world. In the liberalization years (since
1991) this has come down from 1.3 per cent (in itself a very low figure. This is what
the World Bank and IMF led reform has meant for the Health Sector – savage cut in
public expenditure. Now this is sought to be legitimized through doublespeak by the
World Bank – essentially saying that if the State cannot or will not pay let us explore
ways in which the people can be made to pay for their health care.
The Paper goes on to speak of water supply and sanitation: “One-fifth of India’s
national disease burden can be attributed to environmental causes – with the largest
environmental risks to health coming from the lack of access to safe water and
sanitation, and cooking with traditional biomass fuels resulting in high levels of
indoor air pollution… a major Bank study to measure the health impact of improved
rural water supply is underway and will be completed in FY…”
These are mere platitudes about issues that are common knowledge. Do we really
require the World Bank to tell us that safe work environment have a major impact on
health? Why the World Bank should spend money on inflated “dollar” salaries for
self-styled experts to reinvent the wheel is beyond comprehension. The real issue that
the Paper does not address even in passing is that in all the areas the policies of neo-
liberalism that the World Bank champions, have led to a steady deterioration of public
facilities. In the economic “reform” period, public expenditure in these areas has
declined and privatization has been actively promoted.
The real intent of the World Bank’s interest in this area becomes clear when we read
further: “There have been some important lessons from the Bank engagement.
Foremost among these is that sustainability is a major challenge – which is best
addressed by involving communities in the design, construction and operation of
schemes, including through their contribution to capital costs and their full financing
of operational costs”.
A brilliant piece of reasoning indeed! After saying that safe water supply and
sanitation is critical for health care, the Bank now prescribes privatization of the same
as the only solution.
The Paper expands further on the World Bank’s strategy: “During FY05-08 the Bank
would be ready to support this objective by lending to states that decide to adopt a
participatory approach to Rural Water Supply and Sanitation (RWSS) statewide”.
Note the use of the phrase “adopt a participatory approach to RWSS statewide”. If
read along with the previous paragraph, it means that the Bank is willing to assist
those states that are willing to privatize their water and sanitation systems.
“Participatory” has become an euphemism for ways in which the poor can be forced
to “participate” in paying for services that the State should provide free of cost.
332 32.4.3 Infectious Disease Control
The Paper then turns to the issue of “Controlling Infectious Diseases”. It says: “Future
(World) Bank support for disease control is also focused on integrating programmes at
the state level, reorienting public sector interventions towards priority outcomes and
expanding on opportunities for public-private partnerships. For example, since most
tuberculosis cases are seen by private medical doctors or other private practitioners,
there are important potential benefits to reorienting the state public health system to
work more closely with the private sector”.
The World Bank’s fetish for the private sector is truly amazing. If, today, most
patients of TB are forced to go to the private sector the remedy should be a
strengthening of the public sector. In a weird sleight of hand the Bank believes that
this constitutes an argument for strengthening the private sector. Tuberculosis is
universally acknowledged as a “disease of poverty”, a disease furthermore that
accounts for more than half a million deaths every year. Further, the whole approach
of targeting a few diseases through vertical top-down programmes (no matter how
important these diseases are) is essentially flawed. The attempt should be a
strengthening of the entire public health delivery system and a location of diseases
surveillance, control and prevention measures within such a comprehensive system.
The World Bank is loath to suggest that such measures are against the grain of its
philosophy of a reduced role for the State and a greater emphasis on market
mechanisms.
The Report turns to immunization, stating: “In close cooperation with he World
Health Organization (WHO), the Bank supports Gol’s polio eradication campaign….
GOI and the Bank are exploring ways to revitalize routine immunization programmes
in some states where they have been stagnant or even declining”.
This is gross dishonesty, for what the World Bank does not say is in fact the most
contentious issue in this area. There is concern today about declining achievements of
routine immunization programmes because the entire emphasis of the health system as
regards immunization has been on the pulse polio campaign. This is a clear example
of the problems of running vertical campaigns without strengthening basic health
service delivery systems.
Finally, how can a multilateral agency not talk of HIV-AIDS. The Paper devotes a
large section to HIV-AIDS control. The Paper says: “While ensuring a continued
focus on prevention, the Bank Group could also provide assistance to Gol in
monitoring provision of anti-retroviral therapy (ART) and measuring its impact as the
treatment programme is rolled out. Assistance to…. A manageable programme could
also be provided”.
The difference in the ways in which India and Brazil have approached the problem of
HIV-AIDS is worth looking at in this context. Brazil chose to make the public health
system responsive to the problem by providing treatment for HIV-AIDS. India chose
to set up a white elephant called NACO that just does surveillance studies and
pontificates on the problem of HIV-AIDS (India is still to offer treatment with
antiretrovirals through the public health system). There is absolutely no alternative
again to the location of the treatment, control, surveillance of HIV-AIDS in the overall
public health system. The issue then is where do the funds come from? Repeatedly we
come back to the necessity of greatly enhancing the public expenditure on health care.
The World Bank funds are incidental (they still constitute a fraction of what the Gol
spends on health care). In the whole section on Health the Paper talks of the need for
greater public expenditure in just one place – in passing.
It is easy to dismiss such prescriptions, because on merit they deserve to be dismissed
outright. Unfortunately, the World Bank’s platitudes are taken as the gospel truth by
people who formulate policy today. The World Bank can always say that its CAS is
just its own strategy paper, and the Indian government is free to formulate its own 333
policy. Unfortunately this is only half the story. We have seen over the last decade and Health Agencies
a half how, shamelessly, the priorities of our domestic policies seem to echo the thrust
areas that the World Bank sets itself. This hegemonisation of the policy making space
by the World Bank is what makes papers like this dangerous. Dangerous because they
will be taken seriously by those who formulate our policies.
The World Bank is the world’s largest source of development assistance, providing
nearly $ 16 billion in loans annually to its client countries. It uses its financial
resources, highly trained staff, and extensive knowledge base to help each developing
country onto a path of stable, sustainable, and equitable growth in the fight against
poverty.
32.4.4 World Bank and HIV/AIDS

HIV/AIDS is at the center of the Bank’s development agenda. At the 2000 Spring
Meetings, the Bank made a public commitment to ensuring “unlimited” resources for
well-designed national HIV/AIDS programs. The Many Bank financed health projects
emphasize the prevention, control, and treatment of specific conditions such as
malaria, diarrhea, measles, and HIV/AIDS through strengthened primary – and
district-level health services. For example, the Bank worked with the government of
India and other donors to finance a 1993 leprosy project that improved outreach to
poor communities and promoted more effective treatment and service packages. The
number of registered leprosy cases has since dropped from 1.7 million in 1992 to 0.5
million in 1996.
More recently, the World Bank has become increasingly active in health sector reform
projects undertaken in partnership with governments. While issues vary from country
to country, the guiding principles of this work are to ensure equity, access, quality,
consumer satisfaction, and efficiency in the financing and provision of health services,
while controlling the growth in expenditures for health in line with economic growth.
From The World Bank: Health, Nutrition, & Population.
World Bank has committed more than US$1.01 billion to 99 HIV/AIDS-related
projects in 56 countries. HIV/AIDS program lending is likely to rise as more countries
turn to the Bank for financial and technical assistance in response to the epidemic.
The Bank’s approach to the epidemic stands on four pillars: advocacy; increased
resources; programs for prevention, care and treatment; and knowledge.
32.4.5 Nutrition
Over half of child mortality in low-income countries can be linked to malnutrition.
The World Bank supports a multisectoral approach to nutrition that targets the poor,
especially young children and their mothers. To reach these groups the Bank
emphasizes community – and school-based nutrition programs, food fortification
programs, and food policy reforms. The Bank’s nutrition portfolio is also giving
increased attention to micronutrient deficiencies, the impact of nutrition on education
and learning ability, and early childhood development projects. Since 1976, the World
Bank has provided over $1 billion of Population and Reproductive Health.
The Bank takes a comprehensive approach to population, linking population policies
and programs to poverty reduction and human development agendas, particularly
those that empower women. This approach simultaneously addresses concerns about
rapid population growth and the need to improve individual and family welfare. The
Bank is committed to operationalising the goals of the 1994 International Conference
on Population and Development, which places reproductive health at the center of the
population and development agenda. Assistance emphasizes the provision of quality
334 services and information that (a) expand access to a range of family planning
methods, (b) enable women to go safely through pregnancy and childbirth, and
(c) prevent and treat reproductive and sexually transmitted diseases. Since 1970,
lending has totaled $1.7 billion for more than 100 projects.
32.5 CARE
32.5.1 About
CARE is a leading humanitarian organization fighting global poverty. Non-political
and non-sectarian, which operates each year in more than 65 countries in Africa, Asia,
Latin America, the Middle East and Eastern Europe, reaching more than 50 million
people in poor communities. CARE helps tackle-underlying causes of poverty so that
people can become self-sufficient. CARE is often one of the first to deliver emergency
aid to survivors of natural disasters and war and, once the immediate crisis is over,
help people rebuild their lives. While CARE is a large international organization with
more than 14,500 employees worldwide, have a strong local presence: more than 90%
of staff members are nationals of the countries where programmes are run.
32.5.2 Vision
We seek a world of hope, tolerance and social justice, where poverty has been
overcome and people live in dignity and security. CARE will be a global force and
partner of choice within a worldwide movement dedicated to ending poverty. We will
be known everywhere for our unshakeable commitment to the dignity of people.
32.5.3 Mission
CARE’s mission is to serve individuals and families in the poorest communities in the
world. Drawing strength from our global diversity, resources and experience, promote
innovative solutions and advocate for global responsibility. It promotes lasting change
by:
1. Strengthening capacity for self-help.
2. Providing economic opportunity.
3. Delivering relief in emergencies
4. Influencing policy decisions at all levels
5. Addressing discrimination in all its forms
32.5.4 Core Values

z Respect – affirm the dignity, potential and contribution of participants, donors,
partners and staff.
z Integrity – act consistently with CARE’s mission, being honest and transparent in
what we do and say, and accept responsibility for our collective and individual
actions.
z Commitment – work together effectively to serve the larger community.
z Excellence – constantly challenge ourselves to the highest levels of learning and
performance to achieve greater impact.
32.5.5 Structure
CARE International (CI) is a confederation composed of twelve national Members,
each being an autonomous non-governmental organization in its own right. CI
Members in North America, Europe, Asia and Australia carry out a range of project-
related, advocacy, fundraising and communications activities in support of CARE’s 335
relief and development programmes in over 65 countries worldwide. Health Agencies
32.5.6 Care International Secretariat

The CI Secretariat is based in Geneva, Switzerland, with representation offices in
New York and in Brussels to liaise with the United Nations and the European
institutions respectively.
The CI Secretariat is an international foundation, registered under Swiss law, and
governed by the CARE International Board of Directors. Under the leadership of CI
Secretary General, Denis Caillaux, it coordinates and supports the work of the CARE
national Members and Country Offices, carrying out the following activities:
z Providing support to the CI Board of Directors
z Implementing policy decisions made by the Board of Directors
z Promulgating and ensuring Member and Country Office compliance with the CI
Code, a document that comprises policies and guidelines by with Members agree
to conduct their domestic and overseas activities, and to interact with one another.
z Ensuring effective representation on behalf of the Members and Country Offices
with multilateral institutions and other international bodies.
z Coordinating CI’s response to humanitarian disasters
z Coordinating CI’s policy and advocacy response to humanitarian and
development issues prioritized by the membership
z Supporting the organizational development of CI’s Members establishing and
overseeing standards and criteria that pertain to membership of CI.
z Overseeing CI’s organizational evolution.
32.5.7 Care International Members

Each CARE Member is registered is registered as a non-profit charitable organization
according to the laws of its own country, and is regulated by these laws and its
statutes. Governance oversight is provided by a board of directors, who serve as
trustees. The management of each CARE Member is conducted under the leadership
of the National Director, who is the chief executive, and his/her senior management
team. The international members are CARE International Japan, Nederland, CARE,
CARE Osterreich, Raks Thai Foundation (CARE Thailand), CARE International UK,
CARE USA, CARE Australia, CARE Canada, CARE Denmark, CARE International
Deutschland, & CARE France.
32.5.8 History
CARE is one of the world’s largest independent international humanitarian
organizations, committed to helping families in poor communities improve their lives
and achieve lasting victories over poverty. CARE traces its roots back to the days
immediately following World War II when 22 American organizations combined
forces to rush emergency food rations in the form of ‘CARE Packages’ to war-torn
Europe. On May 11, 1946, the first 20,000 packages reached the battered port of Le
Havre, France. Some 100 million more CARE Packages reached people in need
during the next two decades, first in Europe and later in Asia and other parts of the
developing world. As the economies of the former wartime nations and improved
throughout the 1950s and 1960s, the focus of CARE’s work shifted from Europe to
the problems of the developing world. In the 1950s, CARE pioneered primary health
care programs. In the 1970s, CARE responded to massive famines in Africa with both
emergency relief and long-term agro forestry projects, integrating environmentally
336 sound tree-and land-management practices with farming programs. CARE is now a
proven leader among international humanitarian organizations. We have become a
global force – a sought – after partner in the fight against poverty – striving to bring
about lasting meaningful change in some of the world’s poorest communities. In
2006, CARE celebrates its 60th anniversary.
32.5.9 Activities
CARE tackles underlying causes of poverty so that people can become self-sufficient.
It runs around 1200 projects each year in over 65 countries, reaching more than 50
million people in poor communities. It places special focus on working alongside poor
women because, equipped with the proper resources, women have the power to help
entire families and communities escape poverty. CARE is also one of the first to
respond in emergencies such as natural disasters or civil conflict. Its projects directly
assist survivors of natural disasters and conflict through immediate relief and longer-
term community rehabilitation, which includes food, temporary shelter, clean water,
sanitation services, medical care, family planning and reproductive health services,
and seeds and tools.
32.5.10 Agriculture and Natural Resources

CARE helps families produce more food and increase their income while managing
their natural resources and preserving the environment for future generations. CARE
works with farmers to increase their crop and livestock yields through activities such
as planting new seed varieties, animal husbandry, home gardening and irrigation.
32.5.11 Education
CARE is dedicated to promoting basic education for all. Experience shows that
educated people have healthier families and greater earning potential. Its projects
promote and facilitate discussion between parents; teachers and other members of the
community to overcome barriers to education that help keep families mired in
poverty. CARE also provides economic incentives to help parents cover the cost of
keeping their children in school.
32.5.12 Health
A family cannot be economically healthy if it is not physically healthy. CARE’s
health projects focus on mothers and children, who often are the most vulnerable to
disease and malnutrition. We are particularly interested in increasing the capacity of
our local partners to deliver quality health services. This includes training local health
volunteers as counselors, mentors of community health. CARE is focused on
interventions ranging from nutrition and education to birth spacing and clinical
services. Out reproductive health projects encompass family planning, prenatal care,
labour and delivery services, and the prevention detection and treatment of Sexually
Transmitted Diseases (STDs), including HIV/AIDS.
32.5.13 HIV/AIDS
CARE’s HIV/AIDS programmes link with out other sectors, including health,
education and economic development. Through HIV/AIDS programmes, CARE helps
communities care for children who have become orphaned and vulnerable by
HIV/AIDS, develop peer education and outreach in communities, and increase access
to services such as condoms, voluntary counseling and testing, anti-retroviral
treatment, and Sexually Transmitted Infections (STI) prevention and treatment.
32.5.14 Nutrition
Proper nutrition is vital to a child’s healthy development and an adult’s ability to work
and care for his or her family. CARE projects focus on teaching techniques and
practices that help prevent malnutrition. These include demonstrating proper breast- 337
feeding, educating families and communities about how to cultivate and prepare Health Agencies
nutritious food, providing food as part of emergency relief efforts, and managing
food-for-work projects to help communities improve infrastructure.
32.5.15 Economic Development

CARE’s economic development programs assist impoverished families by supporting
money making activities, especially those operated by women. CARE initiates
community savings-and-loan programs and provides technical training to help people
begin or expand small businesses that will increase family income.
32.5.16 Water, Sanitation and Environmental Health

CARE helps communities to build and maintain clean water systems and latrines.
Both directly and through local organizations, CARE provides training and subsidizes
construction, but communities make significant contributions both in cash and labour,
and pay the cost of operation and maintenance. The goal of these projects is to reduce
the health risks of water-related diseases and to increase the earning potential of
households by saving time otherwise spent fetching water. Projects also include
educating people about good hygiene practice, which reduces the risk of illnesses.
32.6 ROCKEFELLER FOUNDATION

32.6.1 History
The Rockefeller Foundation was established in 1913 by John D. Rockefeller, Sr., to
“promote the well-being” of humanity by addressing the root causes of serious
problems. The Foundation works around the world to-expand opportunities for poor
or vulnerable people and to help ensure that globalization’s benefits are more widely
shared. With assets of more than $ 3.5 billion, it is one of the few institutions to
conduct such work both within the United States and internationally.
As John D. Rockefeller said, “The best philanthropy is constantly is search of the
finalities – a search for a cause, an attempt to cure evils at their source.” This
approach has produced such breakthrough work as the professionalisation of public
health, the development of a vaccine against yellow fever, the “Green Revolution” in
Latin American, Asian and Indian agriculture, and the creation of public-private
partnerships to develop promising new vaccines.
32.6.2 How we see the World

