Private Hospitals and Medical Clinics Act

(CHAPTER 248)

(Original Enactment: Act 27 of 1980)

REVISED EDITION 1999

(30th December 1999)

An Act to provide for the control, licensing and inspection of private hospitals, medical clinics, clinical laboratories and healthcare establishments, to prohibit trading in human blood, and for purposes connected therewith.

[1st January 1993]

Short title

1. This Act may be cited as the Private Hospitals and Medical Clinics Act.

Interpretation

2. In this Act, unless the context otherwise requires —

“authorised officer” means —

(a)	any public officer appointed by the Director under section 3(2) to perform the duties and exercise the powers of the Director under this Act or any regulations made thereunder; and
(b)	any person authorised by the Director under section 3(3) to assist in the administration of this Act;

“clinical laboratory” means any premises used or intended to be used for any type of examination of the human body or of any matter derived therefrom for the purpose of providing information for the diagnosis, prevention or treatment of any disease or for the assessment of the health of any person, or for ascertaining the cause of death or the result of any medical or surgical treatment given to any person, but does not include any such premises —

(a)	which are maintained by the Government or the National University of Singapore;
(b)	which form part of the premises of a licensed private hospital; or
(c)	which are maintained by a medical practitioner or dentist as part of his medical clinic for the exclusive use of his practice;

“dentist” means a person who is duly registered under the Dentists Act 1999 (Act 24 of 1999);

“Director” means the Director of Medical Services;

“healthcare establishment” means any premises or conveyance —

(a)	which is used or intended to be used for the provision of any service, or for carrying out any practice or procedure, that is related to the diagnosis, treatment or care of persons suffering from any disease, injury or disability; and
(b)	which is declared by the Minister, by order published in the Gazette, to be a healthcare establishment for the purposes of this Act,

but does not include a private hospital, medical clinic or clinical laboratory or part thereof, or an establishment or conveyance maintained by the Government or the National University of Singapore;

“licence” means a licence issued under this Act to use any premises as a private hospital, medical clinic, clinical laboratory or healthcare establishment, and “licensed” shall be construed accordingly;

“maternity home” means any premises used or intended to be used for the reception of pregnant women or of women immediately after childbirth;

“medical clinic” means any premises used or intended to be used by a medical practitioner, a dentist or any other person —

(a)	for the diagnosis or treatment of persons suffering from, or believed to be suffering from, any disease, injury or disability of mind or body; or
(b)	for curing or alleviating any abnormal condition of the human body by the application of any apparatus, equipment, instrument or device requiring the use of electricity, heat or light,

but does not include any such premises —

(i)	which are maintained by the Government or the National University of Singapore; or
(ii)	which form part of the premises of a licensed private hospital;

“medical practitioner” means a person who is duly registered under the Medical Registration Act (Cap. 174);

“nursing home” means any premises other than a maternity home used or intended to be used for the reception of, and the provision of nursing for, persons suffering or convalescing from any sickness, injury or infirmity;

“private hospital” means any premises (other than a Government hospital or a hospital maintained by the National University of Singapore) used or intended to be used for the reception, lodging and treatment and care of persons who require medical treatment or suffer from any disease, and includes a maternity home and a nursing home.

[19/99]

Administration of Act and appointment of officers, etc.

3.—(1) The Director shall, subject to the general or special directions of the Minister, be responsible for the administration of this Act.

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(2) The Director may, in writing, appoint any public officer to perform all duties imposed and exercise all powers conferred on the Director by this Act or any regulations made thereunder, subject to such conditions and limitations as the Director may specify.

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(3) The Director may, in writing, authorise any other person to assist in the administration of this Act.

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(4) The Director and every authorised officer shall be deemed to be public servants within the meaning of the Penal Code (Cap. 224).

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(5) The Minister may establish one or more advisory committees consisting of such persons as he may appoint for the purpose of advising on such matters arising out of the administration of this Act as are referred to them by the Minister or the Director.

