Need for clarity in emergency healthcare: MLSI issues advisory

Pune: The Medico Legal Society of India (MLSI) on Monday released an advisory for healthcare facilities and public regarding emergency medical care, hospital responsibilities and patient expectations. The statement comes in response to recent directives from the Pune Municipal Corporation (PMC) and the state government directing private hospitals to not demand advance deposits from patients during medical emergencies or refuse urgent treatment due to financial constraints.

MLSI said that as hospitals do not have the same facilities, critical patients have to be transferred from private to government hospitals because of inadequate infrastructure. Expecting advanced care from such hospitals is unrealistic and often delays treatment during the critical “golden hour”.

The association of doctors and legal professionals has recommended better use of cardiac ambulances and timely transfer to advanced government hospitals for best survival chances.

As per the MLSI, the current law mandates that all hospitals—private and government—must stabilise a patient in an emergency before transferring them to a better-equipped facility. However, no state government has passed a law for reimbursement of emergency treatment costs as recommended by the Law Commission in 2006. As a result, hospitals that offer free emergency treatment may suffer financial losses without any legal protection or reimbursement.

Dr Rajeev Joshi, founder, MLSI, said that doctors form a small part of the total hospital bill in private setups. “Doctors should not be blamed for billing estimates, which are governed by hospital policies,” he said.

The advisory outlines that in non-emergency cases, hospitals have the right to ask for an advance before starting treatment. If patients cannot pay, there is currently no legal way for hospitals to recover costs after treatment. In emergencies, however, hospitals must provide care and later transfer patients safely to public hospitals or charitable facilities, depending on the patient’s financial status.

Dr Joshi said that MLSI calls for a balanced understanding from the public, noting that doctors have both legal duties and professional rights. A collaborative approach involving the government, hospitals, and public is needed to ensure fair and effective emergency healthcare.