For the arenas in which the Rockefeller Foundation works, the central reality of the
modern world is globalization. Globalization is the product of worldwide revolutions
in the technology of transportation, finance and especially information.
Globalization represents increased interconnection and interdependence; it also spurs
transitional conflict and sometimes exacerbates inequities. Globalization produces
both increased risks and increased opportunities.
New opportunities, may the result of the spreading benefits of scientific and
technological innovation, create the potential for dramatic improvement in economic
conditions, stemming poverty overall.
At the same time, in some places and within some groups, risks are increasingly
shifted to individuals, creating greater economic vulnerabilities for many and causing
some people to fall farther behind.
338 32.6.3 Activities
The Rockefeller Foundation works around the world to expand opportunities for poor
shared. It is one of the few institutions to conduct such work both within the United
States and internationally.
Its initiatives are largely focused in a small group of areas in which the Rockefeller
Foundation may play a special role by virtue of its history and legacy: global health,
agricultural productivity, innovation for development, economic resilience and urban
life. These areas may change from time to time-while remaining consistent with its
core strengths and global perspective—as work is completed and new, pressing
opportunities arise.
We organize our operations by time-bound initiatives, rather than by program areas.
Initiatives take many forms and use many methods, but nearly all draw on its long-
held beliefs in creating opportunities for the world’s poor or vulnerable people by
spurring entrepreneurship, promoting innovation, building human and institutional
capital, catalyzing the creation of new fields and expanding access to and distribution
of resources.
We endeavor to be strategic in our grant making, and therefore concentrate its
resources where they will have the greatest impact.
We try to avoid the temptation to engage in areas where others are more appropriately
involved – in many cases public entities (especially where large sums of money are
required). It recognizes that our resources alone are generally insufficient to
adequately support basic research, or to take most innovations to scale. It seeks and
welcomes opportunities for new partnerships and new networks.
We relentlessly press the advantages of our history and structure. Among these: a
capacity for the calculated risk that underlies most innovation, for venturing where
others remain reluctant to go; an ability, while ultimately insisting on measurable
results, to be patient in developing sustainable solutions rather than illusory quick-
fixes; and its heritage, which provides us with both inspiration and standing, including
its convening power and also the potential to move not just money but minds and
policies.
It is not he investments that determine how any great organization is judged, but the
outcomes of those investments. For us, those outcomes are guided by its ability to
innovate, influence, and, in the end, to generate impact.
By innovate, it means the ability to identify more than just what is new. It means
being both creative and expansive in how it identifies and understands deep contextual
challenges and flexible and agile in how it devises and deploys potential solutions.
Influence is a critical currency in today’s rapidly changing world, where the
complexities of market systems, governmental structures and cultures interact and
compete for limited resources and advantage. The capacity to gain, retain and leverage
influence in order to catalyze opportunities is essential to its efforts.
Impact is tangible, identifiable and in many cases, measurable. It focuses on its own
attention on issues and places not only where it knows that change is needed, but
where it has a real ability to affect change.
32.6.4 Functions
Its work begins not with some top-down plan for the improvement of societies or an
official model or economic development, but with a search for new ideas with unusual
potential for significant impact.
We seek out these ideas in both traditional and non-traditional manners. It seeks ideas
that are rooted in facts, and work to analyze facts from diverse sources and in fresh
ways. It looks to current academic thought and literature, and to the perspectives of 339
those already working in fields it are exploring (grantees and prospective partners), Health Agencies
but it also directly seeks out the views of the ultimate beneficiaries of its work, and
regard these views as a key element in shaping its own perspectives. It works with
value strategic partners who enhance its ability to listen to the potential beneficiaries
of its investments.
It selects the ideas that form the heart of initiatives it undertakes based on their
potential for significant impact. Each such initiative addresses a problem with severe
consequences and has the potential to positively affect a large number of poor or
vulnerable people.
Its initiatives are also situational. Almost all are selected because an opportunity for
impact has been created by the potential to break a bottleneck, surface a new issue or
re-frame an old one, take advantage of a current or anticipated tipping point, or, with
partners, scale-up a proven solution.
Moreover, its initiatives are designed with specificity. Each has a clear timeframes,
with identified activities and products, and a projected endpoint. While initiative
timeframes will vary, each is both intended and required to yield some measurable
outcomes within at most three to five years. Some of the complex problems, it
addresses demand longer-term solutions, but this requirement helps ensure that each
initiative is either achieving impact; or being modified in order to do so, or is
abandoned because impact has proven beyond its reach. This requirement of short-
term outcomes as well as long-term objectives also helps promote flexibility in its
operations, and constant receptivity to new ideas and new work.
We implement its initiatives with rigor. It requires that our grantees have proven or
well-justified operating models designed to yield impact, committed and capable
leadership, a plan for sustainable outcomes and an open, ongoing and transparent
approach to evaluation and learning. It uses the full range of our own assets and
capacities to support each of its initiatives. And it learns from our efforts, and helps
others to do so, seeking to identify, measure and disclose what works and what
doesn’t. Because it takes calculated risks, it does not expect always to succeed.
Because it assesses, it expects to succeed more often, to effect more change, to have
grater impact.
32.7 COLOMBO PLAN

32.7.1 Creation of the Colombo Plan
In view of the momentous changes that had occurred during the immediate post-war
years, senior ministers of independent countries within the Commonwealth decided in
1949 to meet for the first time since World War II. This Commonwealth Conference
of Foreign Ministers was held in Colombo, Sri Lanka (then Ceylon) in January 1950.
The meeting was momentous for two reasons. It was to be the first Commonwealth
Foreign Ministers meting to be held in Asian soil, and it was a meeting of eminent
statesmen.
Among them were: Percy Spender, Minister for External Affairs, Australia; Ernest
Bevin, Foreign Secretary, Britain; Lester Pearson, Minister for External Affairs,
Canada; Pandit Jawaharlal Nehru, Prime Minister of India; Fredrick Doidge, Minister
for External Affairs, New Zealand; Ghulam Mohammed, Minister of Finance,
Pakistan; D. S. Senanayake, Prime Minister of Ceylon and J. R. Jayewardene, then
Finance Minister who later became President of Sri Lanka.
At the Colombo Meeting, a Consultative Committee was establish to survey needs,
assess the resources available and required, focus world attention on the problems
340 involved, and provide a frame work within which international cooperation efforts
could be promoted to raise the living standards of the people in the region.
At the first meeting of the Consultative Committee in May 1950 in Sydney, it was
agreed that the Commonwealth Countries in the area should draw up development
programmes covering a six years period from July 1, 1951 and that other countries in
the area should be invited to take similar action. The plan’s life has since been
extended from time to time at five-year intervals. At the Consultative Committee
Meeting in Jakarta in November 1980, the plan’s life was extended indefinitely.
When the Consultative Committee met for the second time, in London in September
1950, the six-years development programmes, proposals including a constitution for a
Council of Technical Co-operation were written in to its report which was entitled
“The Colombo Plan for Co-operative Economic Development in South and South-
East Asia”. The name was later changed to “The Colombo Plan for Co-operative
Economic and Social Development in Asia and the Pacific” in December 1977.
The Plan embodies the concept of a collective intergovernmental effort toward the
economic and social development of member countries in the Asia-Pacific region. It
provides a forum for discussion of development needs of member countries and
through consensus implements programmes in response to their identified needs. The
Plan encourages developing member countries to become donors themselves and
participate in economic and technical cooperation among developing countries.
The primary focus of all Colombo Plan activities is human resources development in
the Asia-Pacific region.
The Colombo Plan is not a “plan” in the economic sense. There is no single integrated
plan for the whole area, nor is there a master plan to which national plans are expected
to conform. It is an aggregate of bilateral arrangements involving foreign aid and
technical assistance for the economic and social development of Asia and the Pacific.
32.7.2 Purpose
The purpose of the Colombo Plan is clearly stated in its title. It is for the co-operative
economic and social development in Asia and the Pacific. Again, as its motto
“Planning Prosperity Together” declares, the Colombo Plan is a collaborative effort of
nations to bring about the well being of peoples through self-help and mutual-help of
countries in the region.
32.7.3 Objectives
z To promote interest in and support for the economic and social development of
Asia and the Pacific;
z To promote technical co-operation and assist in the sharing and transfer of
technology among member countries;
z To keep under review relevant information on technical co-operation between the
member governments, multilateral and other agencies with a view to accelerating
development through co-operative effort;
z To facilitate transfer and sharing of the developmental experiences among
member countries within the region with emphasis on the concept of South- South
Co-operation.
32.7.4 Member Countries

Over the years, the Colombo Plan grew from the group of seven Commonwealth
nations – Australia, Britain, Canada, Ceylon (now Sri Lanka), India, New Zealand and
Pakistan – into an international organization of 25 including non-Commonwealth
nations. Britain and Canada withdrew from the Colombo Plan in 1991. Vietnam
joined in 1951, withdrew from its membership in 1978 and re-joined again in 2001. 341
Cambodia withdrew from the Colombo Plan in 2004. Health Agencies
The current member countries and the dates of their joining are as follows:
Afghanistan (1963), Australia (1950), Bangladesh (1972), Bhutan (1962); Fiji (1972),
India (1950), Indonesia (1953), Iran (1966), Japan (1954), Korea, Rep. of (1962) Laos
(1951), Malaysia (1957). Maldives (1963), Mongolia (1998), Myanmar (1952), Nepal
(1952), New Zealand (1950), Pakistan (1950), Papua New Guinea (1973), Philippines
(1954), Singapore (1966), Sri Lanka (1950), Thailand (1962), USA (1951), Vietnam
(2001).
Check Your Progress
1. What is UNICEF?
…………………………………….………………………………………..
…………………………………….………………………………………..
2. What are the Goals of UNDP?
…………………………………….………………………………………..
…………………………………….………………………………………..
3. List out the core values of CARE?
…………………………………….………………………………………..
…………………………………….………………………………………..
4. What is the prime motive of Rockefeller Foundation?
…………………………………….………………………………………..
…………………………………….………………………………………..
5. What is the prime focus of Colombo plan?
…………………………………….………………………………………..
…………………………………….………………………………………..
32.7.5 Organizational Structure

The principal organs of the Colombo Plan are:
1. The Consultative Committee comprising all member governments and is the
principal review and deliberative body of the Colombo Plan. Its biennial meetings
provide a forum for the exchange of views on current development problems
facing member countries and reviews economic and social progress within the
region.
2. The Colombo Plan Council’s major function is to identify important development
issues facing its members and ensures the implementation of the Consultative
Committee’s directives. It is represented by heads of member governments’
diplomatic missions resident in Colombo, Sri Lanka.
3. The Colombo Plan Secretariat which is located in Colombo, Sri Lanka,
participates in an advisory capacity at Consultative Committee Meetings; assist
the Council in the discharge of its functions; and provides administrative support
for the delivery of programmes of the Colombo Plan. The Secretary-General of
the Colombo Plan Secretariat gives guidance to the programmes and is in overall
charge of all financial and administrative matters on which he reports to the
Council.
342 32.7.6 Funding
A special characteristic of the Colombo Plan is that the administrative costs of the
Colombo Plan Council and the Colombo Plan Secretariat are borne equally by all
member Governments.
The programmes costs of the Colombo Plan activity are voluntarily funded by
traditional as well as newly emerging donors among its member countries.
Programme could also be funded through non-member government, international,
regional, public and private sector foundations, enterprises and other entities.
32.7.7 Financial Year 2006-2007: US Government Provided Additional

US$ 1.9 Million
The Colombo Plan Drug Advisory Programme received additional US$ 1.9 million
grant from Bureau for International Narcotics & Law Enforcement Affairs (INL), US
Department of State to support 8-drug demand reduction projects in Afghanistan.
Under this assistance the Colombo Plan Drug Advisory Programme will strengthen
the operations of Mosque-based drug prevention and aftercare programme, conduct
two symposiums for religious leaders and District Council Members, introduce life
skills co-curricula to schools, provide advanced training for mosque-based programme
operators, strengthen the local community and faith-based organizations in drug
demand reduction, and establish five treatment facilities for drug dependents and
provide consultancies and other technical support. These projects are implemented
with close collaboration with the Ministry of Counter Narcotics and other relevant
agencies.
32.7.8 Programmes
The Colombo Plan Secretariat in Colombo, Sri Lanka has five programmes:
z Programme for Private Sector Development (PPSD).
z Drug Advisory Programme (DAP).
z Programme on Environment (PE).
z Programme for Public Administration (PPA).
z Long-Term Fellowship Programme (LTFP).
The Colombo Plan Secretariat will issue formal invitation to the Colombo Plan
national focal point of member countries to nominate participants for international
training courses, workshops, seminars; etc organizes by the international organizations
or training institutions.
Only nominations and applications received from the national focal point within the
deadline will be considered. Final selection will be made through a joint selection
process comprised of representatives from the Colombo Plan Secretariat, the host
government and the training institution. No consideration will be given to applications
forwarded to the Colombo Plan Secretariat without formal nomination by the national
focal point.
32.8 LET US SUM UP

UNICEF United Nations General Assembly on December 11, 1946. In 1953, its name
was shortened from United nations international children’s emergency fund. It is main
activities are education, especially for girls, immunization plus, Child Protection
HIV/AIDS. UNDP is the UN’s global development network, and organization
advocating for change and connecting countries to knowledge, experience and
resources to help people build a better life. We are on the ground in 166 countries,
working with them on their own solutions to global and national development
challenges UNDP’s network links and coordinates global and national efforts to reach 343
these Goals. Our focus is helping countries build and share solutions to the challenges Health Agencies
of:
1. Democratic Governance
2. Poverty Reduction
3. Crisis Prevention and Recovery
4. Energy and Environment
5. HIV/AIDS
The World Bank has been, for some time, soliciting comments on its Country Action
Strategy (CAS) for the World Bank Group in India, which is essentially a draft plan
for intervention in India by the World Bank in different sectors form 2005 to 2008
CARE is a leading humanitarian organization fighting global poverty. Non-political
and non-sectarian, which operates each year in more than 65 countries in Africa, Asia,
Latin America, the Middle East and Eastern Europe, reaching more than 50 million
people in poor communities CARE’s mission is to serve individuals and families in
the poorest communities in the world. Drawing strength from our global diversity,
resources and experience, promote innovative solutions and advocate for global
responsibility. It promotes lasting change by:
1. Strengthening capacity for self-help.
2. Providing economic opportunity.
3. Delivering relief in emergencies
4. Influencing policy decisions at all levels
5. Addressing discrimination in all its forms
CARE International (CI) is a confederation composed of twelve national Members,
each being an autonomous non-governmental organization in its own right. CI
Members in North America, Europe, Asia and Australia carry out a range of project-
related, advocacy, fundraising and communications activities in support of CARE’s
relief and development programmes in over 65 countries worldwide.
The Rockefeller Foundation was established in 1913 by John D. Rockefeller, Sr., to
“promote the well-being” of humanity by addressing the root causes of serious
problems. The Foundation works around the world to-expand opportunities for poor
shared. With assets of more than $ 3.5 billion, it is one of the few institutions to
conduct such work both within the United States and internationally.
The primary focus of all Colombo Plan activities is human resources development in
the Asia-Pacific region. The purpose of the Colombo Plan is clearly stated in its title.
It is for the co-operative economic and social development in Asia and the Pacific.
Again, as its motto “Planning Prosperity Together” declares, the Colombo Plan is a
collaborative effort of nations to bring about the well being of peoples through self-
help and mutual-help of countries in the region.

What is the impact of globalization on International Voluntary Health Organization?
32.10 KEYWORDS
UNICEF: Headquartered in New York City, UNICEF provides long-term
humanitarian and developmental assistance to children and mothers in developing
344 countries. A voluntarily funded agency, UNICEF relies on contributions from
governments and private donors.
UNDP: It is the UN’s global development network, and organization advocating for
change and connecting countries to knowledge, experience and resources to help
people build a better life.
CARE: It is a leading humanitarian organization fighting global poverty.

1. Explain the functions and objectives of UNICEF.
2. What is UNDP? Explain its activities.
3. Explain about CARE.
4. World bank and health sector. Discuss.
5. Explain the Rockefeller foundation.
6. Explain the Colombo plan and its activities.

1. The United Nations Children’s Fund.
2. Democratic Governance, Poverty Reduction, Crisis Prevention and
Recovery, Energy and Environment and HIV/AIDS.
3. Core values of CARE are:
Respect
Integrity
Commitment
Excellence
4. “promote the well-being”
5. The primary focus of all Colombo Plan activities is human resources
development in the Asia-Pacific region.

