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THE BALUCHISTAN PRIVATE HOSPITAL REGULATORY RULES, 2005 THE BALUCHISTAN PRIVATE HOSPITAL REGULATORY RULES, 2005 [26th September, 2005] No. PC(H)/BHRA/2005/4695-98, dated 26.9.2005.-- In exercise of the powers conferred by Section 10 of the Balochistan Private Hospital. Regulatory Act, 2004, the Government of Balochistan is pleased to make following rules namely,-‑ Part I PRELIMINARY 1. Short title, application and commencement.--(1) These Rules may be called as the Balochistan Private Hospital Regulatory Rules, 2005. (2) They shall apply to all Private Hospitals in the Province of Balochistan. (3) They shall come into force at once. 2. Definitions.--In these Rules, unless the context otherwise requires, the following expressions shall have the meaning hereby respective assigned to them, that is say,-‑ (a) "Act" means the Balochistan Private Hospital Regulatory Act, 2004; (b) "Chairman" means the Chairman of the Private Hospital Regulatory Board appointed under sub-section (1) of Section 3 of the Act; (c) "Member" means the members of the Private Hospital Regulatory Board appointed under Section (1) of Section 3 of the Act; (d) "Schedule" means schedule to these Rules; (e) "Secretary" means the Secretary of the respective District Hospital Regulatory Board posted by the Government. He shall be the officer of the Health Department not below the Grade of BPS-18 and shall be posted against the post of Secretary on the basis of transfer. (2) All words and expressions used in these Rules, but not defined shall unless the context otherwise requires here the same meanings as in the Balochistan Private Hospital Regulatory Act, 2004. Part H 3. Procedure of the Board.-- (1) The Board shall meet at least once in three months to review the conditions of the Hospitals in the areas of respective jurisdiction. (2) The quorum to constitute a meeting shall he five including the Chairman, hut necessarily having the presence of at least two owners/representatives of the private hospitals. (3) In the absence of Chairman, the members of the Board shall elect one members amongst them as Chairman. (4) The District Hospital Regulatory Board through tits Chairman may request to the Provincial Government for temporary provision of experts, consultants and advisors from amongst in service officers of the Health Department under sub-section (5) of Section 3 of the Act. (5) The Board shall ascertain the names of such directors/partners and employees of the Hospitals who are prima facie responsible for the commissions of any offence under the Act and the rules and also prosecution only against such persons. (6) The Board shall inspect twice a year all the Private Hospitals. (7) The Board shall investigate any complaint which may be made to the Board. (8) The Secretary shall conduct all the correspondence for and on behalf of the Board. (9) The Secretary shall be responsible for day-to-day affairs of the Board and shall perform such other functions as may be assigned to him by the Chairman/Board, including the summing of the persons for appearance before the Board. The Secretary shall also appear before the Court of law for assistance of the counsel of the Board. (10) No act or proceeding of the Board shall be invalid merely on the ground of the existence of any vacancy in, or any defect in the constitution of the Board. (11) All the decisions of the Board shall be taken by majority of members present, in case of tie, the Chairman shall exercise a casting vote. 4. Summoning and holding of meetings of the Board.-- (1) The Secretary with approval of the Chairman shall call the meeting of the Board. (2) The Secretary may-with the prior approval from the Chairman or upon the written request of not less than five members of the Board shall call a special and urgent meeting to deal with the urgent and special matter, requiring consideration, after giving at least three days notice of such meetings. (3) The Secretary shall dispatch to each member a notice of every meeting specifying in the date, time and place of such meetings along with agenda. (4) Any member may with the permission of the Chairman move any motion or discuss on any subject or any item, which is not included in the agenda of the meeting. (5) The majority of the members present in the meeting shall decide any item of the agenda of a meting. (i) Voting shall be by show of hands. (ii) The result of the voting shall he declared immediately after the voting, by the Chairman and such decision shall he final and conclusive. (iii) In case of equality of votes, the Chairman shall have a second or casting vote. (6) The Chairman may at any time adjourn a meting to any further date. (7) The Chairman or any two members with the consent of the Chairman may either at the beginning of the meeting or after the conclusion of the discussion on a particular item on the agenda and the business of the meeting shall move any objection regarding conflict of decision and shall proceed according to the changed order. (8) The Chairman shall decide all points of order, which may arise in the course of meeting. (9) In the same instances if any question arises with reference to a conflict in respect of a matter for whom these rules made no provision or insufficient text. The majority of members shall decide the same and the decision shall be final. Part III 5. Procedure for the grant of licence to a Private Hospital.