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Buying and selling of human blood

4.—(1) No person shall —

(a)	buy or offer to buy; or
(b)	sell, or offer to sell,

human blood or the right to take blood from the body of another person.

(2) Any person who contravenes subsection (1) shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $20,000 or to imprisonment for a term not exceeding 2 years or to both.

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Licences for private hospitals, medical clinics, clinical laboratories and healthcare establishments

5.—(1) No premises shall be used as a private hospital, medical clinic, clinical laboratory or healthcare establishment except under the authority and in accordance with the terms and conditions of a licence issued by the Director.

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(2) If a private hospital, medical clinic, clinical laboratory or healthcare establishment is not licensed or is used otherwise than in accordance with the terms and conditions of its licence, every person having the management or control thereof shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $20,000 or to imprisonment for a term not exceeding 2 years or to both.

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(3) The Director may order the person having the management or control of any unlicensed private hospital, medical clinic, clinical laboratory or healthcare establishment to close that private hospital, medical clinic, clinical laboratory or healthcare establishment either forthwith or within such time as the Director may specify.

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(4) If the person to whom an order is given under subsection (3) fails to comply with the order —

(a)	he shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $10,000 or to imprisonment for a term not exceeding 12 months or to both and, in the case of a continuing offence, to a further fine not exceeding $1,000 for every day or part thereof during which the offence continues after conviction; and
(b)	the Director may take such measures as he thinks necessary to secure the closure of the unlicensed private hospital, medical clinic, clinical laboratory or healthcare establishment. [4 [19/99]

Application for issue and renewal of licences

6.—(1) An application for a licence shall be made to the Director in the prescribed form and shall be accompanied by —

(a)	the prescribed fee;
(b)	such particulars, information and documents as may be specified by the Director; and
(c)	if required by the Director, a statutory declaration by the applicant verifying any information contained in or relating to the application. [19/99]

(2) On receipt of an application under subsection (1), the Director may —

(a)	issue the licence applied for subject to such terms and conditions as he thinks fit to impose; or
(b)	refuse to issue the licence applied for. [19/99]

(3) In determining whether to issue or refuse to issue a licence, the Director shall have regard to —

(a)	the character and fitness of the applicant to be issued with a licence or, where the applicant is a body corporate, the character and fitness of the members of the board of directors or committee or board of trustees or other governing body of the body corporate;
(b)	the ability of the applicant to operate and maintain a private hospital, medical clinic, clinical laboratory or healthcare establishment, as the case may be, in accordance with the prescribed standards;
(c)	the suitability of the premises (including the facilities and equipment therein) to be licensed for use as a private hospital, medical clinic, clinical laboratory or healthcare establishment, as the case may be; and
(d)	the adequacy of the nursing and other staff that is to be employed at the premises to be licensed. [19/99]

(4) For the purpose of subsection (3), the Director, before issuing the licence applied for, may —

(a)

inspect the premises to be licensed, or cause such premises to be inspected by an authorised officer; and

(b)

require the applicant at his own expense —

(i)	to make such alteration or improvement to the premises to be licensed; or
(ii)	to provide, fix or install such facilities and equipment therein,

as the Director may specify.

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(5) The Director may, at any time, vary or revoke any of the existing terms or conditions imposed under subsection (2)(a) or impose new terms and conditions.

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(6) Every licence issued under this section —

(a)	shall be in such form as the Director may determine;
(b)	shall be valid for the period stated therein unless it is sooner revoked under section 9; and
(c)	may be renewed upon its expiry. [19/99]

(7) Subsections (1) to (6) shall apply, with the necessary modifications, to an application for the renewal of a licence.

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Kinds of licensed private hospitals

7.—(1) Every licensed private hospital shall, according to the tenor of the licence issued in respect thereof, be of one of the following kinds:

(a)	a maternity hospital;
(b)	a medical hospital;
(c)	a surgical hospital;
(d)	a psychiatric hospital;
(e)	a convalescent hospital;
(f)	a children’s hospital;
(g)	a hospital licensed for any 2 or more of the abovementioned purposes; or
(h)	such other kind of hospital as the Minister may, by notification in the Gazette, specify.