LESSON UNIT V 347
National Health Policy
33
NATIONAL HEALTH POLICY
CONTENTS
33.1 Introduction
33.2 Important Features on NHP-1983
33.3 Objectives
33.4 Current Scenario
33.4.1 Financial Resources
33.4.2 Equity
33.4.3 Delivery of National Public Health Programmes
33.4.4 State of Public Health Insurance
33.4.5 Extending Public Health Services
33.4.6 Role of Local Self-Government Institutions
33.4.7 Norms for Health Care Personnel
33.4.8 Education of Health Care Professionals
33.4.9 Need for Specialists in ‘Public Health’ and ‘Family Medicine’
33.4.10 Nursing Personnel
33.4.11 Use of Generic Drugs and Vaccines
33.4.12 Urban Health
33.4.13 Mental Health
33.4.14 Information, Education and Communication
33.4.15 Health Research
33.4.16 Role of the Private Sector
33.4.17 Role of Civil Society
33.4.18 National Disease Surveillance Network
33.4.19 Health Statistics
33.4.20 Women’s Health
33.4.21 Medical Ethics
33.4.22 Enforcement of Quality Standards for Food and Drugs
33.4.23 Regulation of Standards in Para Medical Disciplines
33.4.24 Environmental and Occupational Health
33.4.25 Providing Medical Facilities to Users from Overseas
33.5 Impact of Globalization on the Health Sector
33.6 Inter-Sectoral Contribution to Health
Contd….
348 33.7 Population Growth and Health Standards
33.8 Alternative Systems of Medicine
33.9 Let us Sum up
33.11 Keywords

z Know the important features of NHP
z Understand the current scenario in NHP
z Get an idea about impact of globalization on the health sector
33.1 INTRODUCTION
A National Health Policy (NHP) was last formulated in 1983 and since then, there
have been marked changes in the determinant factors relating to the health sector.
Some of the policy initiatives outlined in the NHP-1983 have yielded results, while, in
several other area, the outcome has not been as expected.
33.2 IMPORTANT FEATURES ON NHP-1983

The NHP-1983 gave a general exposition of the policies, which required
recommendation in the circumstances then prevailing in the health sector. The
noteworthy initiatives under that policy were:
1. A phased, time-bound programme for setting up a well-dispersed network of
comprehensive primary health care services, linked with extension and health
education, designed in the context of the ground reality that elementary health
problems can be resolved by the people themselves.
2. Intermediation through health volunteers having appropriate knowledge, simple
skills and requisite technologies.
3. Establishment of a well worked out referral system to ensure that patient load at
the higher levels of the hierarchy is not needlessly burdened by those who can be
treated at the decentralized level.
4. An integrated network of evenly spread specialty and super specialty services,
encouragement of such facilities through private investments for patients who can
pay, so that the draw on the Government’s facilities is limited to those entitled for
free use of these facilities.
33.3 OBJECTIVES
The main objective of this policy is to achieve an acceptable standard of good health
amongst the general population of the country. The approach would be to increase
access to the decentralized public health system by establishing new infrastructure in
deficient areas, and by upgrading the infrastructure in the existing institutions.
Overriding importance would be given to ensuring a more equitable access to health
services across the social and geographical expanse of the country. Emphasis will be
given to increasing the aggregate public health investment through a substantially
increased contribution by the Central Government. It is expected that this initiative 349
will strengthen the capacity of the public health administration at the State level to National Health Policy
render effective service delivery. The contribution of the private sector in providing
health services would be much enhanced, particularly for the population group, which
can afford to pay for services. Primacy will be given to preventive and first-line
curative initiatives at the primary health level through increased sectoral share of
allocation. Emphasis will be laid on rational use of drugs within the allopathic system.
Increased access to tried and tested systems of traditional medicine will be ensured.
33.4 CURRENT SCENARIO

33.4.1 Financial Resources
The public health investment in the country over the years has been comparatively
low and as a percentage of GDP, has declined form 1.3% in 1990 to 0.9% in 1999.
The aggregate expenditure in the health sector is 5.2% of the GSP. Out of this, about
17% of the aggregate expenditure is public health spending, the balance being out-of-
pocket expenditure. The central budgetary allocation for health over this period, as a
percentage of the total Central Budget, has been stagnant at 1.3%, while that in the
States has declined from 7.0% to 5.5%. The current annual per capital public health
expenditure in the country is no more than Rs.200. Given these statistics, it is no
surprise that the reach and quality of public health services has been below the
desirable standard. Under the constitutional structure, public health is the
responsibility of the States. In this framework, it has been the expectation that the
principal contribution for the funding of public health services will be from the
resources of the States, with some supplementary input from Central resources. In this
backdrop, the contribution of Central resources to the overall public health funding
has been limited to about 15%. The fiscal resources of the State Government are
known to be very inelastic. This is reflected in the declining percentage of State
resources allocated to the health sector out of the State Budget. If the decentralized
public health services in the country are to improve significantly, there is a need for
the injection of substantial resources into the health sector fro the Central Government
Budget. This approach is a necessity – despite the formal Constitutional provision in
regard to public health – if the State public health services, which are a major
component of the initiatives in the social sector, are not to become entirely moribund.
The NHP – 2002 has been formulated taking into consideration these ground realities
in regard to the availability or resources.
33.4.2 Equity
In the period when centralized planning was accepted as a key instrument of
development in the country, the attainment of an equitable regional distribution was
considered one of its major objectives. Despite this conscious focus in the
development process, the attainment of health indices has been very uneven across the
rural – urban divide.
Given a situation in which national averages in respect of most indices are themselves
at unacceptably low levels, the wide inter-State, access to public health services is
nominal and health standards are grossly inadequate. Despite a thrust in the NHP-
1983 for making good the unmet needs of public health services by establishing more
public health institutions at a decentralized level, a large gap in facilities still persists.
Applying current norms to the population projected for the year 2000, it is estimated
that the shortfall in the number of SCs/PHCs/CHCs is of the order of 16%. However,
this shortage is as high as 58% when disaggregated for CHCs only. The NHP-2002
will need to address itself to making good these deficiencies so as to narrow the gap
between the various States, as also the gap across the rural-urban divide.
350 Access to, and benefits from, the public health system have been very uneven between
the better endowed and the more vulnerable sections of society. This is particularly
true for women, children and the socially disadvantaged sections of society.
The principal objective of NHP-2002 to evolve a policy structure, which reduces the
iniquities and allows the disadvantaged sections of society a farer access to public
health services.
33.4.3 Delivery of National Public Health Programmes

It is self-evident that in a country as large as India, which has a wide variety of socio-
economic settings, national health programmes have to be designed with enough
flexibility to permit the State public health administrations to craft their own
programme package according to their needs. Also, the implementation of the national
health programme can only be carried out through the State Governments’
decentralized public health machinery. Since, for various reasons, the responsibility of
the Central Government in funding additional public health services will continue
over a period of time, the role of the Central Government in designing broad-based
public health initiatives will inevitably continue. Moreover, it has been observed that
the technical and managerial expertise for designing large-span public health
programmes exists with the Central Government in a considerable degree; this
expertise can be gainfully utilized in designing national health programmes for
implementation in varying socio-economic settings in the States. With this
background, the NHP-2002 attempts to define the role of the Central Government and
the State Governments in the public health sector of the country.
Over the last decade or so, the Government has relied upon a ‘vertical’
implementational structure for the major disease control programmes. Through this,
the system has been able to make a substantial dent in reducing the burden of specific
diseases. However, such an organizational structure, which requires independent
manpower for each disease programme, is extremely expensive and difficult to
sustain. Over a long time-range, ‘vertical’ structures may only be affordable for those
diseases, which offer a reasonable possibility of elimination or eradication in a
foreseeable time-span.
It is a widespread perception that, over the last decade and a half, the rural health staff
has become a vertical structure exclusively for the implementation of family. Welfare
activities. As a result, for those public health programmes where there is no separate
vertical structure, there is no identifiable service delivery system at all. The Policy
will address this distortion in the public health system.
33.4.4 State of Public Health Insurance

The delineation of NHP-2002 would be based on an objective assessment of the
equality and efficiency of the existing public health machinery in the field. It would
detract from the quality of the exercise if, while framing a new policy, it were not
acknowledged that the existing public health infrastructure is far from satisfactory.
For the outdoor medical facilities in existence, funding is generally insufficient; the
presence of medical and para-medical personnel is often much less than that required
by prescribed norms; the availability of consumables is frequently negligible; the
equipment in many public hospitals is often obsolescent and unusable; and the
buildings are in a dilapidated state. In the indoor treatment facilities, again, the
equipment is often obsolescent; the availability of essential drugs is minimal; the
capacity of the facilities is grossly inadequate, which leads to overcrowding, and
consequentially to a steep deterioration in the quality of the services. As a result of
such inadequate public health facilities, it has been estimated that less than 20% of the
population, which seek OPD services, and less than 45% of that which seek indoor
treatment, avail of such services in public hospitals. This is despite the fact that most
of these patients do not have the means to make out-of-pocket payments for private
health services except at the cost of other essential expenditure for items such as basic 351
nutrition. National Health Policy
33.4.5 Extending Public Health Services

While there is a general shortage of medical personnel in the country, this shortfall is
disproportionately impacted on the less developed and rural areas. No incentive
system attempted so far has induced private medical personnel to go to such areas and,
even in the public health sector; the effort to deploy medical personnel in such
underserved areas has usually been a losing battle. In such a situation, the possibility
needs to be examined of entrusting some limited public health functions to nurses,
paramedics and other personnel from the extended health sector after imparting
adequate training to them.
India has a vast reservoir of practitioners in the Indian System of Medicine and
Homoeopathy, who have undergone formal training in their own disciplines. The
possibility of using such practitioners in the implementation of State/Central
Government public health programmes, in order to increase the reach of basic health
care in the country, is addressed in the NHP – 2002.
33.4.6 Role of Local Self-Government Institutions

Some States have adopted a policy of devolving programmes and funds in the health
sector through different levels of the Panchayati Raj Institutions. Generally, the
experience has been an encouraging one. The adoption of such an organizational
structure has enabled need-based allocation of resources and closer supervision
through the elected representatives. The Policy examines the need for a wider
adoption of this mode of delivery of health services – in other parts of the country, in
rural as well as urban areas.
33.4.7 Norms for Health Care Personnel

It is observed that the deployment of doctors and nurses, in both public and private
institutions, is ad-hoc and significantly short of the requirement for minimal standards
of patient care. This policy will make a specific recommendation in regard to this
deficiency.
33.4.8 Education of Health Care Professionals

Medical and dental colleges are not evenly spread across various parts of the country.
Apart from the uneven geographical distribution of medical institutions. The quality
of education is highly uneven and in several instances even substandard. It is a
common perception that the syllabus is excessively theoretical, making it difficult for
the fresh graduate to effectively meet even the primary health care needs of the
population. There is a general reluctance on the part of graduate doctors to serve in
areas distant from their native place. NHP-2002 will suggest policy initiatives to
rectify the resultant disparities.
Certain medical disciplines, such as molecular biology and gene-manipulation, have
become relevant in the period after the formulation of the previous National Health
Policy. The components of medical research in recent years have changed radically. In
the foreseeable future such research will rely increasingly on the new disciplines. It is
observed that the current undergraduate medical syllabus does not cover such
emerging subjects. The policy will make appropriate recommendations in respect of
such deficiencies.
Also, certain specialty disciplines – Anesthesiology, Radiology and Forensic
Medicine – are currently very scarce, resulting in critical deficiencies in the package
of available public health services. This policy will recommend some measures to
alleviate such critical shortages.
352 33.4.9 Need for Specialists in ‘Public Health’ and ‘Family Medicine’
In any developing country with inadequate availability of health services, the
requirement of expertise in the areas of ‘Public health’ and ‘Family medicine’ is
markedly more than the expertise required for other clinical specialties. In India, the
situation is that public health expertise is non-existent in the private health sector, and
far short of requirement in the public health sector. Also, the current curriculum in the
undergraduate / post-graduate courses is outdated and unrelated to contemporary
community needs. In respect of ‘family medicine’, it needs to be noted that the more
talented medical graduates generally seek specialization in clinical disciplines, while
the remaining go into general practice. While the availability of postgraduate
education facilities is 50% of the total number of qualifying graduates each year, and
can be considered adequate, the distribution of the disciplines in the postgraduate
training facilities is overwhelmingly in favour of clinical specializations. NHP – 2002
examines the possible means for ensuring adequate availability of personnel with
specializations in the ‘Public health’ and ‘Family medicine’ disciplines, to discharge
the public health responsibilities in the country.
33.4.10 Nursing Personnel

The ratio of nursing personnel in the country vis-à-vis doctors / beds is very low
according to professionally accepted norms. There is also an acute shortage of nurses
trained in super-specialty disciplines for deployment in tertiary care facilities. NHP-
2002 addresses these problems.
33.4.11 Use of Generic Drugs and Vaccines

India enjoys a relatively low-cost health care system because of the widespread
availability of indigenously manufactured generic drugs and vaccines. There is an
apprehension that globalization, will lead to an increase in the costs of drugs, thereby
leading to rising trends in overall health costs. This Policy recommends measures to
ensure the future Health Security of the country.
33.4.12 Urban Health

In most urban areas, public health services are very meager. To the extent that such
services exist, there is no uniform organizational structure. The urban population in
the country is presently as high as 30 per cent and is likely to go up to around 33 per
cent by 2010. The bulk of the increase is likely to take place through migration,
resulting in slums without any infrastructure support. Even the meager public health
services, which are available, do not percolate to such unplanned habitations, forcing
people to avail of private health care through out-of-pocket expenditure.
The rising vehicle density in large urban agglomerations (e.g. Delhi) has also led to an
increased number of serious accidents requiring treatment in well-equipped trauma
centers. NHP-2002 will address itself to the need for providing this unserved urban
population a minimum standard of broad-based health care facilities.
33.4.13 Mental Health

Mental health disorders are actually much more prevalent than is apparent on the
surface. While such disorders do not contribute significantly to mortality, they have a
serious bearing on the quality of life of the affected persons and their families.
Sometimes, based on religious faith, mental disorders are treated as spiritual affection.
This has led to the establishment of unlicensed mental institutions as an adjunct to
religious institutions where reliance is placed on faith cure. Serious conditions of
mental disorder require hospitalization and treatment under trained supervision.
Mental health institutions are woefully deficient in physical infrastructure and trained
manpower. NHP-2002 will address itself to these deficiencies in the public health
sector.
33.4.14 Information, Education and Communication 353
National Health Policy
A substantial component of primary health care consists of initiatives for
disseminating to the citizenry, public health-related information. IEC initiatives are
adopted not only for disseminating curative guidelines (for the TB, Malaria, Leprosy,
Cataract Blindness Programmes), but also as part of the effort to bring about a
behavioural change to prevent HIV/AIDS and other life-style diseases. Public health
programmes, particularly, need high visibility at the decentralized level in order to
have an impact. This task is difficult as 35% of out country’s population is illiterate.
The present IEC strategy is too fragmented, relies too heavily on the mass media, and
does not address the needs of this segment of the population. It is often felt that the
effectiveness of IEC programmes is difficult to judge, and consequently, it is often
asserted that accountability, in regard to the productive use of such funds, is doubtful.
The Policy, while projecting an IEC strategy, will fully address the inherent problems
encountered in any IEC programme designed for improving awareness and bringing
about a behavioural change in the general population.
It is widely accepted that school and college students are the most impressionable
targets for imparting information relating to the basic principles of preventive health
care. The policy will attempt to target this group to improve the general level of
awareness in regard to ‘health-promoting’ behaviour.
33.4.15 Health Research

Over the years, health research activity in the country has been very limited. In the
Government sector, such research has been confined to the research institutions under
the Indian Council of Medical Research, and other institutions funded by the States /
Central Government. Research in the private sector has assumed some significance
only in the last decade. In our country, where the aggregate annual health expenditure
is of the order of Rs. 80,000 crore; the expenditure in 1988-99 on research, both
public and private sectors, was only of the order of Rs. 1,150 crore. It would be
reasonable to infer that with such low research expenditure, it is virtually impossible
to make any dramatic breakthrough within the country, by way of new molecules and
vaccines; also, without a minimal back-up of applied and operational research, it
would be difficult to assess whether the health expenditure in the country is being
incurred through optimal applications and appropriate public health strategies.
Medical research in the country needs to be focused on therapeutic drugs / vaccines
for tropical diseases, which are normally neglected by international pharmaceutical
companies on account of their limited profitability potential. The thrust will need to be
in the newly emerging frontier areas of research based on genetics, genome-based
drug and vaccine development, molecular biology, etc. NHP-2002 will address these
inadequacies and spell out a minimal quantum of expenditure for the coming decade,
looking to the national needs and the capacity of the research institutions to absorb the
funds.
33.4.16 Role of the Private Sector

Considering the economic restructuring under way in the country, and over the globe,
in the last decade, the changing role of the private sector in providing health care will
also have to be addressed in this Policy. Currently, the contribution of private health
care is principally through independent practitioners. Also the private sector
contributes significantly to secondary-level care and some tertiary care. It is a
widespread perception that Private health serves are also perceived to be financially
exploitative, and the observance of professional ethics is noted only as an exception.
With the increasing role of private health care, the implementation of statutory
regulation, and the monitoring of minimum standards of diagnostic centers / medical
institutions becomes imperative. The Policy will address the issues regarding the
establishment of a comprehensive information system, and based on that the
354 establishment of a regulatory mechanism. To ensure the maintaining of adequate
standards by diagnostic centers / medical institutions, as well as the proper conduct of
clinical practice and delivery of medical services.
Currently, non-Governmental service providers are treating a large number of patients
at the primary level for major diseases. However, the treatment regimens followed are
diverse and not scientifically optimal, leading to an increase in the incidence of drug
resistance. This policy will address itself to recommending arrangements, which will
eliminate the risks arising form inappropriate treatment.
The increasing spread of information technology raises the possibility of its adoption
in the health sector. NHP-2002 will examine this possibility.
33.4.17 Role of Civil Society

Historically, it has been the practice to implement major national disease control
programmes through the public health machinery of the State / Central Governments.
It has become increasingly apparent that certain components of such programmes
cannot be efficiently implemented merely through government functionaries. A
considerable change in the mode of implementation has come about in the last two
decades, with the increasing involvement of NGOs and other institutions of civil
society. It is to be recognized that widespread debate on various public health issues
has, in fact, been initiated and sustained by NGOs and other members of the civil
society. Also, an increasing contribution is being made by such institutions in the
delivery of different components of public health services. Certain disease control
programmes require close interaction with the beneficiaries for regular administration
of drugs; require close interaction with the beneficiaries for regular administration of
drugs; periodic carrying out of pathological tests; dissemination of information
regarding disease control and other general health information. NHP-2002 will
address such issues and suggest policy instruments for the implementation of public
health programmes through individuals and institutions of civil society.
33.4.18 National Disease Surveillance Network

The technical network available in the country for disease surveillance is extremely
rudimentary and to the extent that the system exists, it extends only up to the district
level. Disease statistics are not flowing through an integrated network from the
decentralized public health facilities to the State/Central Government health
administration. Such an arrangement only provides belated information, which, at
best, serves a limited statistical purpose. The absence of an efficient disease
surveillance network is a major handicap in providing a prompt and cost-efficient
health care system. The efficient disease surveillance network set up for Polio and
HIV/AIDS has demonstrated the enormous value of such a public health instrument.
Real-time information on focal outbreaks of common communicable diseases –
Malaria, GE, Cholera and JE – and the seasonal trends of diseases, would enable
timely intervention, resulting in the containment of the thrust of epidemics. In order to
be able to use an integrated disease surveillance network for operational purposes,
real-time information is necessary at all levels of the health administration. The policy
would address itself to this major systemic shortcoming in the administration.
33.4.19 Health Statistics

The absence of a systematic and scientific health statistics database is a major
deficiency in the current scenario. The health statistics collected are not the product of
a rigorous methodology. Statistics available from different parts of the country, in
respect of major diseases, are often not obtained in a manner, which makes
aggregation possible or meaningful.
Further, the absence of proper and systematic documentation of the various financial
resources used in the health sector is another lacuna in the existing health information
scenario. This makes it difficult to understand trends and levels of health spending by 355
private and public providers of health care in the country, and, consequently, to National Health Policy
address related policy issues and to formulate future investment policies.

