Department of law & Human Rights

Course code: Law- 406

Course Title : Medical & Drug Law

Submitted By
Shafayat Islam Noor
4th year, 1st semester
Reg No: 20211038

Submitted To
Nushera Tazrin Darin
Lecturer,Department Of Law & Human Rights
Shastho Sheba O Shurokkha Ain, 2023 (Draft): A Critical Analysis of This Draft Act
Considering The Core Provisions of The Medical Practice And Laboratories (Regulation)
Ordinance, 1982

Introduction
News of various complications starting from patient's death due to medical negligence and
mistake are often in the headlines. Doctors and health workers are constantly being
attacked by patients' relatives in the country's hospitals and clinics for wrong treatment.
Again, due to the absence of specific laws and regulations, the private hospitals and clinics
of the country are cutting the pockets of patients in the name of examination and
treatment. To prevent these irregularities and instability in the medical system of the
country, the process of preparing the 'Health Care and Protection Act' was started. All the
private medical colleges, hospitals and clinics of the country were being governed by 'The
Medical Practice and Private Clinics and Laboratories (Regulation) Ordinance' of 1982.
Article 19 of the Fourth Schedule relating to approval and support of ordinances issued
under military orders is repealed. As a result, the Ordinances were repealed by the
Fifteenth Amendment of the Constitution. Hence, there is a need for up-to-date legislation
to ensure the protection of individuals, institutions and service recipients and accountability
of institutions involved in healthcare. Therefore, the Ministry of Health started the work of
making this law. For which the work on Health Protection Act 2023(Draft) was started.
Draft Act Overview:
The draft introduces significant provisions aimed at addressing medical negligence, ensuring
the quality of healthcare services, and imposing penalties for violations within the
healthcare sector. It emphasizes the need for accountability, patient safety, and proper
licensing standards for private hospitals.
 Prosecution and Compensation:
The draft calls for prosecution under criminal law and the recovery of compensation in cases
of patient death due to medical negligence. It outlines offenses of negligence against
hospitals or institutions and individuals providing treatment. Additionally, recommendations
for license cancellation and doctor deregistration are included.
 Licensing Standards (Section 5):
Section 5 outlines conditions for obtaining a private hospital license. Requirements include
maintaining a suitable patient hygienic environment, adequate space per patient, air-
conditioned operating rooms, essential medical equipment, life-saving drugs, and sufficient
specialist doctors. It emphasizes the importance of a functional normal delivery system.
  Regulatory Measures (Sections 6 and 10):
Section 6 empowers regulatory bodies to suspend or terminate licenses of private hospitals
found in violation of healthcare standards or public health safety. Section 10 restricts
healthcare providers from offering services in private facilities during official hours without
regulatory permission, ensuring accountability and oversight.

 Crimes and Penalties (Section 25):

Section 25 establishes penalties for various violations within private healthcare
establishments. These include fines or imprisonment for offenses such as obstructing
inspections, threatening or injuring healthcare institution property, and employing
government health service personnel without proper authorization. Failure to maintain
emergency care facilities or adequate seating space in private medical practices also incurs
penalties.

Overall, the draft aims to enhance accountability, uphold patient rights, and ensure the
quality and safety of healthcare services. It establishes clear regulations and penalties to
deter malpractice and maintain standards within the healthcare sector.
Changes and Recommendations Between Shastho Sheba O Shurokkha Ain, 2023 (Draft)
and The Medical Practice And Laboratories (Regulation) Ordinance, 1982:

 Preamble Definition: In the 1982 ordinance, the preamble only defined the effects
of the ordinance, while the 2023 draft version now includes both the cause and
effect of the ordinance, providing a more comprehensive overview of its purpose.

 Government Definition: The 2023 draft introduces a new government definition,

HSD (Health Services Division), MOHFW (Ministry of Health and Family Welfare),
whereas in 1982, it was defined as "Director-General" of Health Services. This change
aims to streamline administrative processes and align with current government
structures.

