Pune: The Indian Medical Association (IMA)’s state chapter has written to health minister Prakash Abitkar and sought urgent changes to the Maharashtra Nursing Home Registration Act (MNHRA), saying that current rules have put severe strain on small and medium nursing homes and a uniform regulatory framework is unfair to facilities of different sizes and capacities.In its letter dated June 23, the IMA has recommended a bed-based classification system for healthcare facilities, with separate norms for large corporate hospitals, mid-sized general hospitals and smaller clinics or daycare centres. It has also called for a single-window registration system to reduce the administrative burden on doctors and a five-year validity period for licence renewal instead of annual ones.The association said strict infrastructure requirements were difficult for old hospitals operating in existing structures. It said compliance costs and repeated licencing procedures were forcing many small providers to consider closure, especially in semi-urban and rural areas where affordable local healthcare is crucial. The letter cites Bihar’s precedent of amending the state’s Clinical Establishment Act for a more practical, graded approach to regulation.The IMA has been pushing for changes in the existing MNHRA and also the proposed Clinical Establishment Act since the last few months.The letter reads: ”We would like to bring to your notice a significant policy change implemented in Bihar (Feb 2026). Following observations made by the Patna high court regarding the impracticality of applying a one-size-fits-all approach, the Bihar state cabinet approved an amendment to the Clinical Establishments Act. Accordingly, all healthcare centres with fewer than 40 beds have been exempted from mandatory registration. The court and the state govt recognised that applying the same structural mandates to a 10-bed clinic as a 500-bed corporate hospital is legally arbitrary/discriminatory and creates obstacles for the common man in accessing healthcare services.”IMA Maharashtra president Dr Santosh Kulkarni said small nursing homes were facing difficulties to comply with stringent infrastructure regulations in the state. Many hospitals in small cities operate out of old, well-established buildings and making structural changes there is practically impossible.“The cost of complying with these regulations and managing annual renewals is forcing small-scale doctors to shut down their hospitals or pass on the cost to patients. Consequently, people in rural and semi-urban areas are being deprived of affordable, localised healthcare. Instead of completely scrapping the Act, we propose a scientific categorisation of medical establishments — category A: Large/corporate hospitals (over 50 beds), category B: Medium general hospitals (15-50 beds) and category C: Small clinics/daycare centres (less than 15 beds),” Kulkarni said.He further said a single-window system should be implemented for hospital registration and renewals. “This will effectively reduce the financial, administrative and mental harassment that doctors face from govt departments. Also the renewal of hospital licences should be extended and made valid for a period of five years each.”Repeated calls were made and messages sent to Abitkar, but there was response till the time of going to press.