-- (1) The Licence to a Private Hospital shall be issued in Form IV. (2) The licence issued under these rules shall, unless sooner suspended or cancelled, remain-in force for three (3) years for the date of its issuance. (3) The application for the grant or renewal of licence shall be made in Form I One month before its expiry along with all the information regarding the hospital in Form II to the Licensing Authority and shall be accompanied by a challan of twenty thousand rupees (Rs. 2.0,000) for new licence and ten thousand rupees (Rs. 10,000) in case of renewal of such licence. 6. Issuance and renewal of licence.-- (1) The Licensing Authority shall not licence in Form IV unless information required in From II and Form III are furnished. (2) The Board shall arrange for completion of formalities and inspection on II at the cost of hospital concerned and decide its licence status within sixty (60) days of such an application. (3) Any Hospital found deficient at the stage of initial inspection shall he prescribed in sub-section (6) of Section 4 of the Act. (4) All record of admission and discharge, case history files etc. shall be 1 preserved by the hospital for a period of at least one year. (5) An application for renewal of licence shall be disposed of within three months of the receipt of such application. 7. Cancellation and suspension of licence.-- The licensing authority may on the recommendations of the Board/Inspection team or on its own motion after giving the licensee an opportunity of hearing on a show-case notice cancel/suspend for such period as it thinks fit. Part IV 8. Minimum Physical and Technical Standard of a Private Hospital.-- (1) The General Wards, semi Private Rooms, Private Rooms. The size of the rooms shall not be less than 10 x 12 feet. . (2) These spaces of admission should be equipped with minimum basic needs of indoor/admitted patients i.e Hospital Bed, medicine side trolley, intravenous therapy stands, fixed or portable system of oxygen supply with equipment of oxygen therapy. (3) All the Beds should be having the mattresses in optimally good conditions. All the pillow cover and bed sheets of admitted patients should be changed daily. The change of pillow cover and sheets should be on multiple terms if the patient is contaminating the sheets. (4) Every admitted patient should be entitled to get one neat and clean underlined blanket or bed sheet according to his demand irrespective of weather conditions. (5) Ever space of admission as determined above shall be having the proper arrangements of wash rooms with continuous water supply and arrangement of sanitation. (6) All the hospital admission spaces should be white washed/distempered annually. In case of tiled spaces these should be kept clean with detol. (7) All the hospitals should have the Duty Doctors round the clock to look after the admitted patients and to carry out the follow up orders of the specialist doctors. (8) Every specialist doctor shall be responsible for the treatment of his/her admitted patients. The duty doctors and nurses shall act according to the advice of the specialist doctor in cases of their admitted patients. (9) Every specialist doctor shall minimally attend his admitted patient twice in twenty four hours in a half consultation fee. (10) The specialists doctor in case of his absence from the city shall make responsible one of his companion specialist doctor of same specialty to attend his admitted patient in his absence. The name of such alternate specialist doctor shall be disclosed to the hospital management. (11) The number of duty doctors should be related to the number of admitted patients. Every twenty-five admitted patients should have minimally one duty doctor. (12) Along with the duty doctors every hospital Should have preferably the qualified male or female nurses but in case of non-availability of qualified nurses the hospital can have the services of qualified Lady Health Visitors/Medical Techniciones/Dispensers as nurse to provide the nursing care to the admitted patients. (13) The Nurses/Dispensers on duty shall ensure that prior to administration of any drug to the patient its name, brand and date of expiry has been properly checked. The administration of that drug store shall act and issue in accordance with the written advice of the qualified doctor. In case of any doubt they shall seek advice from the duty doctor. (14) The number of Nurses and Dispensers should also be related to the number of admitted patients. Every ten patients minimally should have one Nurse or Dispenser. (15) All the hospitals should also have the tier of Ward Boys to take care of the ward cleanliness and for patient help in shifting of the patients. (16) All the Medical and Para-medical staff of the hospital should be present at a common place (Nursing station), which should be in easy approach of the patients or attendants of the patients. (17) The duty doctors