NHP-2002 will address itself to the programme for putting in place a modern and
scientific health statistics database as well as a system of national health accounts.
33.4.20 Women’s Health

Social, cultural and economic factors continue to inhibit women from gaining
adequate access even to the existing public health facilities. This handicap does not
merely affect women as individuals; it also has an adverse impact on the health,
general well-being and development of the entire family, particularly children. This
policy recognizes the catalytic role of empowered women in improving the overall
health standards of the community.
33.4.21 Medical Ethics

Professional medical ethics in the health sector is an area, which has not received
much attention. Professional practices are perceived to be grossly commercial and the
medical profession has lost its elevated position as a provider of basic services to
fellow human beings. In the past, medical research has been conducted within the
ethical guidelines notified by the Indian Council of Medical Research. The first
document containing these guidelines was released in 1960, and was comprehensively
revised in 2001. with the rapid developments in the approach to medical research, a
periodic revision will no doubt be more frequently required in future. Also, the new
frontier areas of research – involving gene manipulation, organ / human cloning and
stem cell research – impinge on visceral issues relating to the sanctity of human life
and the moral dilemma of human intervention in the designing of life forms. Besides
this, in the emerging areas of research, there is the uncharted risk of creating new life
forms, which may irreversibly damage the environment, as it exists today. NHP-2002
recognizes that this moral and religious dilemma, which was not relevant even two
years ago, now pervades mainstream health sector issues.
33.4.22 Enforcement of Quality Standards for Food and Drugs

There is an increasing expectation and need of the citizenry for efficient enforcement
of reasonable quality standards for food and drugs. Recognizing this, the Policy will
make an appropriate policy recommendation on this issue.
33.4.23 Regulation of Standards in Para Medical Disciplines

It has been observed that a large number of training institutions have mushroomed,
particularly in the private sector, for Paramedical personnel with various skills – lab
technicians, radio diagnosis technicians, physiotherapists, and others. Currently, there
is no regulation/monitoring, either of the curriculae of these institutions, or of the
performance of the practitioners in these disciplines. This Policy will make
recommendations to ensure the standardization of such training and the monitoring of
actual performance.
33.4.24 Environmental and Occupational Health

The ambient environmental conditions are a significant determinant of the health risks
to which a community is exposed. Unsafe drinking water, unhygienic sanitation and
air pollution significantly contribute to the burden of disease, particularly in urban
settings. The initiatives in respect of these environmental factors are conventionally
undertaken by the participants, where private or public, in the other development
sectors. In this backdrop, the Policy initiatives, and the efficient implementation of the
linked programmes in the health sector, would succeed only to the extent that they are
356 complemented by appropriate policies and programmes in the other environment-
related sectors.
Work conditions in several sectors of employment in the country are sub-standard. As
a result, workers engaged in such employment become particularly vulnerable to
occupation-linked ailments. The long-term risk of chronic morbidity is particularly
marked in the case of child labour. NHP-2002 will address the risk faced by this
particularly vulnerable section of society.
33.4.25 Providing Medical Facilities to Users from Overseas

The secondary and tertiary facilities available in the country are of good quality and
cost-effective compared to international medical facilities. This is true not only of
facilities in the allopathic disciplines, but also of those belonging to the alternative
systems of medicine, particularly Ayurveda. The Policy will assess the possibilities of
encouraging the development of paid treatment-packages for patients from overseas.
33.5 IMPACT OF GLOBALIZATION ON THE

HEALTH SECTOR
There are some apprehensions about the possible adverse impact of economic
globalization on the health sector. Pharmaceutical drugs and other health services
have always been available in the country at extremely inexpensive prices. India has
established a reputation around the globe for the innovative development of original
process patents for the manufacture of a wide-range of drugs and vaccines within the
ambit of the existing patent laws. With the adoption of Trade Related Intellectual
Property Rights (TRIPS), and the subsequent alignment of domestic patent laws
consistent with the commitments under TRIPS, there will be a significant shift in the
scope of the parameters regulating the manufacture of new drugs/vaccines. Global
experience has shown that the introduction of a TRIPS-consistent patent regime for
drugs in a developing country results in an across-the-board increase in the cost of
drugs and medical services. NHP-2002 will address itself to the future imperatives of
health security in the country, in the post-TRIPS era.
33.6 INTER-SECTORAL CONTRIBUTION TO HEALTH

It is well recognized that the overall well-being of the citizenry depends on the
synergistic functioning of the various sectors in the socio-economy the health status of
the citizenry would, inter alia, be dependent on adequate nutrition, safe drinking
water, basic sanitation, a clean environment and primary education, especially for the
girl child. The policies and the mode of functioning in these independent areas would
necessarily overlap each other to contribute to the health status of the community.
Form the policy perspective, it is therefore imperative that the independent policies of
each of these inter-connected sectors, be in tandem, and that the interface between the
policies of the two connected sectors, be smooth.
Sectoral policy documents are meant to serve as a guide to action for institution and
individual participants operating in that sector. Consistent with this role, NHP-2002
limits itself to making recommendations for the participants operating within the
health sector. The policy aspects relating to inter-connected sectors, which, while
crucial, fall outside the domain of the health sector, will not be covered by specific
recommendations in this policy document. Needless to say, the future attainment of
the various goals set out in this policy assumes a reasonable complementary
performance in these inter-connected sectors.
357
33.7 POPULATION GROWTH AND HEALTH STANDARDS National Health Policy
Efforts made over the years for improving health standards have been partially
neutralized by the rapid growth of the population. It is well recognized that population
stabilization measures and general health initiatives, when effectively synchronized,
synergistically maximize the socio-economic well being of the people. Government
has separately announced the ‘National Population Policy 2000’. The principal
common features covered under the National Population Policy 2000 and NHP-2002,
relate to the prevention and control of communicable diseases, giving priority to the
containment of HIV/AIDS infection; the universal immunization of children against
all major preventable diseases; addressing the unmet needs for basic and reproductive
health services, and supplementation of infrastructure. The synchronized
implementation of these two Policies-National Population Policy-2000 and National
Health Policy-2002-will be the very cornerstone of any national structural plan to
improve the health standards in the country.
Check Your Progress
1. What is the primary objectives of NHP?
……………………………………………………………………………...
……………………………………………………………………………...
2. List out alternative systems of medicine.
……………………………………………………………………………...
……………………………………………………………………………...
33.8 ALTERNATIVE SYSTEMS OF MEDICINE

Under the overarching umbrella of the national health framework, the alternative
systems of medicine-Ayurveda, Unani, Siddha and Homoeopathy-have a substantial
role. Because of inherent advantages, such as diversity, modest cost, low level of
technological input and the growing popularity of natural plant-based products, these
systems are attractive, particularly in the underserved, remote ant tribal areas. The
alternative systems will draw upon the substantial untapped potential of India as one
of the eight important global centers for plant diversity in medicinal and aromatic
plants. The Policy focuses on building up credibility for the alternative systems, by
encouraging evidence – based research to determine their efficacy, safety and dosage,
and also encourages certification and quality marking of products to enable a wider
popular acceptance of these systems of medicine. The Policy also envisages the
consolidation of documentary knowledge contained in the these systems to protect it
against attack from foreign commercial entities by way of malafide action under
patent laws in other countries. The main components of NHP-2002 apply equally to
the alternative systems of medicines.
However, the Policy features specific to the alternative systems of medicine will be
presented as a separate document.
33.9 LET US SUM UP

A National Health Policy (NHP) was last formulated in 1983. The main objective of
this policy is to achieve an acceptable standard of good health amongst the general
population of the country. This lesson emphasized the current scenario of NHP in the
areas: financial resources, equity, delivery of national public health programmes, the
state of public health insurance, extending public health services, role of local self-
government institutions, norms for health care personnel education of health care
professionals, need for specialists in ‘public health’ and ‘family medicine’, nursing
358 personnel, use of generic drugs and vaccines, urban health mental health information,
education and communication, health research, role of the private sector, the role of
civil society, national disease surveillance network health statistics women’s health ,
medical ethics enforcement of quality standards for food and drugs etc.

How far the medical tourism is developing after the implementation of new health
policy? Discuss.
33.11 KEYWORDS
National Health Policy: It is last formulated in 1983 and since then, there have been
marked changes in the determinant factors relating to the health sector.
Paramedical Personnel: Lab technicians, radio diagnosis technicians,
physiotherapists, and others.
Alternative Systems of Medicine: Under the overarching umbrella of the national
health framework, the alternative systems of medicine - Ayurveda, Unani, Siddha and
Homeopathy - have a substantial role.

1. Explain important features of NHP-1983.
2. Explain the current scenario in NHP.
3. Explain the impact of globalization on the health sector.

1. The main objective of this policy is to achieve an acceptable standard of
good health amongst the general population of the country.
2. Ayurvedic, Unani, Sidha and Homeopathy.

Goel, S.L., “Health Care Policies and Programmes”, Deep & Deep Publications Pvt. Ltd.,
New Delhi.
359
LESSON National Population
Policy 2000
34
NATIONAL POPULATION POLICY 2000
CONTENTS
34.1 Introduction
34.2 India’s Demographic Achievement
34.3 India’s Population in 1991 and Projections to 2016
34.4 Objectives
34.5 National Socio-Demographic Goals for 2010
34.6 Population Growth in India
34.7 Strategic Themes
34.7.1 Decentralised Planning and Programme Implementation
34.7.2 Convergence of Service Delivery at Village Levels
34.7.3 Empowering Women for Improved Health and Nutrition
34.7.4 Child Health and Survival
34.7.5 Meeting the Unmet Needs for Family Welfare Services
34.7.6 Under-served Population Groups
34.7.7 Collaboration with and Commitments from NGOs and the Private
Sector
34.7.8 Mainstreaming Indian Systems of Medicine and Homeopathy
34.7.9 Contraceptive Technology and Research on Reproductive and Child Health
34.7.10 Providing for the Older Population
34.8 National Commission on Population
34.9 State/UT Commissions on Population
34.10 Coordination Cell in the Planning Commission
34.11 Technology Mission in the Department of Family Welfare
34.12 Let us Sum up
34.14 Keywords
360
Health Laws and Policies 34.0 AIMS AND OBJECTIVES
z Know about the India’s demographic achievement and India’s population
projection
z Explain the strategic themes to achieve the socio-demographic goals for 2010
z Know about the state and national commission on population
34.1 INTRODUCTION
The overriding objective of economic and social development is to improve the
quality of lives that people lead, to enhance their well-being, and to provide them with
opportunities and choices to become productive assets in society.
In 1952, India was the first country in the world to launch a national programme,
emphasizing family planning. After 1952, sharp declines in death rates were, however,
not accompanied by a similar drop in birth rates. The National Health Policy, 1983
stated that replacement levels of Total Fertility Rate (TFR) should be achieved by the
year 2000.
34.2 INDIA’S DEMOGRAPHIC ACHIEVEMENT

Half a century after formulating the national family welfare programme, India has:
z Reduced Crude Birth Rate (CBR) from 40.3 (1951) to 26.4 (1988, SRS);
z Halved the Infant Mortality Rate (IMR) from 146 per 1000 live births (1951) to
72 per 1000 live birth (1998, SRS);
z Quadrupled the Couple Protection Rate (CPR) from 10.4 percent (1971) to 44
percent (1999);
z Reduced Crude Death Rate (CDR) from 25 (1951) to 9.0 (1998, SRS);
z Added 25 years to life expectancy from 37 years to 62 years;
z Achieved nearly universal awareness of the need for and methods of family
planning, and
z Reduced total fertility rate from 6.0 (1951) to 3.3 (1997, SRS).
34.3 INDIA’S POPULATION IN 1991 AND

PROJECTIONS TO 2016
Population Projections for India (In Million)
March 1991 March 2001 March 2011 March 2016
846.3 1012.4 1178.9 1263.5
Source: Technical Group on Population Projections, Planning Commission.
z Stabilising population is an essential requirement for promoting sustainable

development with more equitable distribution. However, it is as much a function
of making reproductive health care accessible and affordable for all, as of
increasing the provision and outreach of primary and secondary education,
extending basic amenities including sanitation, safe drinking water and housing,
besides empowering women and enhancing their employment opportunities, and
providing transport and communications.
z The National Population Policy, 2000 (NPP 2000) affirms the commitment of 361
National Population
government towards voluntary and informed choice and consent of citizens while Policy 2000
a availing of reproductive health care services, and continuation of the target free
approach in administering family planning services. The NPP 2000 provides a
policy framework for advancing goals and prioritizing strategies during the next
decade, to meet the reproductive and child health needs of the people of India, and
to achieve net replacement levels (TFR) by 2010. It is based upon the need to
simultaneously address issues of child survival, maternal health, and
contraception, while increasing outreach and coverage of a comprehensive
package of reproductive and child health services by government, industry and the
voluntary non-government sector, working in partnership.
34.4 OBJECTIVES
The immediate objectives of the NPP 2000 is to address the unmet:
1. Needs for contraception
2. Health care infrastructure
3. Health personnel
4. To provide integrated service delivery for basic reproductive and child health
care.
In pursuance of these objectives, the following National Socio-Demographic Goals to
be achieved in each case by 2010 are formulated:
34.5 NATIONAL SOCIO-DEMOGRAPHIC

GOALS FOR 2010
1. Achieve universal immunization of children against all vaccine preventable
diseases.
2. Achieve 80 percent institutional deliveries and 100 percent deliveries by trained
persons.
3. Achieve universal access to information/counseling, and services for fertility
regulation and contraception with a wide basket of choices.
4. Achieve 100 percent registration of births, deaths, marriage and pregnancy.
5. Prevent and control communicable diseases.
If the NPP 2000 is fully implemented, we anticipate a population of 1107 million (110
crores) in 2010, Instead of 1162 million (116 crores) projected by Technical Group on
Population Projections:
34.6 POPULATION GROWTH IN INDIA

z The large size of the population in the reproductive age-group (estimated
contribution 58 percent).
z Higher fertility due to unmet need for contraception (estimated contribution 20
percent).
z High wanted fertility due to the high infant mortality rate (IMR) (estimated
contribution about 20 percent).
z Over 50 percent of girls marry below the age of 18, the minimum legal age of
marriage.
362
Health Laws and Policies 34.7 STRATEGIC THEMES
We identify 11 strategic themes which must be simultaneously pursued in “stand
alone” or inter-sectoral programmes in order to achieve the national socio-
demographic goals for 2000.
These are presented below:
34.7.1 Decentralised Planning and Programme Implementation

z The 73rd and 74th Constitutional Amendments Act, 1992, made health, family
welfare, and education a responsibility of village panchayats. The panchayati raj
institutions are an important means of furthering decentralized planning and
programme implementation in the context of the NPP 2000.
z Further, since 33 percent of elected panchayat seats are reserved for women,
representative committees of the panchayats (headed by an elected woman
panchayat member) should be formed to promote a gender sensitive, multi-
sectoral agenda for population stabilization, that will “think, plan and act locally,
and support nationally”.
z These committees may identify area-specific unmet needs for reproductive health
services, and prepare need-based, demand-driven, socio-demographic plans at the
village level, aimed at identifying and providing responsive, people-centred and
integrated, basic reproductive and child health care.
z Panchayats demonstrating exemplary performance in the compulsory registration
of births, deaths, marriages, and pregnancies, increasing safe deliveries, bringing
about reductions in infant and maternal mortality, and promoting compulsory
education up to age 14, be nationally recognized and honored.
34.7.2 Convergence of Service Delivery at Village Levels

z Current health infrastructure includes 2,500 community health centres, 25,000
primary health centres (each covering a population of 30,000), and 1.36 lakh
subcentres (each covering a population of 5,000 in the plains and 3,000 in hilly
regions).
z Inadequacies in the existing health infrastructure have led to an unmeet need of
28 percent for contraception services.
z A key feature of the integrated service delivery will be the registration at village
levels, of births, deaths, marriage, and pregnancies.
z Each village should maintain a list of community midwives and trained birth
attendants, village health guides, panchayat sewa sahayaks, primary school
teachers and aanganwadi workers who may be entrusted with various
responsibilities in the implementation of integrated service delivery.
z The panchayats should seek the help of community opinion makers to
communicate the benefits of smaller, healthier families, the significance of
education girls, and promoting female participation in paid employment. The
should also involve civil society in monitoring the availability, accessibility and
affordability of services and supplies.
34.7.3 Empowering Women for Improved Health and Nutrition

z Discriminatory childcare leads to malnutrition and impaired physical development
of the girl child. Under nutrition and micronutrient deficiency in early adolescence
goes beyond mere food entitlements to those nutrition related capabilities that
become crucial to a woman’s well-being, and through her, to the well-being of
children.
z To the extent that women are over-represented among the poor, interventions for 363
National Population
improving women’s health and nutrition are critical for poverty reduction. Policy 2000
z Malnutrition, frequent pregnancies, unsafe abortions, RTI and STI, all combine to
keep the maternal mortality ratio in India among the highest globally.
z The extent of maternal mortality is an indicator of disparity and inequity in access
to appropriate health care and nutrition services throughout a lifetime.
z Programmes for Safe Motherhood, Universal Immunisation, Child Survival and
Oral Rehydration have been combined into an Integrated Reproductive and Child
health Programme, which also includes promoting management of STIs and RTIs.
34.7.4 Child Health and Survival

Infant mortality is a sensitive indicator of human development. High mortality and
morbidity among infants and children below 5 years occurs on account of inadequate
care, asphyxia during birth, premature birth, low birth weight, acute respiratory
infections, diarrhea, vaccine preventable diseases, malnutrition and deficiencies of
nutrients, including Vitamin A. Infant mortality rates have not significantly declined
in recent years. Our priority is to intensify neo-natal care. A National Technical
Committee should be set up, consisting principally of consultants in obstetrics,
pediatrics (neonatologists), family health, medical research and statistics from among
academia, public health professionals, clinical practitioners and government.
34.7.5 Meeting the Unmet Needs for Family Welfare Services