(2) Every licence to use any premises as a private hospital shall specify the kind of private hospital for which it is issued, and the purposes for which the licensed private hospital may be maintained.

(3) A licensed private hospital shall not be used for any purpose other than the purposes in respect of which the licence is issued, and purposes reasonably incidental thereto.

(4) If a licensed private hospital is used in any manner contrary to subsection (3), the licensee and the person or body responsible for the management thereof shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $20,000 or to imprisonment for a term not exceeding 2 years or to both.

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(5) The Director may, on an application in writing by a licensee of a private hospital, vary the terms or conditions of the licence, by endorsement thereon or otherwise in writing, by altering, in such manner as he thinks fit, the kind of private hospital for which the licence is in force, or the purpose or purposes for which the licensed private hospital may be maintained.

8. The Director shall cause to be kept and maintained a register of all licensed private hospitals, medical clinics, clinical laboratories and healthcare establishments.

[19/99]

Suspension and revocation of licences

9.—(1) The Director may suspend or revoke a licence if —

(a)

the issue of the licence has been obtained by fraud or misrepresentation;

(b)

the person to whom the licence has been issued is contravening or has contravened or failed to comply with —

(i)	any of the provisions of this Act or any regulations made thereunder;
(ii)	any term or condition of his licence; or
(iii)	any direction given to him by the Director or an authorised officer under this Act or any regulations made thereunder;

(c)

he is no longer satisfied as to any of the matters specified in section 6(3);

(d)

the private hospital, medical clinic, clinical laboratory or healthcare establishment in respect of which the licence was issued has ceased to operate as such; or

(e)

it is in the public interest to do so.

[19/99]

(2) Before suspending or revoking the licence under subsection (1), the Director shall —

(a)	give to the holder of the licence notice in writing of his intention to do so; and
(b)	in such notice, call upon the holder of the licence to show cause within such time as may be specified in the notice as to why his licence should not be suspended or revoked. [19/99]

(3) If the holder of the licence —

(a)	fails to show cause within the period of time given to him or such extended period of time as the Director may allow; or
(b)	fails to show sufficient cause,

as to why his licence should not be suspended or revoked, the Director shall give notice in writing to the holder of the licence of the date from which the suspension or revocation of his licence is to take effect.

[19/99]

Appeal

10.—(1) Any person who is aggrieved by —

(a)	the refusal of the Director to issue or renew a licence under section 6; or
(b)	the decision of the Director to suspend or revoke a licence under section 9,

may, within 21 days of the date of receipt of the notice informing him of such refusal, suspension or revocation, as the case may be, appeal in writing to the Minister whose decision shall be final.

[19/99]

(2) Before making a decision under subsection (1), the Minister shall refer the matter to an advisory committee consisting of —

(a)	in the case of an appeal by a medical practitioner relating to his medical clinic, 3 members of the Medical Council established under the Medical Registration Act (Cap. 174) as the Council may designate; and
(b)	in the case of an appeal by a dentist relating to his medical clinic, 3 members of the Dental Council established under the Dentists Act 1999 (Act 24 of 1999) as the Council may designate,

and in making his decision, the Minister shall have regard to any report made to him by the advisory committee.

[19/99]

Quality assurance committees

11.—(1) The licensee of a private hospital or a healthcare establishment shall establish one or more quality assurance committees to —

(a)	monitor and evaluate the quality and appropriateness of the services provided and the practices and procedures carried out at the private hospital or healthcare establishment ;
(b)	identify and resolve problems that may have arisen in connection with any service provided or any practice or procedure carried out at the private hospital or healthcare establishment ;
(c)	make recommendations to improve the quality of the services provided and the practices and procedures carried out at the private hospital or healthcare establishment ; and
(d)	monitor the implementation of the recommendations made under paragraph (c). [19/99]

(2) The licensee of a private hospital or a healthcare establishment shall report to the Director the activities, findings and recommendations of each quality assurance committee of the private hospital or healthcare establishment as and when required by the Director.

