Paramedicals running Independent Laboratories in Mumbai: PCI told to take action

Mumbai: Alleging malpractices against the Maharashtra Paramedical Council, the doctors under the umbrella of the Maharashtra Association of Practicing Pathologists & Microbiologists (MAPPM) have recently written to the DMER, and Medical Education & Drugs Department of Maharashtra seeking disciplinary action against the Council.

Such a demand has been made by MAPPM as it challenged the practice of the Council in allowing paramedical personnel to run independent laboratories, which is allegedly illegal as per the law of the land. Further, the association has contended that the Paramedical Council violated doctors' right to practice pathology as it mentioned in 2021 that no person other than paramedical council registered technician is allowed to run clinical laboratory independently

Writing to the authorities, the association has sought for direction upon the council to withdraw its "illegal letters" and also the 2020 resolution which allowed paramedical personnel to run laboratory independently and certify/sign laboratory test report in the name of technical analysis report without recording any opinion or diagnosis.

Medical Dialogues had reported on several occasions how MAPPM has remained active over the years regarding its fight against fake pathology centres, functioning without attachment of a registered pathologists. Taking note of the complaints raised by the association, the Maharashtra Medical Council (MMC) had investigated the pathology units in Maharashtra back in 2015. Resultant to the enquiry, it did discover many cases malpractices of issuing diagnostic reports without due supervision and guidance under a qualified pathologist. Many instances were found where diagnostic labs were being run by non-pathologists, manned only on the reliance of technicians. In many others, reports were being generated in the name of pathologists who were not even associated with the laboratories.

Also Read: MMC finds Pathology Labs without Pathologists

Later the association approached the Medical Council of India and questioned the role of DMER in the same matter. In fact, taking note of the issue, the erstwhile MCI had directed MMC to investigate the role of the then DMER and take necessary action in that regard.

However, the issue got complicated with the new rules issued by Maharashtra Paramedical Council (MPC) which allowed paramedical personnel, who are technicians, to run pathological laboratories independently. MPC was constituted by Maharashtra Paramedical Council Act 2011. It is meant for registration of 21 types of technicians like Laboratory technicians, EEG, ECG, etc.

Drawing the line between the paramedical personnel and the pathologists, MAPPM in the recent Press Release clarified, "The union govt suggested some amendments in the Act, especially the nomenclature Paramedical Practitioner was objected instead the paramedical Personnel or Worker was suggested by the Union Govt. In Amendment 2017 the nomenclature was changed to Paramedical Practicing Personnel and definition stating that these personnel have to work ancillary to Medical practitioners in practice and teaching was added. This amendment was suggested to avoid future litigation in practice amongst technicians and medical practitioners."

"So, its crystal clear from MPC Act 2011 and Amendment 2017 that Council registered Paramedical personnel can not practice independently. Registered laboratory technician is not permitted to run laboratory independently and certify reports," the association added.

Speaking to Medical Dialogues in this regard, the President of MAPPM, Dr Sandeep Yadav explained, "Maharashtra Paramedical Council was constituted for the registration for paramedical personnel, who assist the doctors. Like nurses, there are 21 other types of technical courses for helping the doctors. In paramedical council there is no provision in the act that the council will allow the registered people to start practicising independently. In fact while preparing the act, the Central Government suggested changes in the term "Paramedical practitioner" which was amended to "Paramedical practicising personnel" in order to avoid future litigation. From the definition of the amended term it is clear that such personnel are meant to assist doctors in medical practice as well as teaching." 

In fact, the association also referred to the Supreme Court order dated 12.12.2017, which had clearly stated that Laboratory report can only be countersigned by the registered medical practitioner with post graduate qualification in Pathology.

In contrast to these set norms, the association has alleged that MPC in a letter dated 06.08.2018 had stated that the order of the Supreme Court was not applicable in the State of Maharashtra.

Referring to this Dr. Yadav said, "That was clearly unconstitutional and illegal. How can someone say that?"

The Association in its Press Release dated 10.05.2022 has further referred to the letter of the Paramedical Council dated 10.05.2021. Addressing the letter that was directed to all district collectors, Health officers and police officers, the association pointed out, "In it its written that no person other than paramedical council registered technician is allowed to run clinical laboratory independently. It meant that the MMC registered Pathologist (who is only eligible to certify reports as per Medical Council of India and Hon,. Supreme court order) is not eligible to run clinical laboratory independently as he is not registered to Paramedical Council. Same meaning was drawn by many of the officers instate and Notices are issued to MMC registered Pathologists to close the laboratories as they don't have Registration of Paramedical Council."

"It is funny, for a Medical council registered doctor to registered for paramedical council. Pathologists from Gadchiroli, Shrirampur were harassed by the officers for Paramedical council registration. This is violation right to practice of MMC registered doctor. This is encroachment of Paramedical council in the Jurisdiction of Medical Council," it added.

"They sent notices to qualified pathologists and declared their laboratories to be illegal since they were not registered with the paramedical council. The doctors associated with our association are unnecessarily harassed as their right to practice pathology is getting violated. Our right to practice is ensured by IMC Act, 1956. In a way, Maharashtra Paramedical Council is encroaching in the field of Medical Council," Dr. Yadav told Medical Dialogues.

Further reference was also made to the MPC resolution dated 11.02.2020, which stated Paramedical council registered laboratory technician can run laboratory independently and certify / sign laboratory test report in the name of technical analysis report without recording any opinion or diagnosis.

Opining that such practices are compromising the quality of pathological labs, he added, "Human Rights Commission said that these laboratories run by the technicians are violating the basic human right of health. They are making huge money by looting people. So, there is economical loss, as well as the loss of health."

The Association has now written to the concerned authorities including the DMER and Medical Education & Drugs Department in this regard. Referring to the fact that under Section 38 of the Paramedical Council Act the government has powers to dissolve the Council and take disciplinary actions on members of council for exceeded or misuse of powers, the Association has made the following demands to the authorities:

1. Direct Maharashtra Paramedical council to withdraw their illegal letters dated 06.08.2018 , 10.05.2021 and resolution in the meeting dated 11.02.2020 and

When asked about their future course of action, Dr. Yadav informed that if they do not get any positive response in this regard from the concerned authorities, they might consider taking the route of agitation or take up the matter to Court.

Also Read: Maharashtra: Probe against DMER for fake pathology centres