In both rural and urban areas there continue to be unmet needs for contraceptives,
supplies and equipment for integrated service delivery, mobility of health providers
and patients, and comprehensive information.
34.7.6 Under-served Population Groups

z Urban Slums: Nearly 100 million people live in urban slums, with little or no
access to potable water, sanitation facilities, and health care services. This
contributes to high infant and child mortality.
z Tribal communities, hill area populations and displaced and migrant
populations:
Populations in remote and low density areas do not have adequate access to
affordable health care services.
Information and counseling on infertility, and regular supply of standardized
medication will be included.
z Adolescents:
Adolescents represent about a fifth of India’s population. The needs of
adolescents, including protection from unwanted pregnancies and Sexually
Transmitted Diseases (STD), have not been specifically addressed in the past.
Programmes should encourage delayed marriage and child-bearing, and
education of adolescents about the risks of unprotected sex. Reproductive
health services for adolescent girls and boys is especially significant in rural
India, where adolescent marriage and pregnancy are widely prevalent.
Their special requirements comprise information, counseling, population
education, and making contraceptive services accessible and affordable,
providing food supplements and nutritional services through the ICDS, and
enforcing the Child Marriage Restraint Act, 1976.
364 z Increased Participation of Men in Planned Parenthood:
In the past, population programmes have tended to exclude men folk. Gender
inequalities in patriarchal societies ensure that men play a critical role in
determining the education and employment of family members, age at
marriage, besides access to and utilization of health, nutrition, and family
welfare services for women and children.
The active involvement of men is called for in planning families, supporting
contraceptive use, helping pregnant women stay healthy, arranging skilled
care during delivery, avoiding delays in seeking care, helping after the baby is
born and, finally, in being a responsible father.
The special needs of men include re-popularising vasectomies and focusing
on men in the information and education campaigns to promote the small
family norm.
34.7.7 Collaboration with and Commitments from NGOs and the Private
Sector
z A national effort to reach out to households cannot be sustained by government
alone. We need to put in place a partnership of non-government voluntary
organizations, the private corporate sector, government and the community.
However mobilizing the private (profit and non-profit) sector to serve public
health goals raises governance issues of contracting, accreditation, regulation,
referral, besides the appropriate division of labour between the public and
private health providers, all of which need to be addressed carefully.
34.7.8 Mainstreaming Indian Systems of Medicine and Homeopathy

z India’s community supported indigenous systems of medicine with effective cures
and remedies for numerous conditions, including those relating to women and
children, with minimal side effects.
z Particular challenges include providing appropriate training, and raising
awareness and skill development in reproductive and child health care.
z ISMH practices may be applied at village maternity huts, and at household levels,
for ante-natal, and post natal care, and for nurture of the new born.
34.7.9 Contraceptive Technology and Research on Reproductive and

Child Health
z Government must constantly advance, encourage, and support medical, social
science, demographic and behavioural science research on maternal, child and
reproductive health care issues.
z The International Institute of Population Sciences, and the population research
centres which have been set up to pursue applied research in population related
matters, need to be revitalized and strengthened.
z The National Health and Family Welfare Survey provides data on key health and
family welfare indicators every five years.
z Annual data is generated by the Sample Registration Survey, which, inter alia,
maps at state levels the birth, death and infant mortality rates.
34.7.10 Providing for the Older Population

z Improved life expectancy is leading to an increase in the absolute number and
proportion of persons aged 60 years and above, and is anticipated to nearly double
during 1996-2016, from 62.3 million to 112.9 million.
z When viewed in the context of significant weakening of traditional support 365
National Population
systems, the elderly are increasingly vulnerable, needing protection and care. Policy 2000
z Promoting old age health care and support will, over time, also serve to reduce the
incentive to have large families.
z The Ministry of Social Justice and Empowerment has adopted in January 1999 a
National Policy on Older Persons.
z Formal and informal schemes that make the elderly economically elf-reliant;
providing for and routinising screening for cancer, osteoporosis, and
cardiovascular conditions and exploring tax incentives to encourage grown-up
children to look after their aged parents.

z Information, Education and Communication (IEC) of family welfare messages
must be clear, focused and disseminated everywhere, including the remote corners
of the country, and in local dialects. This will ensure that the messages are
effectively conveyed. These need to e strengthened and their outreach widened,
with locally relevant, and locally comprehensible media and messages.
z There is need to undertake a massive national campaign on population related
issues, via artists, popular film stars, doctors, vaidyas, hakims, nurses, local
midwives, women’s organizations, and youth organizations.
Check Your Progress
1. What was the India’s population in 1991 and what will be on 2016?
……………………………………….……………………………………..
……………………………………….……………………………………..
2. What are the main objectives of national population policy?
……………………………………….……………………………………..
……………………………………….……………………………………..
3. What are the National socio-demographic goals for 2010?
……………………………………….……………………………………..
……………………………………….……………………………………..
4. What are the important reasons for continues growth of population in
India?
……………………………………….……………………………………..
……………………………………….……………………………………..
34.8 NATIONAL COMMISSION ON POPULATION

A National Commission on Population presided over by the Prime Minister, will have
the Chief Ministers of all States and UTs, and the Central Minister in-charge of the
Department of Family Welfare and other concerned Central Ministries and
Departments, for example Department of Women and Child Development,
Department of Education, Department of Social Justice and Empowerment in the
Ministry of HRD, Ministry of Rural Development, Ministry of Environment and
Forest, and others as necessary, and reputed demographers, public health
professionals, and MGOs as members.
This commission will oversee and review implementation of policy. The Commission
Secretariat will be provided by the Department of Family Welfare.
366
Health Laws and Policies 34.9 STATE / UT COMMISSIONS ON POPULATION
Each state and UT may consider having a State/UT Commission on Population,
presided over by the Chief Minister, on the analogy of the National Commission, to
likewise oversee and review implementation of the NPP 2000 in the State/UT.
34.10 COORDINATION CELL IN THE PLANNING

COMMISSION
The Planning Commission will have a Coordination Cell for inter-sectoral
coordination between Ministries for enhancing performance, particularly in
States/UTS needing special attention on account of adverse demographic and human
development indicators.
34.11 TECHNOLOGY MISSION IN THE DEPARTMENT OF

FAMILY WELFARE
To enhance performance, particularly in states with currently below average socio-
demographic indices that need focused attention, a technology Mission in the
Department of Family Welfare will be established to provide technology support in
respect of design and monitoring or projects and programmes for reproductive and
child health, as well as for IEC campaigns.
In the new millennium, nations are judged by the well-being of their peoples; by
levels of health, nutrition and education; by the civil and political liberties enjoyed by
their citizens; by the protection guaranteed to children and by provisions made for the
vulnerable and the disadvantaged.
The vast numbers of the people of India can be its greatest asset if they are provided
with the means to lead healthy and economically productive lives.
34.12 LET US SUM UP

Stabilizing population is an essential requirement for promoting sustainable
development with more equitable distribution. The National Population Policy, 2000
(NPP 2000) affirms the commitment of government towards voluntary and informed
choice and consent of citizens while a availing of reproductive health care services,
and continuation of the target free approach in administering family planning services.
The NPP 2000 provides a policy framework for advancing goals and prioritizing
strategies during the next decade, to meet the reproductive and child health needs of
the people of India, and to achieve net replacement levels by 2010. The Strategic
themes are: Decentralised planning and programme, implementation convergence of
service delivery at village levels, Empowering women for improved health and
nutrition child health and survival, Meeting the unmet needs for family welfare
services under-served population groups, Collaboration with and commitments from
non-government organizations and the private sector, Mainstreaming Indian systems
of medicine and homeopathy, contraceptive technology and research on reproductive
and child health, providing for the older population and information, education, and
communication

Does the population decreased or stabled due to the implementation of the policy?
Discuss.
367
34.14 KEYWORDS National Population
Policy 2000
NPP-2000: A policy framework for advancing goals and prioritizing strategies during
the next decade, to meet the reproductive and child health needs of the people of
India, and to achieve net replacement levels (TFR) by 2010.
Immediate Objective: To meet needs of contraception, health infrastructure, health
personnel and to provide integrated service for basic reproductive and child health
care.
Medium-term Objective: To lower down the total fertility rates to the replacement
level by 2010.
Long-term Objective: To achieve a stable population by 2045.

1. Explain the India’s Demographic achievement and the India’s population
projection on 2016.
2. What are the National Socio-demographic Goals for 2010?
3. Elaborate the strategic themes to achieve the national socio-demographic goals for
2010.
4. Explain the National and State Commission on population.

1. Population Projections For India (In Million)
March 1991 March 2001 March 2011 March 2016
846.3 1012.4 1178.9 1263.5
2. The immediate objectives of the NPP 2000 is to address the unmet:
1. Needs for contraception.
2. Health care infrastructure
3. Health personnel
4. To provide integrated service delivery for basic reproductive and
child health care.
3. National Socio-Demographic Goals for 2010 are:
Achieve universal immunization of children against all vaccine
preventable diseases.
Achieve 80 percent institutional deliveries and 100 percent deliveries
by trained persons.
Achieve universal access to information/counseling, and services for
fertility regulation and contraception with a wide basket of choices.
Achieve 100 percent registration of births, deaths, marriage and
pregnancy.
Prevent and control communicable diseases.
4. Population growth in India continues to be high on account of:
The large size of the population in the reproductive age-group
(estimated contribution 58 percent).
Higher fertility due to unmet need for contraception (estimated
contribution 20 percent).
High wanted fertility due to the high infant mortality rate (IMR)
(estimated contribution about 20 percent).
Over 50 percent of girls marry below the age of 18, the minimum
legal age of marriage.
368
Singh Sehgal B.P., “Population Policy and the Law”, Deep & Deep Publications, New Delhi.
369
LESSON Pharmacy Legislation in India
35
PHARMACY LEGISLATION IN INDIA
CONTENTS
35.1 Introduction
35.2 Pharmacy Legislation in India-Overview
35.3 Present Act and Rules
35.3.1 Drugs and Cosmetics Act, 1940
35.3.2 Pharmacy Act, 1948
35.3.3 Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954
35.3.4 Narcotic Drugs and Psychotropic Substances Act, 1985
35.4 Some Other Laws
35.5 Historical Development of Pharmaceutical Education In India
35.6 Let us Sum up
35.8 Keywords

z Understand about the different pharmacy legislation in India
z Know the history and development of pharmaceutical education in India
35.1 INTRODUCTION
In the beginning of the current century Drug Industry was practically non-existent in
India and pharmaceuticals were being important from abroad. The first world war
changed the situation and not only were finished and cheap drugs imported in
increasing volume, the demand for indigenous products also was voiced from all
sides. With the clamour for swadeshi goods manufacturing concerns, both Indian and
Foreign, sprang up to produce pharmaceuticals at cheaper rates to compete with
imported products. Naturally some of these were of inferior quality and harmful for
public health. The Government was, therefore, called upon to take notice of the
situation and consider the matter of introducing legislation to control the manufacture,
distribution and sale of drugs and medicines.
The Indian traditional systems of medicine have been Ayurveda, Siddha and Unani.
Ayurveda and Siddha originated in India itself. Unani, the Greco- Arabic medical
system, came from West Asia. The European colonizers brought the western system
370 of medicine to the country. During the colonial period, the new system, commonly
referred to as allopathy, got firmly established. It held the sway and came to have
controlling influence on health care. On the country attaining independence there was
no going back. Chronicling the medico-pharmaceutical developments of the modern
period is an attractive subject of study.
35.2 PHARMACY LEGISLATION IN INDIA – OVERVIEW

Two of the laws, The Poisons Act and the Dangerous Drugs Act were passed in 1919
and 1930 respectively. The Opium Act was quite old having being adopted as early as
1878. But to have a comprehensive legislation, which the rapid expansion of the
pharmaceutical production and drug market required by the end of the second decade
for its control, the Indian Government appointed, in 1931, a Drugs Enquiry
Committee under the Chairmanship Lt. Col. R. N. Chopra which was asked to make
sifting enquiries into the whole matter of drug production, distribution and sale by
inviting opinions and meeting concerned people. The Committee was asked to make
recommendations about the ways and means of controlling the production and sale of
drugs and pharmaceuticals in the interest of public health. The Chopra Committee
toured all over the country and after carefully examining the data placed before it,
submitted a voluminous report to government suggesting creation of drug control
machinery at the centre with branches in all provinces. For an efficient and speedy
working of the controlling department the committee also recommended the
establishment of a well-equipped Central Drugs Laboratory with competent staff and
experts in various branches for data standardization work. Under the guidance of the
Central Laboratory, it was suggested, small laboratories would work, in the provinces.
For the training of young men and women, the Committee recommended the
permission of Central Pharmacy Council, and the Provincial Pharmacy Councils, with
registrars who would maintain the lists containing names and addresses of the licensed
pharmacists.
The outbreak of the second world war in 1939 delayed the introduction of legislation
on the lines suggested by the Chopra Committee which the Indian government
contemplated and considered as urgent. However, the Drugs Act was passed in 1940
partly implementing the Chopra recommendations. With the achievement of
independence in 1947 the rest of the required laws were put on the Statute Book. In
1985, the Narcotic Drugs and Psychotropic Substances Act was enacted repealing the
Dangerous Drugs Act 1930 and the Opium Act of 1878.
35.3 PRESENT ACT AND RULES

At present the following Acts and Rules made there under that govern the
manufacture, sale, import, export and clinical research of drugs and cosmetics in
India:
z Drugs and Cosmetics Act, 1940
z The Pharmacy Act, 1948
z The Drugs and Magic Remedies (Objectionable Advertisement) Act, 1954
z The Narcotic Drugs and Psychotropic Substances Act, 1985
z The Medicinal and Toilet Preparations (Excise Duties) Act, 1956
z The Drugs (Prices Control) Order 1995 (under the Essential Commodities Act)
35.3.1 Drugs and Cosmetics Act, 1940

The object of the Act is to regulate the import, manufacture, distribution and sale of
drugs. Under the provisions of this Act, the Central Government appoints the Drugs
Technical Advisory Board to advise the Central Government and the State 371
Governments on technical matters arising out of the administration of this Act. The Pharmacy Legislation in India
board can constitute subcommittees for the consideration of a particular matter.
35.3.2 Pharmacy Act, 1948

The Pharmacy Act was passed in 1948 and was amended in 1959, 1976 and 1984. The
aim of this law is to regulate the profession of Pharmacy in India. Under the
provisions of this act the Central Government constitutes a Central Pharmacy Council
of India consisting of following members:
a) Six members from the Teachers of pharmacy.
b) Six members from practicing pharmacists or Pharmaceutical Chemists holding
degree of diploma.
c) One member elected by the Medical Council of India.
d) The Director-General of Health Services.
e) The Director of the Central Drugs Laboratory.
f) The Chief Chemist, Central Revenues.
g) One member to represent each state elected by members of State Councils who
shall be a registered pharmacist.
h) One member to represent each State Government who shall be either registered
medical practitioner or a registered pharmacist.
The President and Vice-President of the Central Council of Pharmacy are elected by
the members of the Council among themselves, hold office for five years and are
eligible for re-election.
The conducting of courses of study for pharmacists, and the examinations in
Pharmacy in the states are subject to the approval of the Central Council. Besides the
Council has the responsibility to supervise the Education of Pharmacy in the States.
Where it is found that the course of study is not in conformity with the Education
Regulations, the Council may withdraw approval accorded to the course or the
examination. The Central Council can approve qualifications granted by an outside
authority for qualifying for registration under this Act.
z State Pharmacy Councils: The Act makes it incumbent upon the State
Governments to constitute State Pharmacy Councils with the following members:
a) Six members elected from amongst themselves by registered Pharmacists of
the state.
b) Five members of whom at least two shall be persons possessing a prescribed
degree or diploma in Pharmacy or Pharmaceutical Chemistry or members of
the Pharmaceutical profession nominated by the State Government.
c) One member elected by the State Medical Council.
d) The Chief Medical Officer of the State.
e) The State Drug Controller.
f) The Government Analyst.
z Registration of Pharmacists: The State Government has under the provisions of
the Pharmacy Act to get a register of the State Pharmacists prepared and it is the
State Pharmacy Council which has to maintain the register. The register shall
contain the name and residential address of Pharmacist, the date of his first
admission to the register, qualifications for registration, his professional address,
the name of his employer and prescribed particulars.
372 35.3.3 Drugs and Magic Remedies (Objectionable Advertisements)
Act, 1954
This Act is meant to control the advertisements regarding drugs; it prohibits the
advertising of remedies alleged to possess magic qualities and to provide for matters
connected therewith.
The Drugs and Magic Remedies Act prohibits a person from taking part in publication
of any advertisement referring to any drug which suggests use of the drug for:
z the procurement of miscarriage in women or prevention of conception in women;
and
z the maintenance or improvement of the capacity of the human being for sexual
pleasure;
z the correction of menstrual disorders in women;
z the diagnosis, cure, mitigation, treatment or prevention of any venereal disease. It
is prohibited to directly or indirectly give a false impression regarding the true
character of a drug or make false claim for it or to convey any false or misleading
information in any material particular about it. No person shall import into or
export from India any document containing advertisement of this nature.
Whoever contravenes the provisions of this Act shall, on conviction, be punishable
with imprisonment which may extend to six months, with or without fine. In case of
subsequent convictions the imprisonment can be extended to one year. The document,
article or thing which contains the offending advertisement can be seized and
confiscated.
If the person contravening any of the provisions of the Act is a company, every person
who at the time the offence was committed was in charge of the business of the
company shall be deemed guilty.
The prohibition under this Act does not apply to: (a) any signboard or notice displayed
by a registered medical practitioner including the treatment for any of the disease,
(b) any treaties or book dealing with any of the matters from a bonafide scientific
standpoint, (c) any advertisement related to any drug sent confidentially to any
registered medical practitioners or to chemists for distribution among registered
medical practitioners or to a hospital or laboratory, and (d) Government
advertisements.
35.3.4 Narcotic Drugs and Psychotropic Substances Act, 1985

This is an Act to consolidate and amend the law relating to Narcotic Drugs, to make
stringent provisions for the control and regulation of operations relating to Narcotic
Drugs and Psychotropic Substances and for matters connected therewith.
35.4 SOME OTHER LAWS