[19/99]

(3) A person who is or was a member of a quality assurance committee is neither competent nor compellable —

(a)	to produce before any court, tribunal, board or person any document in his possession or under his control that was created by, at the request of or solely for the purpose of the quality assurance committee; or
(b)	to disclose to any court, tribunal, board or person any information that has come to his knowledge as a member of the quality assurance committee. [19/99]

(4) Subsection (3) shall not apply to a requirement made by any court, tribunal, board or person for the production of any document or the disclosure of any information in proceedings in respect of any act or omission by a quality assurance committee or by a person as a member of a quality assurance committee, unless the Director directs otherwise.

[19/99]

(5) A finding or recommendation by a quality assurance committee as to the need for changes or improvements in relation to any service provided or any practice or procedure carried out at a private hospital or a healthcare establishment is not admissible in any proceedings as evidence that the service, practice or procedure is or was inappropriate or inadequate.

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(6) Anything done by a quality assurance committee, a member of a quality assurance committee or any person acting under the direction of a quality assurance committee in good faith for the purposes of the exercise of the quality assurance committee’s functions, does not subject such a member or person personally to any action, liability, claim or demand.

[19/99]

(7) Without limiting subsection (6), a member of a quality assurance committee has qualified privilege in proceedings for defamation in respect of —

(a)	any statement made orally or in writing in the exercise of the functions of a member; or
(b)	the contents of any report or other information published by the quality assurance committee. [10 [19/99]

Powers of entry, inspection, search, seizure, etc.

12.—(1) The Director or an authorised officer may, at any time and without warrant, enter, inspect and search any premises which is being used, or which he has reasonable cause to believe is being used, as a private hospital, medical clinic, clinical laboratory or healthcare establishment in order to —

(a)	investigate whether this Act or any regulations made thereunder has been or is being contravened; or
(b)	assess the quality and appropriateness of the facilities and services provided and the practices and procedures being carried out at the private hospital, medical clinic, clinical laboratory or healthcare establishment. [19/99]

(2) For the purposes of subsection (1), the Director or authorised officer may —

(a)	inspect any apparatus, appliance, equipment or instrument used or found in the private hospital, medical clinic, clinical laboratory or healthcare establishment;
(b)	inspect, test, examine, take, remove and detain samples of blood, blood products, human tissue or fluid or any product of the human body, dialysate, chemicals, pharmaceuticals or any other substance found in the private hospital, medical clinic, clinical laboratory or healthcare establishment;
(c)	inspect, test, examine, take and remove all containers, articles and other things that the Director or authorised officer reasonably believes to contain or to have contained blood, blood products, human tissue or fluid or any product of the human body, dialysate, chemicals, pharmaceuticals or any other substance;
(d)	inspect any test or procedure performed or carried out at the private hospital, medical clinic, clinical laboratory or healthcare establishment in order to ensure compliance with the provisions of this Act and any regulations made thereunder;
(e)	inspect and make copies of and take extracts from, or require the licensee or person having the management or control of the private hospital, medical clinic, clinical laboratory or healthcare establishment to provide copies of or extracts from, any book, document, record or electronic material relating to the affairs of the private hospital, medical clinic, clinical laboratory or healthcare establishment or the facilities or services provided or the practices or procedures being carried out thereat;
(f)	inspect and make copies of and take extracts from, or require the licensee or person having the management or control of the private hospital, medical clinic, clinical laboratory or healthcare establishment to provide copies of or extracts from, the medical record of any person who has been or who is being treated or examined at the private hospital, medical clinic, clinical laboratory or healthcare establishment, notwithstanding that the prior consent of such person has not been obtained; and
(g)	seize and remove from the private hospital, medical clinic, clinical laboratory or healthcare establishment any book, record, document, apparatus, equipment, instrument, material, article, sample, blood, blood product, human tissue or fluid or any product of the human body, dialysate, chemical, pharmaceutical or other substance which the Director or authorised officer reasonably believes to be the subject-matter of, or to be connected with the commission of, an offence under this Act or any regulations made thereunder. [19/99]

