The functioning of the healthcare sector could be substantially influenced by the design and implementation of regulatory policies that govern the behaviour of various stakeholders. The empirical challenge is to assess whether and how far regulations have brought about 'desirable and intended' changes in the functioning of the healthcare delivery system. In this study, we assess the experience of the Consumer Protection Act (1986) and the Transplantation of Human Organs Act (1995) in the context of Tamil Nadu (India). In particular, we address the following questions: 1. Have CPA and THOA been able to achieve their stated goals? 2. What factors have influenced their effective implementation? and 3. How have various stakeholders responded to these regulatory mechanisms? Our empirical analysis shows that both CPA and THOA have not been effective in bringing about desirable changes. Commercialization of human kidneys is as common as before the introduction of the THOA. Also, the CPA has become more complex, long-drawn and expensive over the years, while it was meant to be a simple, quick and inexpensive legal mechanism. The present study highlights several underlying causes, including administrative, procedural, institutional and transactional costs, that have influenced the effective implementation of these regulatory measures in the context of Tamil Nadu. We have used a variety of primary and secondary sources in recording our observations. Official records, in-depth personal interviews and workshops were used as part of our methodology. The study is confined to the experience in the state of Tamil Nadu, but we believe that our observations will hold good to a large extent to other parts of India as well.
Prasad, S.R.; Muraleedharan, V.R. Regulation in health care in Tamil Nadu (India): A study of the implementation of Transplantation of Human Organs Act (THOA) 1994, and Consumer Protection Act (CPA) 1986. London School of Hygiene and Tropical Medicine, London, UK (2003) [HEFP working paper 08/03]