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Exploring Data Practices of Private Healthcare Facilities

When I last posted, I mentioned I was involved in the formal process of filing documents under the Right to Information Act (RTIs). It has been a mere two weeks since then and the RTIs have started trickling in. I have received information on private and public hospitals in Chennai as well as on leptospirosis and malaria incidences in the city. An initial glimpse of the disease data reveals that private hospitals report significantly fewer disease cases (at least for malaria and leptospirosis) than government hospitals. This might be indicative of poor reporting practices on part of private facilities, a concern that has been voiced by public health experts.¹

I have also begun the process of interviewing private hospitals, which has been quite challenging, as interviews are hard to obtain. When hospitals hear that I want to understand their data collection, reporting, storage and usage practices, many are resistant to agree. I imagine that the term “data,” causes concerns over privacy and confidentiality. This is regardless of the fact that the objective of this research is to examine data generally and does not entail obtaining specific information regarding private hospital’s patients or disease statistics.

As of now, I have completed four interviews. Based on these interviews, it appears that the methods of reporting data (electronic submissions or mailed hard copies) to the CoC are outlined by the zonal health officer. This format varies from zone to zone. It would seem that on the CoC’s end, receiving data in various formats would result in difficulties compiling and organizing the data. I will need to interview more hospitals to determine whether this arbitrariness is a trend.

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¹ http://articles.timesofindia.indiatimes.com/2012-02-04/chennai/31024267_1_malaria-cases-dengue-cases-health-department (accessed 20 November 2013)

On Data and Diseases

I have been interning with Transparent Chennai for only one week now, and have already been introduced to the hurdles and hassles that accompany obtaining data in Chennai. The project I am working on entails understanding the Corporation of Chennai’s data collection practices on communicable diseases, including malaria, tuberculosis, leptospirosis and cholera. This project will also explore the circulation of data between the public and private healthcare systems, in attempts to understand the healthcare information ecosystem. I quickly discovered, much to my dismay, that there is little, if at all any, data on disease statistics in Chennai. One would think the public would desire access to this information, given the prevalence and critical nature of communicable diseases.

In my attempts to acquire data, I ventured to the Health Department in the Corporation of Chennai. I was told by officials at the department that they could not provide me with data on diseases. “Why,” I asked. They explained that members of the department had been suspended for a situation in which this very sort of information was leaked. The number of cholera mortalities, which was inaccurate, had been released by the Health department. This resulted in the Corporation of Chennai taking action against Health Department employees for the release of confidential information as well as for the data inaccuracies.[1] I realized I would have to try other avenues to obtain this data.

I am currently going through the formal process for obtaining data – filing documents under the Right to Information Act, 2005. Under this act, the Indian government is mandated to provide citizens information, except that which infringes on privacy or concerns issues of national security. These documents are submitted to information officers in their respective offices and must be addressed within 30 days. It is very possible for no information to be provided, but it is an avenue worth pursuing. As I continue this project, I look forward to updating you all on the trials, tribulations and triumphs in data collection.


[1] http://www.thehindu.com/news/cities/chennai/cholera-deaths-chennai-city-health-officer-4-others-suspended/article3765868.ece (accessed 13 November 2013)

Demystifying legislative jargon

For the layman, the number of terms used by law and policy makers may be confusing. This post is an attempt to demystify the various terms used in the legislative and rule making process.

1. Law: An Act, Ordinance, Regulation, Rule, (Order, bye-law, etc.) which is enforceable i.e. required to be followed by all persons.

2. Draft Law: A draft of a law or legislation is the first stage of law making procedure. It is a proposal for a new Act or an amendment to an existing law. This can be drafted by anyone – a stakeholder, the related government department, a civil society organisation. A Draft Law obviously has no force of law and is only a proposal for a law. It would require to be tabled before Parliament/State Legislature, which can only be done by a MP or MLA.

3. Bill: This is another term for a draft law. The term is usually used for a law which is ready for introduction before a House of Parliament/State Legislature in terms of format.