(3) The Director in order to —

(a)	ascertain whether the provisions of this Act or any regulations made thereunder are being complied with; or
(b)	assess the quality and appropriateness of the facilities and services provided and the practices and procedures being carried out at the private hospital, medical clinic, clinical laboratory or healthcare establishment,

may, at any time, require the licensee or person having the management or control of a private hospital, medical clinic, clinical laboratory or healthcare establishment to furnish such information as the Director may require relating to —

(i)	the persons employed thereat;
(ii)	any apparatus, appliance, equipment or instrument used or any practice or procedure being carried out at the private hospital, medical clinic, clinical laboratory or healthcare establishment; or
(iii)	the condition, treatment or diagnosis of any person who has been or who is being treated or examined at the private hospital, medical clinic, clinical laboratory or healthcare establishment, notwithstanding that the prior consent of such person has not been obtained. [19/99]

(4) Any licensee or person having the management or control of the private hospital, medical clinic, clinical laboratory or healthcare establishment who —

(a)	refuses or fails, without reasonable excuse, to furnish any information to the Director in contravention of subsection (3); or
(b)	gives any false or misleading information,

shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $10,000.

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Confidentiality of information

13.—(1) Except in the case of a prosecution for an offence under this Act or any regulations made thereunder, the Director and an authorised officer shall not be compellable in any proceedings to give evidence in respect of, or to produce any document containing, any information which has been obtained from any private hospital, medical clinic, clinical laboratory or healthcare establishment in the course of carrying out any investigation or performing any duty or function under this Act.

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(2) The Director and an authorised officer shall not disclose any information which is contained in the medical record, or which relates to the condition, treatment or diagnosis, of any person, as may have come to his knowledge in the course of carrying out any investigation or performing any duty or function under this Act unless the disclosure is made —

(a)

under or for the purpose of administering and enforcing —

(i)	this Act;
(ii)	the Infectious Diseases Act (Cap. 137); or
(iii)	the Termination of Pregnancy Act (Cap. 324);

(b)

for the purpose of any disciplinary proceedings under the Dentists Act 1999 (Act 24 of 1999) or the Medical Registration Act (Cap. 174); or

(c)

for any other purpose with the consent of the person to whom the information relates or the representative of such person.

[19/99]

(3) For the purposes of subsection (2)(c), “representative” —

(a)	in relation to a deceased person, means his executor, administrator or next-of-kin;
(b)	in relation to an infant, means one of his parents or his guardian; and
(c)	in relation to a mentally disordered person, means the committee of the estate of that person appointed under the Mental Disorders and Treatment Act (Cap. 178). [12 [19/99]

Directions as to apparatus, appliance, equipment, etc.

14.—(1) Where, in the opinion of the Director or an authorised officer, the use of any apparatus, appliance, equipment or instrument or the carrying out of any practice or procedure in a private hospital, medical clinic, clinical laboratory or healthcare establishment —

(a)	is dangerous or detrimental to any person therein; or
(b)	is otherwise unsuitable for the purpose for which it is used or carried out,

the Director or authorised officer may, by notice, direct the licensee or person having the management or control of the private hospital, medical clinic, clinical laboratory or healthcare establishment to stop using such apparatus, appliance, equipment or instrument or to stop carrying out such practice or procedure.

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(2) The Director or an authorised officer may, by notice, direct the licensee or person having the management or control of a private hospital, medical clinic, clinical laboratory or healthcare establishment to install or replace such apparatus, appliance, equipment or instrument therein, as may be specified in the notice.