and Nurses/Dispensers should be provided with' all the necessary instruments like stethoscope, Blood Pressure measuring apparatus, weighing machine, anti-septic solution like spirit, thermometer, torch etc. (18) The duty doctors and Nurses/Dispensers should also provided with an 9 emergency tray carrying the life saving medicines and ambu-gab. (19) Every doctor on duty shall wear a white coat having a name plate reflecting name and designation. (20) Nurses/Lady Health Visitors/Female Medical Technicians should wear blue coats having name plate reflecting her name and designation. (21) Dispensers/male Nurses should also wear a coat of blue colour having name plates reflecting their respective names and designations. (22) All the hospitals should have the proper electric supply and electric installation. Electrician of the hospital should check all the electric installations periodically. (23) All the hospitals should have the proper system of cooling an heating for winter and summer season. All the hospital admission spaces should have the cooling fans. All the spaces should have the arrangement of exhaust fans. In the winter season all the admission spaces should be heated with safe and sound heating system. (24) All the hospitals should compulsorily have the arrangement of alternate electric supply in case of power failure in the form of Electric Generator. (25) All the hospitals should have to receive the patients in emergency room where such patient should be attended urgently and provided with necessary treatment. (26) All the hospitals should have the minimum arrangement of one stretcher and one wheel chair per ten admitted patients. (27) Every hospitals should must have the syringe destroyers installed at the out patient department, emergency, operation theatre and at nursing stations. Every hospitals should use the disposable syringes and after use these syringes shall be destroyed by syringe destroyer. (28) All the hospitals licensed for provision of operative treatment should have minimally two operating suits one for elective cases and other for emergency operations. (29) Ever operation theatre should be constructed keeping in view the principles of anti-sepsis and sterilization. Such operation theatres should have the separate surgeon changing rooms corridors of the operation theatre and operating suits with proper arrangement of air-conditioning/cooling and heating. (30) Every operation theatre suit should have minimally the following equipments: (a) Operation Theatre Table. (b) Operation Theatre Light. (c) Anesthesia Machine with proper installation of connections. (d) Supply system of Oxygen and Nitrous Oxide. (e) Suction machine. (f) Diathermy machine. (31) The operation theatre should he equipped with the machanism of satisfactory level of standard sterilization equipment i.e. Autoclave etc. (32) In all the operation theatres there should be trained staff well conversant with the norms of the operation theatre and equipped with the skill of assistance of different operative procedures. (33) Any Hospitals engaged in provision of maternity services should have a separate Labour Room equipped with necessary standard equipment and instruments used for the purpose of delivery of a baby: (34) All the Hospitals having their X-rays unit shall be registered with the PNRA (Pakistan Nuclear Radiation Regulatory Authority.) (35) All the Hospitals whenever shall refer the case to other hospital of private sector or public sector shall refer the case in proper manner mentioning about the history of the patient and treatment given. 13. Dealing of Medico-Legal Cases.--(1) All the hospitals shall provide the first aid treatment to the medical legal cases and soon after the injured patients shall he referred to the public sector hospital where the medico legal section is available. However, rafter the patient attended by the medico-legal officer at a public hospital would he at liberty whether to stay at public sector hospital or go to private hospital of his choice with the subject to provision that his detention at public sector hospital is not required by law enforcing agencies. (2) If a medico legal case has been brought to a private hospital and there is danger that during the course of transportation/referral the patient might lose his life than the private hospital can admit this patient for the sake of definitive treatment with subject to the provision that the hospital should have got the proper expertise in dealing with that case After the admission of such case the hospital should inform the area police station. The S.H.O. of the area shall arrange the Medico-legal Officer from the nearby public sector hospital for the examination of this patient. 14. Disposal of the Hospital Waste.-- All the hospitals shall be responsible for collection, segregation and storage of the Hospital waste in plastic bags. The waste shall be handed over or displayed of according to the procedure prescribed by the City Government in terms of the rules made under the Environmental Protection Act, 1997. All the hospitals shall be bound to pay the charges levied by the City Government for the disposal of the hospital waste. ***