 Hospital Definition: In the 2023 draft, the definition of a hospital is newly added as a
separate point (Point 17), whereas in the 1982 ordinance, it was defined under
separate points (2(d) and (e)). This restructuring may enhance clarity and
organization within the legislation.
 Designated Person Definition: The draft lacks clear definition for designated persons
in medical practices such as physiotherapy and dental practices (excluding BDS). This
ambiguity could lead to confusion and inconsistency in implementation,
necessitating further clarification.

 Private Hospital Establishment: While the 1982 ordinance specifically mentioned

the establishment of private clinics, the 2023 draft refers to the establishment of
hospitals without distinguishing between private hospitals and clinics. Clarification is
needed to ensure consistency and understanding in licensing procedures.

 Directive Specification: Section 11 of the 1982 ordinance included a directive that

could be more specified in the draft law to enhance clarity and effectiveness in
implementation.

 Treatment Charges for Non-Bangladeshis: In the 1982 ordinance, it was mentioned

that non-Bangladeshi patients could receive medical treatment without any fees or
charges. However, the 2023 draft states that treatment can be obtained with or
without charges, reflecting potential changes in healthcare policies and practices.

 Universal Health Coverage: The 2023 draft guarantees universal health coverage, a
provision absent in the 1982 ordinance, reflecting a progressive approach towards
healthcare accessibility and equity.

 Applicability Specification: While the 1982 ordinance specified applicability for

particular purposes, the draft refers to "customary law" without specification. Clarity
on the applicability of laws is crucial for effective implementation and adherence.

 Offense Specification: Offenses related to healthcare regulations are specified in the

draft, whereas they were not clearly outlined in the 1982 ordinance. This inclusion
enhances accountability and facilitates enforcement of regulations.

 Penalty Specification: Section 24(7) of the draft mentions a penalty for not
maintaining minimum seating space in private medical practices, referencing
customary law without specificity. Section 25(8) presents potential conflicts with
upcoming national telemedicine guidelines, suggesting the need for alignment and
coordination between different healthcare regulations.
These changes and recommendations between the 2023 draft and the 1982 ordinance aim
to modernize healthcare legislation, enhance clarity and effectiveness, and address
emerging challenges in the healthcare landscape.
Changes and Recommendations Compared to the 1982 Ordinance: Several notable
changes and recommendations have been made between the draft Health Care and
Protection Act 2023 and the Medical Practice and Laboratories (Regulation) Ordinance of
1982. These include modifications to the preamble, definitions, licensing requirements, and
penalties. For instance, the draft introduces new definitions, updates licensing criteria, and
specifies offenses and penalties more comprehensively compared to the 1982 ordinance.

Overall, the draft act represents a comprehensive effort to modernize healthcare legislation,
enhance accountability, and ensure the safety of patients while providing clarity and
regulation within the healthcare sector. However, certain areas require further clarification
and refinement to address potential ambiguities and ensure effective implementation.

Why is the delay in adopting the draft law?

The Draft Act has two parts. One is the protection of the patient, the other is the protection
of doctors and hospitals. The government is making a combined law. The law that we have
in our neighboring country, India, has the most emphasis on the protection of doctors. But
the law that has been made in our country does not reflect any demand of doctors.
According to doctors statements the protection of doctors is mentioned in this law, no
protection of doctors has been prioritized. That is why there is anger in the medical
community about the law. The law may not be moving forward without realizing this. The
law prescribes various offenses and penalties for doctors under the criminal law. But
doctors' offenses can never be criminal offences. No doctor would sit in a chamber to kill a
patient. Death is a natural thing. Any person can die at any time. According to the law,
doctors' chambers and hospitals can run mobile courts wherever they want, it should never
be done. Entering the mobile court means interrupting treatment at the hospital. Hospital
is a sensitive place. There are always more than one patient in the operation theatre. At
this time, If the mobile court conducts its activities during any operation, then the
operation program can disrupt. As a result, there is a question of the life of the patient's life.

Conclusion
There are many famous doctors in health service in Bangladesh. Their reputation is
everywhere in the country and abroad. Moreover, it is awarded as the best profession in
Bangladesh. Here a common mistake threatens the life of people and undermines the
reputation of the doctor. So to hold this best profession and service with respect.
Therefore, it is the need of the hour to amend the important sections of the law in
coordination with doctors and doctors' organizations.