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(3) Any licensee or person who fails to comply with any direction given to him under subsection (1) or (2) shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $10,000 or to imprisonment for a term not exceeding 12 months or to both and, in the case of a continuing offence, to a further fine not exceeding $1,000 for every day or part thereof during which the offence continues after conviction.

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[19/99]

Offences by bodies corporate

15. Where an offence under this Act committed by a body corporate is proved to have been committed with the consent or connivance of, or to be attributable to any neglect on the part of, any director, manager, secretary or other similar officer of the body corporate, or any person who purported to act in any such capacity, he as well as the body corporate shall be guilty of that offence and shall be liable to be proceeded against and punished accordingly.

Restriction on disclosure of information

16. If any person discloses to any other person any information obtained by or given to him in pursuance of this Act he shall, unless the disclosure was made in the performance of his duty, be guilty of an offence and shall be liable on conviction to a fine not exceeding $5,000.

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Obstructing Director or authorised officers in execution of their duties

17. Any person who obstructs, hinders or impedes the Director or any authorised officer in the performance or execution of his duty or anything which he is authorised, empowered or required to do under this Act or any regulations made thereunder shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $5,000 or to imprisonment for a term not exceeding 12 months or to both.

[16A

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Protection from liability

18. No suit or other legal proceedings shall lie against the Director, any authorised officer or any member of an advisory committee established under section 3(5), for anything which is done in good faith in the execution or purported execution of this Act or any regulations made thereunder.

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Jurisdiction of Courts

19. Notwithstanding anything to the contrary contained in the Criminal Procedure Code (Cap. 68), a District Court or a Magistrate’s Court shall have jurisdiction to try any offence under this Act or any regulations made thereunder and to impose the full penalty or punishment in respect of any such offence.

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Composition of offences

20.—(1) The Director may, in his discretion, compound any offence under this Act or any regulations made thereunder which is prescribed as a compoundable offence by collecting from a person reasonably suspected of having committed the offence a sum of money not exceeding $2,000.

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(2) On payment of such sum of money, no further proceedings shall be taken against such person in respect of the offence.

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Exemption

21.—(1) The Minister may, subject to such terms or conditions as he may impose, exempt any private hospital, medical clinic, clinical laboratory or healthcare establishment from all or any of the provisions of this Act or any regulations made thereunder.

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(2) An exemption granted under this section may be revoked at any time.

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Regulations

22.—(1) The Minister may make regulations for any purpose for which regulations are required to be made under this Act and generally for carrying out the purposes and provisions of this Act.

(2) Without prejudice to the generality of subsection (1), the Minister may make regulations for or with respect to all or any of the following matters:

(a)	the forms, fees and registers for the purposes of this Act;
(b)	the records of patients treated in a private hospital or a medical clinic, or persons for whom the facilities of a clinical laboratory or healthcare establishment are provided;
(c)	the records of the staff of a private hospital, medical clinic, clinical laboratory or healthcare establishment;
(d)	the requirements as to the number and qualifications of nursing and other staff in a private hospital, medical clinic, clinical laboratory and healthcare establishment;
(e)	the apparatus, appliances, equipment and instruments to be provided and maintained in a private hospital, medical clinic, clinical laboratory and healthcare establishment;
(f)	the ambulances to be provided and maintained by a private hospital;
(g)	the minimum standards of accommodation, sanitation, and other amenities in a private hospital, medical clinic or healthcare establishment;
(h)	the cleanliness and hygiene in a private hospital, medical clinic, clinical laboratory and healthcare establishment;
(i)	the safety and welfare of patients in a private hospital or medical clinic or persons for whom the facilities of a clinical laboratory or healthcare establishment are provided;
(j)	the management, control, superintendence and care of a private hospital, medical clinic, clinical laboratory and healthcare establishment;
(k)	the composition, procedures, duties and responsibilities of quality assurance committees of private hospitals and healthcare establishments. [17 [19/99]

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