There are some other laws which have a bearing on pharmaceutical manufacture,
distribution and sale in India. The important ones being:
1. The Industries (Development and Regulation) Act, 1951
2. The Trade and Merchandise Marks Act, 1958
3. The Indian Patent and Design Act, 1970
4. Factories Act
Pharmacy Legislation in India
List out the different Pharmacy legislations in India.
………………………………………..………………………………………...
………………………………………..………………………………………...
35.5 HISTORICAL DEVELOPMENT OF

PHARMECUTICAL EDUCATION IN INDIA
With a decade of introduction of pharmacy practice education in India, there has been
a paradigm shift in the practice of pharmacy in the country. In spite of this, pharmacy
practice education faces many challenges before it can transform the pharmaceutical
care practice in India from a product-oriented approach to patient-oriented care.
Pharmacy education in India is mainly industry oriented. The curriculum at the
undergraduate level is more or less designed for preparing students towards industry
rather than for patient-oriented services like hospital, clinical, and community
pharmacy. To train the graduate pharmacists to provide patient-oriented services, a
pharmacy practice course was started at a postgraduate level. Pharmacy practice
curriculum enters its tenth year in India since its beginning in 1997. The curriculum
trains the postgraduates in rational therapeutics, patient counseling, pharma-
covigilance, therapeutic drug monitoring, clinical research,and toxicology to name a
few. With the efforts being on introducing the advanced clinical-based courses of the
doctor of pharmacy (PharmD) degree in India, there is a need to contemplate where
the profession stands at this juncture. As of today pharmacy practice is at a crossroads
in India, facing numerous challenges that need to be addressed before marching
further. This letter is an effort to identify deficiencies, vis-à-vis regulatory
requirements, and evaluate the current status of pharmacy practice education in India.
The decade long journey of pharmacy practice curriculum in India provides some key
insights:
z The profession is restricted only to the hospitals linked to a pharmacy practice
school. With the completion of a decade there are few pharmacy schools
providing specialization in pharmacy practice. Due to lack of job avenues,
prospective postgraduates cannot opt to work as a clinical pharmacist in Indian
hospitals as the value of clinical pharmacy services is not recognized.
z Regulatory framework does not recognize the need for clinical pharmacist at the
national level. There are no regulatory guidelines for having qualified clinical
pharmacists in an Indian hospital. Even if the regulations are framed in due
course, a point to ponder is whether there will be any experienced pharmacists left
to practice in the clinical set up as there is a mass migration of trained clinical
pharmacist to pharmaceutical industry. Though clinical pharmacists have gained
the confidence and acceptance of the medical fraternity, that acceptance alone will
not help to overcome the shortcomings, like lack of a regulatory framework or
scarce job opportunities as a clinical pharmacist. Pharmacy councils and
professional leaders need to take initiative by lobbying with relevant government
authorities to create a position in the hospital set-up where a trained clinical
pharmacist can fit in.
z Exodus of trained clinical pharmacists toward industry as there is almost no
opportunity in the hospital setting. As there is no recognition of the job done by
the clinical pharmacist at the regulatory level, the profession failed in to create job
opportunities in hospitals for qualified clinical pharmacy postgraduates. Students
are forced to either seek jobs in industries (clinical research) or continue in
academics, at times teaching subjects which are out of scope of clinical pharmacy
(as not many university hospitals have pharmacy practice school). The last option
374 being to move to countries where the pharmacy profession is well recognized. (A
chart depicting the career model for a pharmacy practice postgraduate in India is
available from the author)
z The need for adding industry relevant topics in course curriculum – Dilemma of
Dilution vs Evolution. There is a widening gap between the number of students
graduating from pharmacy practice institutions and the number actually employed
as pharmacy practitioners. There is a need to take key steps to either create a niche
for clinical pharmacy professionals in the hospital or make them competent to
take up other challenging jobs in the industry. There is a need for introducing
specific roles that include training in pharmacogenomics, pharmacokinetic-
pharmacodynamics, and medical informatics, which are job-oriented skills.
Before the academic move to the next step of bringing PharmD courses, there is a
need to augment the acceptability for existing courses. In an evidence-based
health service, it is not just sufficient to propose new roles for clinical pharmacist
without adequate evidence of benefits. Services should not only be clinically cost
effective but also acceptable to patients and other health care colleagues.
This situation helps the profession to learn the difficulties in implementing patient-
oriented services when the health care system does not recognize the need for
clinically trained pharmacists. The experience in the past decade helped to understand
the lacunae within the profession, especially on the regulatory side. This situation
calls for the sustained effort by academic leaders to work with government authorities
to bring suitable changes in regulation that will help the profession grow towards
patient care. Working on regulatory issues with the respective government authorities
is an important task for profession leaders as the regulatory environment is one of the
important factors that determine the growth of health professions like pharmacy.
The past decade saw the entry-level degree for the profession change over from a
Bachelor of science degree to the doctorate in pharmacy (Pharm.D.). But for the past
decade and more, the entire profession has been undergoing change, as it attempts to
move away from primarily dispensing medications toward being the chief source of
medication information in health care, toward disease state management, and even
medication therapy management. Currently, the requirement for a Pharm.D. consists
of four years of pharmacy school preceded by at least two years of prepharmacy
preparatory classes. The previous entry-level degree had been a B.S.Pharm. degree
(a five-year course), but all pharmacy students graduating since 2004 have earned a
Pharm.D.
35.6 LET US SUM UP

The following Acts and Rules made there under that govern the manufacture, sale,
import, export and clinical research of drugs and cosmetics in India:
z The Drugs and Cosmetics Act, 1940
z The Pharmacy Act, 1948
z The Drugs and Magic Remedies (Objectionable Advertisement) Act, 1954
z The Narcotic Drugs and Psychotropic Substances Act, 1985
z The Medicinal and Toilet Preparations (Excise Duties) Act, 1956
z The Drugs (Prices Control) Order 1995 (under the Essential Commodities Act).
Some other laws which have a bearing on pharmaceutical manufacture, distribution
and sale in India are:
z The Industries (Development and Regulation) Act, 1951
z The Trade and Merchandise Marks Act, 1958
z The Indian Patent and Design Act, 1970 375
Pharmacy Legislation in India
z Factories Act
To summarize, clinical pharmacy education in India after a decade is at a crossroads.
The pharmacy educators are in a dilemma as to whether the course will evolve by
incorporating industry relevant components or progress into a clinically relevant
course with the help of regulatory changes. This dilemma may resolve with time.

Collect the list of Pharmaceutical Institutions in our State.
35.8 KEYWORDS
Indian Traditional System of Medicine: It has been Ayurveda, Siddha and Unani.
Ayurveda and Siddha originated in India itself.
Drugs and Cosmetic Act: It regulate the import, manufacture, distribution and sale of
drugs.
Pharmacy Act: It passed in 1948 and was amended in 1959, 1976 and 1984. The aim
of this law is to regulate the profession of Pharmacy in India.
Drugs and Magic Remedies Act: This Act is meant to control the advertisements
regarding drugs; it prohibits the advertising of remedies alleged to possess magic
qualities and to provide for matters connected therewith.

1. Explain the different pharmaceutical legislation in India.
2. Explain the history and development of pharmaceutical education.

Various Pharmacy legislations are:
z The Drugs and Cosmetics Act, 1940.
z The Pharmacy Act, 1948.
z The Drugs and Magic Remedies (Objectionable Advertisement) Act,
1954.
z The Narcotic Drugs and Psychotropic Substances Act, 1985.
z The Medicinal and Toilet Preparations (Excise Duties) Act, 1956.
z The Drugs (Prices Control) Order, 1995.

376
36
PHARMACY ACT, 1948
CONTENTS
36.1 Introduction
36.2 Brief History of Delhi Pharmacy Council
36.2.1 Constitution of Tribunal
36.2.2 Constitution of Delhi Pharmacy Council
36.4 Definitions
36.5 Pharmacy Council of India
36.6 Incorporation of Central Council
36.7 President and Vice President of Central Council
36.8 Term of Office and Casual Vacancies
36.9 Executive Committee
36.10 Inspection
36.11 Let us Sum up
36.13 Keywords

z Know about the pharmacy council
z Get an idea about the Pharmacy Act
z Understand the committee and its inspection procedures
36.1 INTRODUCTION
Pharmacy Act, 1948 was passed with the objective of regulating the practice of
Pharmacy in India. Delhi Pharmacy Council was constituted under section 19 of
Pharmacy Act, 1948 in the year 1959.
36.2 BRIEF HISTORY OF DELHI PHARMACY COUNCIL

36.2.1 Constitution of Tribunal
In the year 1949 Delhi Pharmacy Tribunal was notified by the Ministry of Health vide
their file No. F-6-4/48/Dc dated 28.2.1949. The Tribunal was notified by Delhi
Administration on 22.06.1949 for the Registration of Pharmacists serving or working 377
in Delhi. Major M.S. Chaddha, Deputy Director of Health Services of Delhi Pharmacy Act, 1948
Administration was made as the 1st President and Mr. S.N.Roy form Drugs Control
Department of Delhi as the Registrar of the Tribunal was started from 01.07.1949 to
30.08.1959.
36.2.2 Constitution of Delhi Pharmacy Council

z Delhi Pharmacy Council was constituted under section 19 of Pharmacy Act, 1948.
z First State Pharmacy Council of Delhi was constituted in the year 1959.
z Second State Pharmacy Council of Delhi was constituted in the year 1965.
z Third State Pharmacy Council of Delhi was constituted in the year 1971.
z Fourth State Pharmacy Council of Delhi was constituted in the year 1984.
z Fifth State Pharmacy Council of Delhi has been constituted & notified in Delhi
Gazette dated 25.06.2002.
Govt. of Delhi revised the registration fees of the pharmacists from time to time and
notified first in the year 1958, second on 1st March 1977, third on 14.06.1979.
Act Objective: An Act to regulate the profession of pharmacy. WHEREAS it is
expedient to make better provision for the regulation of the profession and practice of
pharmacy and for that purpose to constitute Pharmacy Councils.
36.3 SHORT TITLE, EXTENT AND COMMENCEMENT

z This Act may be called the Pharmacy Act, 1948.
z It extends to the whole of India except the State of Jammu and Kashmir.
z It shall come into force at once, but Chapters III, IV and V shall take effect in a
particular State from such date as the State Government may, by notification in
the Official Gazette, appoint in this behalf:
Provided that where on account of the territorial changes brought about by the
reorganization of States on the 1st day of November, 1956, Chapters III, IV and V
have effect only in a part of a State, the said Chapters shall take effect in the
remaining part of that State from such date as the State Government may in like
manner appoint.)
36.4 DEFINITIONS
z “Agreement” means an agreement entered into under section 20;
z “Approved” means approved by the Central Council under section 12 or
section 14;
z “Central Council” means the Pharmacy Council of India constituted under
section 3;
z “Central Register” means the register of pharmacists maintained by the Central
Council under section 15A;
z “Executive Committee” means the Executive Committee of the Central Council or
of the State Council, as the context may require;
z “Indian University” means a University within the meaning of section 3 of the
University Grants Commission Act, 1956 (3 of 1956), and includes such other
institution, being institutions established by or under a Central Act, as the Central
Government may, by notification in the Official Gazette, specify in this behalf;
378 z “Medical practitioner” means a person:
(i) Holding a qualification granted by an authority specified or notified under
section 3 of the Indian Medical Degrees Act, 1916 (7 of 1916), or specified in
the Schedules to the Indian Medical Council Act, 1956 (102 of 1956); or.
(ii) Registered or eligible for registration in a medical register of a State meant for
the registration of persons practicing the modern scientific system of
medicine; or
(iii) Registered in a medical register of a State, who, although not falling within
sub-clause (i) or sub-clause (ii) is declared by a general or special order made
by the State Government in this behalf as a person practicing the modern
scientific system of medicine for the purposes of this Act; or
z “Registered Pharmacist” means a person whose name is for the time being entered
in the register of the State in which he is for the time being residing or carrying on
his profession or business of pharmacy;
z “State Council” means a State Council of Pharmacy constituted under section 19.
and includes a Joint State Council of Pharmacy constituted in accordance with an
agreement under section 20;
z “University Grants Commission” means the University Grants Commission
established under section 4 of the University Grants Commission Act, 1956 (3 of
1956.).
36.5 PHARMACY COUNCIL OF INDIA

z Constitution and composition of Central Council. The Central Government shall,
as soon as may be, constitute a Central Council consisting of the following
members, namely:
Six members, among whom there shall be at least one teacher of each of the
subjects, pharmaceutical chemistry, pharmacy, pharmacology and
pharmacognosy elected by the [University Grants Commission] from among
persons on the teaching staff of an Indian University or a College affiliated
thereto which grants a degree or diploma in pharmacy;
Six members, of whom at least (four) shall be persons, possessing a degree or
diploma in, and practicing pharmacy or pharmaceutical chemistry, nominated
by the Central Government;
One member elected from amongst themselves by the members of the
Medical Council of India;
The Director General, Health Services, ex officio or if he is unable to attend
any meeting, a person authorized by him in writing to do so;
the Drugs Controller, India, ex Officio or if he is unable to attend any
meeting, a person authorized by him in writing to do so;
The Director of the Central Drugs Laboratory, ex officio.
36.6 INCORPORATION OF CENTRAL COUNCIL

The Council constituted under section 3 shall be a body corporate by the name of the
Pharmacy Council of India, having perpetual succession and a common seal, with
power to acquire and hold property both movable and immovable, and shall by the
said name sue and be sued.
379
36.7 PRESIDENT AND VICE PRESIDENT OF CENTRAL Pharmacy Act, 1948
COUNCIL
The President and Vice-President of the Central Council shall be elected by the
members of the said Council from among themselves.
36.8 TERM OF OFFICE AND CASUAL VACANCIES

z Subject to the provisions of this section, a nominated or elected member shall hold
office for a term of five years form the date of his nomination or election or until
his successor has been duly nominated or elected, whichever is longer.
z A nominated or elected member may at any time resign his membership by
writing under his hand addressed to the President, and the seat of such member
shall thereupon become vacant.
z A nominated or elected member shall be deemed to have vacated his seat if he is
absent without excuse, sufficient in the opinion of the Central Council, form three
consecutive meetings of the Central Council or if he is elected under (a), (e) or (g)
of section 3, if he ceases to be a member of the teaching staff, Medical Council of
India or a registered pharmacist, as the case may be.
z A casual vacancy in the Central Council shall be filled by fresh nomination or
election, as the case may be, and the person nominated or elected to fill the
vacancy shall hold office only for the remainder of the term for which the member
whose place he takes was nominated or elected.
z No act done by the Central Council shall be called in question on the ground
merely of the existence of any vacancy in, or any defect in the constitution of, the
Central Council.
z Members of the Central Council shall be eligible for re-nomination or re-election.
36.9 EXECUTIVE COMMITTEE

z The Central Council shall, as soon as may be, constitute and Executive Committee
consisting of the President, (who shall be Chairman of the Executive Committee)
and Vice-President, ex officio, and five other members elected by the Central
Council from amongst its members.
z A member of the Executive Committee shall hold office as such until the expiry
of his term of office as member of the Central Council, but, subject to his being a
member of the Central Council, he shall be eligible for re-election.
36.10 INSPECTION
z The Executive Committee may appoint such number of Inspectors, as it may
deem requisite for the purposes of this Chapter.
z An Inspector may:
Inspect any institution which provides an approved course of study;
Attend at any approved examination;
Inspect any institution whose authorities have applied for the approval of its
course of study or examination, and attend at any examination of such
institution.
1. Who is a registered pharmacist?
……………………………………………………………………………...
……………………………………………………………………………...
2. What are the duties of an inspector under this Act?
……………………………………………………………………………...
……………………………………………………………………………...
36.11 LET US SUM UP

Pharmacy Act was passed on 1948. The main objective of this act to regulate the
profession of pharmacy. Whereas it is expedient to make better provision for the
regulation of the profession and practice of pharmacy and for that purpose to
constitute Pharmacy Councils. This act regulates Constitution and composition of
Central Pharmacy Council. The Central Council shall, as soon as may be, constitute
and Executive Committee consisting of the President, and Vice-President, ex officio,
and five other members elected by the Central Council from amongst its members.
The Executive Committee may appoint such number of Inspectors to inspect any
institution whose authorities have applied for the approval of its course of study or
examination, and attend at any examination of such institution.

Can a pharmacy advertise? Discuss.
36.13 KEYWORDS
Agreement: It means an agreement entered into under section 20.
Approved: It means approved by the Central Council under section 12 or section 14.
Central council: It means the Pharmacy Council of India constituted under section 3.
Central register: It means the register of pharmacists maintained by the Central
Council under section 15A.
Executive committee: It means the Executive Committee of the Central Council or of
the State Council, as the context may require.

1. Explain the pharmacy council of India, its incorporation and explain about its
members.
2. Explain the main features of Pharmacy Act.