4. Ordinance: This is a temporary law made by the Executive to address extraordinary, unforeseen and emergent situations at a time when the Parliament is not in session. It is proposed by the Executive (Prime Minister and his Cabinet) and signed by the President of India to come into effect. An Ordinance is valid till six weeks after the Parliament reassembles. The same limitations on law making that attend an Act also apply to an Ordinance (such as it must not violate fundamental rights and that it must be within the competence of the legislature; for e.g. a central ordinance cannot be on a matter in the state list).

5. Act: This is the final law which is passed by the Legislature. A Bill once passed by both Houses of Parliament and on receiving the President’s assent becomes a Central Act. A State Act is an Act passed by the Legislature of a State and assented to by the Governor of the State. However, an Act comes into effect on notification in the Official Gazette on the date mentioned in the notification.

6. Amendment Bill/Act or simply ‘Amendment’: An Amendment Bill seeks to and an Amendment Act amends an existing Act. An Amendment Bill needs to go through the same procedure as a normal Bill to become an Act. A Constitutional Amendment Bill/Act seeks to amend or amends the Constitution of India.

7. Subordinate or Delegated Legislation: Acts provide the main principles of law and policy which require rules for their operation. An Act usually has a provision giving a particular authority or government department (i.e. the executive wing of government) the power to make rules, regulations, and/or by-laws for the operation of the Act. These Rules or Regulations are required to be within the scope of the parent Act. Once drafted, approved, and notified by the authority/department they are tabled before the legislature (Parliament/State Assembly) where the Committee on Subordinate Legislation may evaluate the Rules for conformity with the parent Act and the Constitution. They are referred to as subordinate or delegated legislation since they are subordinate to the parent Act and the power to formulate them is delegated by the legislature to a subordinate executive body. They can be amended by the executive body as well.

8. Rules: These are a form of subordinate/delegated legislation made in exercise of a power conferred by an enactment. As per the General Clauses Act, the term ‘Rules’ includes a Regulation made as a rule under any enactment (i.e. rules and regulations are similar in the way they are formulated, but differ in content. For e.g. the Employee State Insurance Act, 1948 gives the Central and State Governments the power to make rules to give effect to the provisions of the Act in Section 95 and 96 and give the ESI Corporation the power to make Regulations for the administration of the affairs of the Corpora¬tion and for carrying into effect the provisions of the Act. These Sections also provide the scope of what the Rules and Regulations should cover.

9. Notification: A notification is issued by the executive wing of government (central/state) in exercise of a power granted under an enactment. It is usually in the manner of public announcement of an action under a particular provision such as notification of an area as a slum area under Section 3 of the TN Slum Areas (Improvement and Clearance) Act, 1971. It is an executive action under a legislation.

10. Government Order (G.O.) and Circular: G.Os and Circulars are also forms of executive action in pursuance of powers invested in the executive. They need not be relatable directly to any particular enactment, but they cannot be contrary to any law in force (in terms of content and procedure).

11. Policy Documents: These are in the nature of broad principles of the ruling government on different matters of importance. For e.g. the National Environment Policy, 2006.

12. Guidelines: These are framed by a government department (the executive), usually a governing ministry or other overseeing body, in furtherance of a policy document for the purpose of explaining to the implementing body how to go about its role.

13. Gazette of India or the Official Gazette of a State: These are published on a weekly basis by the Central Government and State Governments to give notice to the public of, among other things, proposed laws (Acts, Rules, etc.), to give effect to proposed laws and to notify the public of executive action taken in furtherance of an enactment (Notification, Government Order, Circulars, etc.). When a law is being given effect to, the Gazette mentions the date from which such law shall come into effect. The Gazettes are authorised legal documents of the respective Governments and are meant to be the most reliable source of Government notices.

The Central Gazette is available at: http://www.egazette.nic.in
The Gazette of the State of Tamil Nadu is available at: http://www.tn.gov.in/stationeryprinting/gazette/gazette_list.php

Written by Avni Rastogi, researcher at Transparent Chennai.