Table 3 Framing of patient rights in subnational health care policies and in medical/nursing curriculum

Patient rights provisions were scattered across multiple subnational policies. For instance, patient rights provisions in KPMEA are mainly for private health facilities. The National Quality Assurance Programme launched in 2013 also emphasizes on patient rights but is only for public health facilities. Apart from these, health facilities can also voluntarily opt for accreditation from the National Accreditation Board for Hospitals and Health Care Providers which mandates the display of patient rights charter in health facilities. Then there is LaQshya programme striving to achieve respectful maternity care in government health facilities. The implementation of regulatory policies to improve quality of care is suboptimal. Such policies were viewed as a licensing tool rather than an instrument for implementing patient rights:

“Those licensing requirements (KPMEA) are more on infrastructure and human resources. I don’t think that any licensing requirement is talking about patient rights”- (KII-Representative, Body for quality accredited health care organizations)

State policies for regulating the conduct of care-providers such as the doctors and nurses do not mention the term “patient rights”. Rather in these regulations, patient rights are implicated as a matter of health professional’s obligations towards care-seeking individuals and avoiding medical malpractices (cfr Indian Medical Council (professional conduct, etiquette, and ethics) regulations, 2002; The Karnataka nurses, midwives & health visitors’ rules, 1964)

In the nursing and medical curriculum, elements of patient rights such as confidentiality, privacy and informed consent are taught from a legal perspective. The Medical Council of India, now renamed as the National Medical Commission, provided guidelines in 2018 to emphasize attitude, ethics, and communication related competencies for Indian medical graduates. However, these are only guidelines that are left entirely to the discretion of medical institutions for its implementation. The medical or the nursing curriculum do not articulate explicitly rights-based approach to health care. The health professional curriculum orients the budding graduates with the idea of rights in a piece-meal fashion (e.g., rights of psychiatric patients, child rights) (cfr undergraduate and post graduate curriculum of National Medical Commission, 2022 and Indian Nursing Council, 2022)