New Delhi: Only 11 states and all Union territories except Delhi have adopted the Clinical Establishments Act, aimed at streamlining healthcare services in India, despite repeated appeals by the central Health Ministry to states to adopt it, the government said Friday. "The Clinical Establishments (Registration and Regulation) Act, 2010 is applicable in 11 states who have adopted it.

"The states - Sikkim, Mizoram, Arunachal Pradesh, Himachal Pradesh, Uttar Pradesh, Bihar, Jharkhand, Rajasthan, Uttarakhand, Assam and Haryana - and all UTs except Delhi have adopted the Act," Minister of State for Health Anupriya Patel told Lok Sabha.

The Act has to be adopted by other states under Article 252 of the Constitution of India. The provisions of the Act shall become applicable in the remaining states only after adoption, she said.

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 Health being a state subject, the enforcement and implementation of the Clinical Establishments Act, 2010 is with the states and UTs.

"The central government is continuously persuading the states to adopt the Act and ensure its strict implementation from time to time," Patel said.

The Clinical Establishments Act was enacted by the Centre to provide for registration and regulation of all clinical organisations in the country with a view to prescribing the minimum standards of facilities and services provided by them

The Act is applicable to all types - both therapeutic and diagnostic - of clinical establishments in public and private sectors.

Under the Act, standard treatment guidelines are specified for 227 diseases, including dengue, chikungunya and malaria. The hospitals are supposed to abide by minimum standards in terms of infrastructure, services, staff, equipment and lighting arrangements.

A technical committee is to be set up to decide on charges for treatment of diseases and procedures at clinical establishments, including private hospitals.

Health facilities are to display the charges for each procedure and facility to keep the patient informed in advance. Failure to adhere to these guidelines would result in the penalty.