Centre proposes NMR based interstate practice for doctors, single-window licensing for hospitals in Kerala

Kochi: The central government has suggested two major health-sector reforms to the Kerala government under Phase II of the 'Compliance Reduction and Deregulation' initiative.

According to TOI report, the proposals focus on allowing doctors and other healthcare professionals to practise across states without fresh registration and creating a single-window system to clear hospital licences.

No Need For Fresh Registration?

Currently, a medical professional registered in one state cannot directly practise in another. In Kerala, medical practice is regulated under the Kerala State Medical Practitioners Act, 2021, which empowers the state medical councils for modern medicine, Indian Systems of Medicine (ISM) and homeopathy to grant registration. This means a doctor registered in another state must obtain fresh registration and often a no-objection certificate (NOC) before working in Kerala.

Similarly, nurses must register under the Kerala Nurses and Midwives Act, 1953, through the Kerala Nursing Council, and paramedical staff must register with the Kerala Paramedical Council.

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However, the Centre has now recommended that healthcare professionals registered in any state medical council or listed in the National Medical Register (NMR) under the National Medical Commission should be allowed to practise in Kerala without applying again or seeking prior approval.

The arrangement may be based on self-certification, and the state need not seek an NOC from the practitioner's previous state. The reform seeks to leverage the National Medical Register framework under the National Medical Commission (NMC) to enable seamless interstate mobility of healthcare professionals.

However, implementing this change will require a policy decision by the state government and possible amendments to existing laws and rules. Any move to dispense with the existing dual-registration requirement would involve legislative changes and procedural adjustments by the respective councils.

Speaking to TOI, Kerala Govt Medical Officers' Association (KGMOA) general secretary Jobin Joseph said, "The proposal to make registration in one state valid in another can help address the shortage of doctors, particularly in rural and border districts. In areas such as Idukki, Palakkad and Wayanad, it could attract more doctors who are registered in neighbouring states. Registrations elsewhere are also granted after due diligence, so there is no reason to doubt their credibility."

One Window for Hospital Licences

The second reform deals with the multiplicity of licences required to establish and operate a healthcare facility in Kerala.

Healthcare establishments in Kerala at present must obtain approvals under multiple laws and regulatory regimes, including the Kerala Clinical Establishments Act, the Drugs and Cosmetics Act, the Biomedical Waste Management Rules, the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, the Surrogacy (Regulation) Act, 2021 and Rules, 2022, the Assisted Reproductive Technology (ART) (Regulation) Act, 2021 and Rules, 2022, the Food Safety and Standards Act for hospital kitchens, fire and safety NOCs, pollution control board consent and local self government trade licences. 

Even a standalone radiology centre may need multiple permissions from different wings within and outside the health department.

To simplify this, the centre has proposed setting up a single nodal agency within the health and family welfare department. This agency would act as the only point of contact for healthcare-related approvals and would coordinate with all departments to secure licences, registrations and NOCs on behalf of investors, as per the daily

The proposal also allows for onboarding a third-party private entity to manage coordination functions against a fee paid by the healthcare establishment.

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