1. Registered Pharmacist means a person whose name is for the time being
entered in the register of the State in which he is for the time being
residing or carrying on his profession or business of pharmacy.
2. An Inspector may:
Inspect any institution which provides an approved course of study;
Attend at any approved examination;
Inspect any institution whose authorities have applied for the approval
of its course of study or examination, and attend at any examination
of such institution.
381
36.15 SUGGESTED READING Pharmacy Act, 1948
382
37
DRUGS AND COSMETICS RULES
CONTENTS
37.1 Introduction
37.2 Commencement
37.3 Application of other Laws not Burred
37.4 Definitions
37.5 Manufacture
37.6 Drugs Technical Advisory Board
37.7 Central Drugs Laboratory
37.8 Import of Drugs and Cosmetics
37.9 Prohibition of Impact of Certain Drugs and Cosmetics
37.10 Application of Law Relating to Sea Customs
37.11 Power of Central Government to Make Rules
37.12 Offences
37.13 Confiscation
37.14 Jurisdiction
37.15 Prohibition of Manufacture and Sale for Certain Drugs and Cosmetics
37.16 Power of Inspectors
37.17 Procedure of Inspectors
37.18 Let us Sum up
37.20 Keywords

z Get an idea about drugs control
z Know about the authorities and advisory board
z Understand the powers and procedures of inspector
37.1 INTRODUCTION
An Act regulates the impact, manufacture, distribution and sale of drugs and
cosmetics.
383
37.2 COMMENCEMENT Drugs and Cosmetics Rules
z This act may be called as the Drug and Cosmetics Rules, 2001.
z It extends to the whole of India.
z The Drugs and Cosmetics Act was passed on 1940 and it was amended. Herein
after referred to as the said rules.
37.3 APPLICATION OF OTHER LAWS NOT BURRED

The provisions of this Act shall be in addition to, and not in derogation of the
Dangerous Drugs Act, 1930.
37.4 DEFINITIONS
z Drugs: Includes all medicines intended for internal and external use for or in the
diagnosis, treatment, lessening the seriousness, mitigation or prevention of
diseases or disorder in human beings or animals.
z The board: Ayurvedic, Siddha and Unani Drugs, Technical Advisory Broad.
z Cosmetics: Any article intended to be rubbed, powdered, sprinkled or sprayed on,
or introduced into, or otherwise applied to the human body or part there of for
cleansing, beautifying, promoting attractiveness or altering the appearance and
includes any article used as a component of a cosmetic.
z “Drug” includes:
All medicines for internal or external use of human beings or animals.
Such substances intended to affect the structure or any function of the human
body or intended to be used for the destruction of vermin or insects.
All substances intended for use as a component or drug including empty
gelato capsules.
Such devices used for internal or external use of diagnosis, treatment,
mitigation or prevention.
z Government Analyst: An analyst appointed by the central or State Government
(Under section 20).
z Inspector: Appointed by the Central or State Government for the case of
cosmetics (Under section 21).
37.5 MANUFACTURE
Any process or a part of process for making, altering ornamenting, finishing, packing,
labeling, breaking up of any drug or a cosmetic with a view to its sale and distribution.
37.6 DRUGS TECHNICAL ADVISORY BOARD

z The Central Government may constitute a board to advise the Central and State
Government on technical matches arising out of the administration of this Act.
z The Board Constitutes of: The Director General of Health Services / the Drugs
Controller, India / the Director of the Central Drugs Laboratory. The Director of
the Central Research Institute / the Director of the Indian Veterinary Research
Institute / the President of Medical Council of India / one person from each part of
the medical council.
384
Health Laws and Policies 37.7 CENTRAL DRUGS LABORATORY
z The Government should as soon as establish a Central Drugs Laboratory under the
act of a Director to be appointed by the Central Government.
z The Central Government may constitute an advisory committee to advise on any
matter lending to secure uniformity throughout India and in the administration of
this Act.
37.8 IMPORT OF DRUGS AND COSMETICS

z Standards of Quality: It means is relation to a drug that the drug compiles with
the standard set out in the second schedule.
z Misbranded Drugs: If it is so colored, coated, powdered or polished that damage
is concealed or if it is made to appear of better or greater therapeutic value than it
really is not labeled in the prescribed manner. It is label or contained bears any
statement, design or device that makes any false claim for the drug.
z Adulterated Drugs: In whole ox part, of any filthy, puttied of decomposed
substance. If it has been prepared, packed or stored under in sanitary conditions. If
it has any poisonous or deleterious substance is its container.
z Specious Drugs: If it is imparted under a name which belongs to another drug. It
the label or contained bears the name of an individual or company is fictitious.
z Misbranded Cosmetics: Contains a colour which is not prescribed or it is not
labeled in the prescribed manner.
z Specious Cosmetics: Imported under a name, which belongs to another cosmetic;
imitation or substitute.
37.9 PROHIBITION OF IMPACT OF CERTAIN DRUGS

AND COSMETICS
Any drug or cosmetic, which is not of standard 9th. That may be misbranded,
adulterated or specious drugs. Any drug or cosmetic that may render it unsafe or
harmful.
z Power of Central Government to Prohibit Import of Drugs and Cosmetics in
Public Interest:
Without prejudice to any other provision, the Central Government has rights to
prohibit the import of such drug and cosmetic, which do not have therapeutic
justification.
37.10 APPLICATION OF LAW RELATING TO SEA

CUSTOMS
The customs collector or any officer of the Government. Authorized by the Central
Government in this behalf, may detain any imported package which he suspects to
contain any drug or cosmetic for the import is prohibited.
37.11 POWER OF CENTRAL GOVERNMENT TO MAKE

RULES
The Government on consultation or recommendation by the Board.
z Should specify the classes of drugs or cosmetics for which the import licenser is
required.
z Prescribe the methods of test or analysis for determining the standard 9th. 385
Drugs and Cosmetics Rules
z Prescribe the color or colors of drug, which may bear.
z Regulate the mode of labeling drugs or cosmetics.
z Prescribe the maximum proportion of any poisonous ingredients.
37.12 OFFENCES
Any person who contravenes the law shall be punishable with imprisonment for up to
3 years and with a fine of Rs.5000.
37.13 CONFISCATION
The consignment of the drugs and cosmetics is which an offence is committed is
liable for confiscation.
37.14 JURISDICTION
Metropolitan Magistrate / Judicial Magistrate shall try an offence punishable.
37.15 PROHIBITION OF MANUFACTURE AND SALE FOR

CERTAIN DRUGS AND COSMETICS
z Drug which is not of standard 9th / cosmetic – misbranded, adulterated, specious.
z Not displayed as prescribed on the label or container.
z Which has been manufactured or imported on the contravenes of the provision of
the Act.
z Cosmetic that renders its unsafe or harmful for usage.
z disclosure of name of the manufacture.
z Maintenance of words and furnishing of information.
37.16 POWER OF INSPECTORS

z To inspect,
z Take samples of any drug or cosmetic,
z At all reasonable times, with such assistances.
37.17 PROCEDURE OF INSPECTORS

If he takes for analysis and testing he should intimate such purpose in writing in the
prescribed form to the person from whom he takes it, in the presence of the person or
he must willfully pack it seal his own.
Check Your Progress
1. What do you mean by drug?
……………………………………………………………………………...
……………………………………………………………………………...
2. What are the powers of inspector?
……………………………………………………………………………...
……………………………………………………………………………...
386
Health Laws and Policies 37.18 LET US SUM UP
The Drugs and Cosmetics Act was passed on 1940 and it was amended. The Drug
and Cosmetics Rules, 2001. As per this Act drugs includes all medicines intended for
internal and external use for or in the diagnosis, treatment, lessening the seriousness,
mitigation or prevention of diseases or disorder in human beings or animals.
Cosmetics means any article intended to be rubbed, powdered, sprinkled or sprayed
on, or introduced into, or otherwise applied to the human body or part there of for
cleansing, beautifying, promoting attractiveness or altering the appearance and
includes any article used as a component of a cosmetic. The Central Government may
constitute a board to advise the Central and State Government on technical matches
arising out of the administration of this Act. The Government should as soon as
establish a central drugs laboratory under the Act of a director to be appointed by the
Central Government. This Act prohibits import of drugs and cosmetics, prohibition of
impact of certain drugs and cosmetics, prohibition of manufacture and sale for certain
drugs and cosmetics etc., and the Government appoints an Inspector under this Act.
Some of the Power of inspectors are: To inspect, Take samples of any drug or
cosmetic at all reasonable times. Contravenes the law shall be punishable.

Try to collect the list of few drugs or cosmetic items which are prohibited to
manufactured, distributed and/or sale.
37.20 KEYWORDS
Drugs: Includes all medicines intended for internal and external use for or in the
diagnosis, treatment, lessening the seriousness, mitigation or prevention of diseases or
disorder in human beings or animals.
Board: Ayurvedic, Siddha and Unani Drugs, Technical Advisory Broad.
Government analyst: An analyst appointed by the Central or State Government
(Under section 20).
Inspector: Appointed by the Central or State Government for the case of cosmetics
(Under section 21).

1. Explain about the Drugs and Cosmetics Act.
2. Explain about the prohibitions under this Act.

1. Includes all medicines intended for internal and external use for or in the
diagnosis, treatment, lessening the seriousness, mitigation or prevention
of diseases or disorder in human beings or animals.
2. Powers of the Inspector are:
a) To inspect
b) Take samples of any drug or cosmetic.
c) At all reasonable times, with such assistances.

387
LESSON Narcotic Drugs and Psychotropic
Substances (Amendment) Act
38
NARCOTIC DRUGS AND PSYCHOTROPIC SUBSTANCES
(AMENDMENT) ACT
CONTENTS
38.1 Introduction
38.2 Commencement
38.3 Definitions
38.4 National Fund for Control of Drug Abuse
38.5 Section–9
38.6 Section – 9A, Punishment for Contravention of Orders
38.7 Section – 27A, Punishments for Financing Elicit Traffic and Harboring Offenders
38.8 Section – 31A - Death
38.9 Section – 32A
38.10 Section – 36A – Constitution of Special Courts
38.11 Section – 36A – Offences Tribale by Special Court
38.12 Section 52A – Disposal of Any Seized Narcotic Drugs and Psychotropic
Substances
38.13 Section – 59
38.14 Section – 68 - N - Appellate Tribunal for Forfeited Property
38.15 Let us Sum up
38.17 Keywords

z Get an idea about narcotic drugs and psychotropic substances
z Understand the punishment for contravening the Act
38.1 INTRODUCTION
This act was proposed in the year 1988. It is for the aim of, “To provide for the
forfeiture of property derived from, or used in, illicit traffic in no colic drugs and
psychotropic substances, to implement the provisions of the international conventions
on narcotic drugs and psychotropic substances”.
388
Health Laws and Policies 38.2 COMMENCEMENT
z This act may be called the Narcotic Drugs and Psychotropic Substances
(Amendment) Act, 1988.
notification in the Official Gazette, appoint: and different dates may be appointed
for different provisions of this Act.
38.3 DEFINITIONS
z “Controlled substances”-means any substance with the Central Government may,
having regard to the available information as to its possible use in the production
or manufacture or narcotic drugs or psychotropic substances or to the provisions
of any International Convention, by notification in the Official Gazette, declare to
be controlled substance.
z “Illicit traffic” – in relation to narcotic drugs and psychotropic substances, means:
1. Cultivating any coca plant or gathering any part of it.
2. Cultivating the opium poppy or any cannabis plant.
3. Engaging in production, manufacture, purchase, storing, sale, concealment or
consumption of the substances, import or export or any interstate exchange.
4. Dealing in any such type of related activities.
5. Handling or letting out any premises for the carrying on of any of the
activities.
6. Financing directly or indirectly for those activities.
7. Abetting or conspiring in the furtherance or in support of it.
8. Harboring persons engaged is any such activities.
z “Use” – in relation to narcotic drugs and psychotropic substances, mean any kind
of use except personal consumption.
38.4 NATIONAL FUND FOR CONTROL OF DRUG ABUSE

z As an inclusion under this Act, the Central Government by notification in the
Official Gazette constitutes a fund to be called as the National fund for control of
drug abuse.
z The fund shall be applied by the Central Government to meet the expenditure
incurred is connection with the measures taken for combating illicit traffic and use
of the drugs.
z The Government will also constitute a Governing Body as it thinks fit to advice
that Government in regard to the application of the fund. (6 members – headed by
a chairman among them).
z The governing body shall have the power to regulate its own procedure.
38.5 SECTION–9
The Government a regard to the use of any controlled substance in the production or
manufacture of any narcotic drug or psychotropic substances, it is necessary or
expedient so to do it in public interest, it may, by order, provide for regulating or
prohibiting the production, manufacture, supply and distribution there of and trade and
commerce therein.
389
38.6 SECTION – 9A, PUNISHMENT FOR Narcotic Drugs and Psychotropic
CONTRAVENTION OF ORDERS Substances (Amendment) Act
Person, who contravenes the order, shall be punishable with rigorous imprisonment
for a term of up to 10 years also be liable to a fine of up to Rs.1 lakh.
38.7 SECTION – 27A, PUNISHMENTS FOR FINANCING

ELICIT TRAFFIC AND HARBORING OFFENDERS
1. Rigorous imprisonment of not less 10 yrs up to 20 yrs.
2. Fine of not less than 1 lakh and can extend up to 2 lakhs.
38.8 SECTION – 31A - DEATH

Penalty for certain offences exceeds 2 lakhs.
z Cultivating any coca plant or gathering any part of it.
z Cultivating the opium poppy or any cannabis plant.
z Engaging in production, manufacture, purchase, storing, sale, concealment or
consumption of the substances, import or export or any interstate exchange.
z Dealing in any such type of related activities.
z Handling or letting out any premises for the carrying on of any of the activities.
z Financing directly or indirectly for those activities.
z Abetting or conspiring in the furtherance or in support of it.
z Harboring persons engaged is any such activities.
Persons who has convicted of the commission of, or attempt to commit, or abetment
of, or criminal conspiracy to commit financing directly or indirectly any of the above
mentioned activities should be punishable with death.
38.9 SECTION – 32A

No suspension, remission or communication is any sentence awarded under this Act.
38.10 SECTION – 36A – CONSTITUTION OF SPECIAL

COURTS
The Government by notification:
1. Can provide as many as special courts for the purpose.
2. Consist a single judge appointed by the Government concurrent with the chief
justice of the High Court.
38.11 SECTION – 36A – OFFENCES TRIBALE BY

SPECIAL COURT
1. All offences under this Act shall be punishable only under the special court of that
specified area.
2. A person accused or suspected of an offence by this Act if forwarded to the
Magistrate and by him authorize the detention of the person in such custody.
Judicial Magistrate – Not exceeding 15 days.
390 Executive Magistrate – Seven days.
3. When trying an offence under this Act, a special court may also try an offence
other than this act, (i.e.) under the Code of Criminal Procedure 1973, be charged
at the same trial.
Check Your Progress
List out two examples for narcotic and psychotropic substances.
……………………………………………..…………………………………...
……………………………………………..…………………………………...
38.12 SECTION 52A – DISPOSAL OF ANY SEIZED

NARCOTIC DRUGS AND PSYCHOTROPIC
SUBSTANCES
1. When any such substances seized are forwarded to the officer in-charge of the
nearest police station; he / shall she should preparation inventory containing the
details of description, quality, quality, mode of packing, marks, numbers and other
identification and further proceedings should submit it to the magistrate.
2. Taking photographs in the Magistrate, for certifying the issue.
3. As in the Indian Evidence Act, 1872, the court shall treat the inventory,
photographs and list of samples as evidence for the case under the special court.
38.13 SECTION – 59
Any addict or any other person who has been charged with an offence under this Act
and who will fully aids in, or confines at, the contravention of any provision – shall be
punishable with rigorous imprisonment of not less than 10 yrs and up to 20 yrs and
also be liable for fine (i.e.) not less than one lakh rupees but may extend up to 2 lakh
rupees.
38.14 SECTION – 68 - N - APPELLATE TRIBUNAL FOR

FORFEITED PROPERTY
1. Any individual who had been residing in the residential premises.
2. Any individual who had been or is managing the affairs or keeping the accounts
of such person.
3. Any association of persons, body of individuals, partnership firm, or private
company of which such person had been or is a member, partner or director.
4. The trusty of any trust, where the trust is created by such person.
The property to be forfeiture includes the corporal or in corporal, movable or
immovable, tangible or intangible and deeds and instruments in relations to;
(1) Spouse of the person (2) brother or sister of the person. (3) Brother or sister of the
spouse of the person (4) any lineal ascendant or descendant of the person (5), (4) – of
the spouse of the person. (6) Spouse of a person in (2), (3), (4), (5)
38.15 LET US SUM UP

Narcotic Drugs and Psychotropic Substances (Amendment) Act, 1988. As an
inclusion under this act, the Central Government by notification in the official gazette
constitutes a fund to be called as the National fund for control of drug abuse. Any
Person, who contravenes the order, shall be punishable with rigorous imprisonment 391
Narcotic Drugs and Psychotropic
for a term of up to 10 years also be liable to a fine of up to Rs.1 lakh. Substances (Amendment) Act

Try to know about the forms and usage of narcotic and psychotropic substances.
38.17 KEYWORDS
Controlled substance: It means any substance with the Central Government may,
having regard to the available information as to its possible use in the production or
manufacture or narcotic drugs or psychotropic substances or to the provisions of any
International Convention, by notification in the Official Gazette, declare to be
controlled substance.
Use: Relation to narcotic drugs and psychotropic substances, mean any kind of use
except personal consumption.

1. What do you mean by narcotic and psychotropic substances?
2. Explain the important features of this Act.

Narcotic drugs and psychotropic substances means:
z Cultivating any coca plant or gathering any part of it.
z Cultivating the opium poppy or any cannabis plant.

392
39
DRUGS AND MAGIC REMEDIES (OBJECTIONABLE
ADVERTISEMENTS) ACT
CONTENTS
39.1 Introduction
39.3 Definitions
39.4 Prohibition of Advertisement of certain Drugs for Treatment of Certain Diseases
and Disorders
39.5 Prohibition of Misleading Advertisements Relating to Drugs
39.6 Prohibition of Advertisement of Magic Remedies for Treatment of certain
Diseases and Disorders
39.7 Prohibition of Import into, and Export from India of Certain Advertisement
39.8 Penalty
39.9 Powers of Entry, Search, etc.
39.11 Offences to be Cognizable
39.12 Jurisdiction to Try Offences
39.13 Let us Sum up
39.15 Keywords

z Understand about the prohibition of advertisement under this Act
z Know the offences and penalties under this Act
39.1 INTRODUCTION
An Act to control the advertisement of drugs in certain cases, to prohibit the
advertisement for certain purposes of remedies alleged to possess magic qualities and
to provide for matters connected therewith.
393
39.2 SHORT TITLE, EXTENT AND COMMENCEMENT Drugs and Magic Remedies
(Objectionable Advertisements) Act
z This Act may be called the Drugs and Magic Remedies (Objectionable
Advertisement) Act, 1954.
z It extends to the whole of India except the State of Jammu and Kashmir, and
applies also to persons domiciled in the territories to which this Act extends who
are outside the said territories.
z It shall come into force on such date; as the Central Government may, by
39.3 DEFINITIONS
z “Advertisement” includes any notice, circular; label, wrapper, or other document,
and any announcement made orally or by any means of producing or transmitting
light, sound or smoke;
z “Drug” Includes:
(i) A medicine for the internal or external use of human beings or animals;
(ii) Any substance intended to be used for or in the diagnosis, cure, mitigation,
treatment or prevention of disease in human beings or animals;
(iii) Any article, other than food, intended to affect or influence in any way the
structure of any organic function of the body of human beings or animals;
H-clauses (i), (ii) and (iii);
z “Magic remedy” includes a talisman mantra kavacha, and any other charm of any
kind which is alleged to possess miraculous powers for or in the diagnosis, cure,
mitigation treatment or prevention of any disease in human beings or animals or
for affecting or influencing in any way the structure or any organic function of the
body of human beings or animals;
z “Registered medical practitioner” means any person:
(i) Who holds a qualification granted by an authority specified in, or notified
under Section 3 of the Indian Medical Degrees Act, 1916 (7 of 1916)
specified in the Schedules to the Indian Medical Council Act, 1956 (102 of
1956); or
(ii) Who is entitled to be registered as a medical practitioner under any law for
the time being in force; in any State to which this Act extends relating to the
registration of medical practitioner;
z Taking any part in the publication of any advertisement includes:
(i) The printing of the advertisement;
(ii) The publication of any advertisement outside the territories to which this Act
extends by or at the instance of person residing within the said territories;
39.4 PROHIBITION OF ADVERTISEMENT OF CERTAIN

DRUGS FOR TREATMENT OF CERTAIN DISEASES
AND DISORDERS
Subject to the provisions of this Act, no person shall take any part in the publication of
any advertisement referring to any drug in terms, which suggest or are calculated to
lead to the use of, that drug for:
z The procurement of miscarriage in women or prevention of conception in women;
or
394 z The maintenance or improvements of the capacity of human beings for sexual
pleasure; or
z The correction of menstrual disorder in women; or
z The diagnosis, cure, mitigation, treatment or prevention of any disease, disorder
or condition specified in the Schedule, or any other disease, disorder or condition
(by whatsoever name called) which may be specified in the rules made under this
Act;
Provided that no such rule shall be made except:
(i) In respect of any disease, disorder or condition which requires timely treatment in
consultation with a registered medical practitioner or for which requires timely
treatment in consultation with a registered medical practitioner or for which there
are normally no accepted remedies, and
(ii) After consultation with the Drugs Technical Advisory Board constituted under the
Drugs and Cosmetics Act, 1940 (23 of 1940), and, if the Central Government
considers necessary, with such other persons having special knowledge or
practical experience in respect of Ayurvedic or Unani systems of medicines as
that Government deems fit.
39.5 PROHIBITION OF MISLEADING ADVERTISEMENTS

RELATING TO DRUGS
Subject to the provisions of this Act, no person shall take any part in the publication of
any advertisement relating to and drug if the advertisement contains any matter which:
z Directly or indirectly gives a false impression regarding the true character of the
drug; or
z Makes a false claim for the drug; or
z Is otherwise false or misleading in any material particular.
39.6 PROHIBITION OF ADVERTISEMENT OF MAGIC

REMEDIES FOR TREATMENT OF CERTAIN
DISEASES AND DISORDERS
No person carrying on or purporting to carry on the profession of administering magic
remedies shall take any part in the publication of any advertisement referring to any
magic remedy which directly or indirectly claims to be efficacious for any of the
purposes specified in Section 3.
39.7 PROHIBITION OF IMPORT INTO, AND EXPORT

FROM INDIA OF CERTAIN ADVERTISEMENT
No person shall import into or export from, the territories to which this Act extends
any document containing and advertisement of the nature referred to in Section 3, or
Section 4, or Section 5, and any documents containing any such advertisement shall
be deemed to be goods of which the import or export has been prohibited under
Section 19 of the Sea Customs Act, 1878 (8 of 1978), and all the provisions of that
Act shall have effect accordingly, except that Section 183, thereof shall have effect as
if for the word “shall” therein the word “may” were substituted.
395
39.8 PENALTY Drugs and Magic Remedies
Whoever contravenes any of the provisions of this Act of the Rules made thereunder
shall, on conviction, be punishable:
z In the case of a first conviction, with imprisonment which may extend to six
months, or with fine, or with both;
z In the case of a subsequent conviction, with imprisonment which may extend to
one year, or with fine, or with both.
39.9 POWERS OF ENTRY, SEARCH, ETC.

z Subject to the provisions of any rules made in this behalf, any Gazetted Officer
authorized by the State Government may, within the local limits of the area for
which he is so authorized:
Enter and search at all reasonable times, with such assistants, if any, as he
considers necessary, any place in which he has reason to believe that an
offence under this Act has been or is being committed;
Seize any advertisement which he has reason to believe contravenes any of
the provisions of this Act:
Provided that the, power of seizure under this clause may be exercised in
respect of any document, article or thing which contains any such
advertisement cannot be separated by reason of its being embossed or
otherwise, from such document, article or thing without affecting the integrity
utility or saleable value thereof;
Examine any record, register, document or any other material object found in
any place mentioned in clause (a) and seize the same if be has reason to
believe that it may furnish evidence of the commission of an offence
punishable under this Act.
z The provisions of the Code of Criminal Procedure 1898 (5 of 1898), shall, so far
as may be, apply to any search or seizure under this Ac as they apply to any
search or seizure made under the authority of a warrant issued under Section 98 of
the said Code.
z Where any person seizes anything under clause (b) or clause (c) of sub-section (1)
he shall, as soon as may be inform a Magistrate and take his orders as to the
custody thereof.
Check Your Progress
1. What is advertisement?
……………………………………………………………………………...
……………………………………………………………………………...
2. What is drug?
……………………………………………………………………………...
……………………………………………………………………………...
3. What do you mean by magic remedy?
……………………………………………………………………………...
……………………………………………………………………………...
396
Health Laws and Policies 39.10 OFFENCES BY COMPANIES
z If the person contravening any of the provisions of this Act is a company, every
person who, at the time the offence 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 shall be deemed to be guilty of the contravention and shall be
liable to be proceeded against and punished accordingly;
z Notwithstanding anything contained in sub-section (1) where an offence under
this Act has been committed by a company and it is prove that the offence was
committed with the consent or connivance of or is attributable to any neglect on
the part of any director or manager secretary or other officer of the company such
director manager secretary or other officer of the company shall also he deemed to
be guilty of that offence and shall be liable to be proceeded against and punished
accordingly.
Explanation – For the purposes of this section:
a) “Company” means any 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.
39.11 OFFENCES TO BE COGNIZABLE

Notwithstanding anything contained in the Code of Criminal Procedure, 1898 (5 of
1898) an offence punishable under this Act shall be cognizable.
39.12 JURISDICTION TO TRY OFFENCES

No court interior to that of a presidency magistrate or a magistrate of the first class
shall try any offence punishable under this Act.
39.13 LET US SUM UP

A medicine for the internal or external use of human beings or animals, Any substance
intended to be used for or in the diagnosis, cure, mitigation, treatment or prevention of
disease in human beings or animals, Any article, other than food, intended to affect or
influence in any way the structure of any organic function of the body of human
beings or animals. Magic remedy includes a talisman mantra kavacha, and any other
charm of any kind which is alleged to possess miraculous powers for or in the
diagnosis, cure, mitigation treatment or prevention of any disease in human beings or
animals or for affecting or influencing in any way the structure or any organic
function of the body of human beings or animals.
This act covers various prohibition regarding advertisement of magic remedy relating
to drugs. Whoever contravenes any of the provisions of this Act of the Rules made
thereunder shall, on conviction, be punishable. If the person contravening any of the
provisions of this Act is a company, every person who, at the time the offence 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 shall be deemed to be guilty of
the contravention and shall be liable to be proceeded against and punished
accordingly.

Collect information regarding a case which is penalized under this Act.
397
39.15 KEYWORDS Drugs and Magic Remedies
Advertisement: Includes any notice, circular; label, wrapper, or other document, and
any announcement made orally or by any means of producing or transmitting light,
sound or smoke.
“Drug” Includes:
1. A medicine for the internal or external use of human beings or animals;
2. Any substance intended to be used for or in the diagnosis, cure, mitigation,
treatment or prevention of disease in human beings or animals;
3. Any article, other than food, intended to affect or influence in any way the
structure of any organic function of the body of human beings or animals;
H-clauses (i), (ii) and (iii).
Magic remedy: Includes a talisman mantra kavacha, and any other charm of any kind
which is alleged to possess miraculous powers for or in the diagnosis, cure, mitigation
treatment or prevention of any disease in human beings or animals or for affecting or
influencing in any way the structure or any organic function of the body of human
beings or animals.

1. Explain about the prohibition of advertisement of certain drugs for treatment of
certain diseases and disorders.
2. Explain about the prohibition of misleading advertisements relating to drugs.
3. Explain about the advertisement of magic remedies for treatment of certain
diseases and disorders
4. Describe about the offences under this Act.

1. Advertisement includes any notice, circular; label, wrapper, or other
document, and any announcement made orally or by any means of
producing or transmitting light, sound or smoke.
2. Drug includes:
(i) A medicine for the internal or external use of human beings or
animals;
(ii) Any substance intended to be used for or in the diagnosis, cure,
mitigation, treatment or prevention of disease in human beings or
animals;
(iii) Any article, other than food, intended to affect or influence in any
way the structure of any organic function of the body of human
beings or animals.
3. Magic remedy includes a talisman mantra kavacha, and any other charm
of any kind which is alleged to possess miraculous powers for or in the
diagnosis, cure, mitigation treatment or prevention of any disease in
human beings or animals or for affecting or influencing in any way the
structure or any organic function of the body of human beings or animals.

398
40
POISONS ACT AND RULES
CONTENTS
40.1 Introduction
40.2 Features
40.3 Punishment
40.4 Let us Sum up
40.6 Keywords

z Get an idea about the features of poisons Act and Rules
z Know about the punishments for contravening this Act
40.1 INTRODUCTION
An Act provides regulations for the possession, distribution, sale and import of
poisons that cause death are fatally affecting the body.
40.2 FEATURES
z Poisons Act, 1952 an Act, which controls the import, possession and sale of
poisons in the country.
z It was originally enacted by the Government of India in 1919 as Poisons Act,
1919 to regulate the import, possession and sale of poisons in India.
z The Act was later on amended to suit the changed circumstances and adopted by
the Pakistan Government in 1952 as Poisons Act, 1952.
z For the purpose of the Act, all substances, that cause death or fatally affect the
animal systems, if ingested even in smaller doses, and those substances, which are
specified as poisons in notifications issued under the Act, are designated as
‘Poisons’. Poisons under the Act are classified into two groups:
Group I: In this group is included those poisons that are used in the treatment
of human diseases. These poisons can be prescribed only by the registered
physicians and sold only by the licensed sellers.
Group II: This group includes those poisonous substances which are used both
in the treatment of human diseases, and as antiseptics and pesticides (such as
insecticides, fungicides, herbicides, etc). These are sold by both licensed and 399
unlicensed sellers. Poisons Act and Rules
The one who is entitled to produce, manufacture, import, export, deliver, sell
or Possess drugs is obliged to keep books on the drugs and to give reports and
information related to them as prescribed by the Ministry of Social Affairs
and Health in greater detail.
z The Rules under the Poisons Act have been divided into 17 Schedules for the
purpose of regulating the various affairs of the poisons.
z The provisions of the Act are in addition to the rules, which have been made for
the dispensing and sale of poisons under the Drugs Act, 1940.
z Persons licensed to import poisons have to bring them into the country across on
of the defined customs frontiers in accordance with the conditions of the license.
z The Government, by making rules, regulates the possession and sale of poisons,
whether wholesale or retail. Rules under the Act provide for the grant of licenses
for the possession and sale of any specified class of poisons.
z The rules also specify the classes of persons to whom the licenses for the
possession and sale of poisons are to be granted, the categories of persons to
whom the poisons may be sold, maximum quantity of any one poison that may be
sold to a person, and provide for the maintenance of a Register for the sale of
poisons by the persons who have been licensed to sell them.
z Rules are also specified for the safe custody of poisons and labeling of the
containers, coverings, etc. In which the poisons are stored or sold.
Check Your Progress
Fill in the blanks:
1. Poisons act was passed on ……………. .
2. Violators of any of the provisions of the act are liable to punishment with
imprisonment up to 3 months or ……………. .
40.3 PUNISHMENT
z Violators of any of the provisions of the Act are liable to punishment with
imprisonment up to 3 months or to a fine up to Rs.500 or both on first conviction,
and with imprisonment up to 6 months or a fine up to Rs.1,000 or both on any
subsequent convictions.
z Any poison, in respect of which an offence has been committed, is liable to
confiscation together with all related materials. However, nothing in the Act
applies to anything used or done in good faith, in the exercise of their profession,
by medical or veterinary practitioners.
40.4 LET US SUM UP

Poisons Act, is an act which controls the import, possession and sale of poisons in the
country. Poisons under the Act are classified into two groups Group I - this group is
included those poisons that are used in the treatment of human diseases Group II This
group includes those poisonous substances which are used both in the treatment of
human diseases, and as antiseptics and pesticides.
The Government, by making rules, regulates the possession and sale of poisons,
whether wholesale or retail. Rules under the Act provide for the grant of licenses for
the possession and sale of any specified class of poisons Rules are also specified for
the safe custody of poisons and labeling of the containers, coverings, etc. In which the
400 poisons are stored or sold Act are liable to punishment with imprisonment up to 3
months or to a fine up to Rs.500 or both.

Get a list of poisons drug which will come under this Act.
40.6 KEYWORDS
Poisons: The purpose of the Act, all substances, that cause death or fatally affect the
animal systems, if ingested even in smaller doses, and those substances, which are
specified as poisons in notifications issued under the Act, are designated as ‘Poisons’.
Group I Poison: This group is included those poisons that are used in the treatment of
human diseases. These poisons can be prescribed only by the registered physicians
and sold only by the licensed sellers.
Group II Poison: This group includes those poisonous substances which are used
both in the treatment of human diseases, and as antiseptics and pesticides (such as
insecticides, fungicides, herbicides, etc). These are sold by both licensed and
unlicensed sellers.

Explain about the Poisons Act and Rules.

1. 1952.
2. fine up to Rs.500.

Model Question Paper
MODEL QUESTION PAPER
MBA
Second Year
Sub: Health Laws and Policies

Time: 3 hours Total Marks: 100
Direction: There are total eight questions, each carrying 20 marks. You have to
attempt any five questions.
1. What do you mean by Code of Ethics? Explain the Duties of the Doctor.
2. Explain the Medical Transplantation of Human Organs Act.
3. What do you mean by Biomedical waste? Explain the Act related to Biomedical
Management.
4. Explain the Health care delivery system at District level. And Give some of the
indices which will measure the hospitals.
5. Explain the History and evolution of Hospitals.
6. Explain any three National level Health care agencies with its functions.
7. Explain the Rockfeller foundation with its activities.
8. Explain briefly the different pharmaceutical legislations in India.

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Health Laws and Policies

MBA Second Year

School of Distance Education

Lesson 1 Introduction about Health Law 9

Lesson 13 Nature of Law 109

Lesson 26 Health Care Delivery System 251

Lesson 30 Indian and International Voluntary Health Agencies 293

1.2 FORENSIC OR LEGAL MEDICINE

1.3 MEDICAL JURISPRUDENCE

1.4 MEDICAL ETHICS

1.5 MEDICAL ETIQUETTE

1.6 INDIAN PENAL CODE (I.P.C.), 1860

1.7 CRIMINAL PROCEDURE CODE (CR.P.C.), 1973

1.8 INDIAN EVIDENCE ACT (I/E/A/), 1872

1.9 CRIMINAL LAW

1.10 CIVIL LAW

1.12 MEDICAL EXAMINER’S SYSTEM

1.14 COURTS OF LAW

1.17 SUBPOENA OR SUMMONS

1.18 CONDUCT MONEY

1.19 CAPITAL PUNISHMENT

1.20 CHAIN OF CUSTODY

1.21 MEDICAL EVIDENCE

1.22 DOCUMENTRAY EVIDENCE

1.24 LET US SUM UP

1.25 LESSON END ACTIVITY

1.27 QUESTION FOR DISCUSSION

1.28 SUGGESTED READING

2.0 AIMS AND OBJECTIVES

2.1 INTRODUCTION— MEDICAL CODE OF ETHICS

2.4 HISTORY OF MEDICAL ETHICS

2.7 MEDICAL NEGLIGENCE

2.7.1 Definition of Medical Negligence

2.7.2 Nature of Medical Negligence

2.7.3 Difference between Civil and Criminal Negligence

Trait Civil Negligence Criminal Negligence

Offence No Specific and Clear violation of Must have specifically violated a

Conduct of Compared to a generally accepted Not a single test

Trial by Civil Court Criminal Court

Evidence Preponderance of evidence is Guilt should be proved beyond

Punishment Liable to pay damage Imprisonment

2.7.4 Difference between Professional Negligence and Infamous Conduct

Damage to Should be present Need not be present

Duty of Care Should be present Need not be present

Trial by Courts: Civil/Criminal State Medical Council

Punishment Fine or Imprisonment Erase of name or warning

Appeal To Higher Court To state and Central Government.

2.7.5 Common Reasons for Allegations of Medical Negligence

2.7.6 Compensation for Medical Negligence

2.7.7 Liability for Negligence

2.7.8 Precautions against Negligence

2.8 LET US SUM UP

2.9 LESSON END ACTIVITY

2.11 QUESTIONS FOR DISCUSSION

Check Your Progress: Model Answers

2.12 SUGGESTED READING

3.0 AIMS AND OBJECTIVES

3.2 SHORT TITLE AND COMMENCEMENT

3.3.2 Duties and Responsibilities of the Physician in General

Regulations made by the Central / State Governments or local Administrative

3.4 DUTIES OF PHYSICIANS TO THEIR PATIENTS

3.5 DUTIES OF PHYSICIAN IN CONSULTATION

3.6 RESPONSIBILITIES OF PHYSICIANS TO