AHA Cites Court Order, Reminds Centre That Hospital Administration Requires Specialised Expertise

The Academy of Hospital Administration (AHA), a national professional body representing qualified hospital and healthcare administrators, has urged the Union Health Ministry to introduce a long-pending uniform policy mandating the appointment of trained medical administrators as Medical Superintendents (MS) across Institutes of National Importance (INIs) and government medical colleges.

In this regard, it has reminded the Ministry of the April 2024 court judgment wherein a Delhi High Court order had highlighted the burden placed on clinicians when administrative responsibilities are added to their clinical duties. The court had also stressed the need for trained professionals in hospital management, noting the absence of a structured administrative cadre in many institutions.

Similarly, an order issued by the Union Health Ministry the same year emphasized that hospital administration functions should be handled by designated hospital managers. While the order stops short of detailing specific roles, it reinforces the principle that management of healthcare facilities requires specialized expertise, the Association said in its representation made recently to the Ministry.

The AHA also expressed concern that despite multiple committee recommendations and policy endorsements over the years, most institutions continue to appoint clinicians—often without formal administrative training—to key leadership positions.

This, it argued, undermines the efficiency and quality of hospital management in an increasingly complex healthcare environment.

The Association has urged the Ministry to issue clear directives ensuring that professionals with recognized qualifications such as MD (Hospital Administration), DNB (Hospital Administration), or Master of Hospital Administration (MHA) are appointed as MS at appropriate levels of seniority. Such a move, it says, would bring consistency, professionalism, and domain expertise into hospital governance.

The AHA pointed out that as per the approved staffing pattern for new AIIMS institutions—endorsed during the first Central Institute Body meeting held way back in 2018—the position of MS is intended to be aligned with the Department of Hospital Administration, with the Professor of the department designated for the role.

However, in practice, this provision is not being implemented, said Prof. (Dr.) Hemchandra, President of the Association, in the letter. Instead, the prevailing eligibility criteria—which allow any postgraduate (MD, MS, or MHA) with administrative experience—often lead to the appointment of senior clinicians from other specialties. According to the AHA, this has resulted in a mismatch between the demands of hospital management and the skill sets of those entrusted with these responsibilities.

For large institutions, including those with capacities of nearly 1,000 beds, the sanctioned staffing pattern already includes dedicated faculty positions in hospital administration alongside the post of MS. The Association contends that bypassing this framework weakens institutional capacity for structured and accountable management.

The Association has also raised concerns regarding the appointment of administrators on a deputation basis. It argued that such arrangements often introduce officials unfamiliar with the patient-centric functioning of tertiary care institutions, leading to disruptions in workflow and decision-making.

Citing past experiences, the AHA noted that deputation-based appointments have, in some cases, resulted in delays, communication gaps, and inconsistencies in care delivery. It stressed that continuity and institutional familiarity are critical for effective hospital management.

Beyond leadership appointments, the AHA has proposed measures to strengthen the academic and professional pipeline in hospital administration. It has recommended upgrading existing Deputy Medical Superintendent (DMS) posts into Assistant Professor positions within the Department of Hospital Administration.

At present, DMS roles are largely administrative and do not offer academic progression, making them less attractive to qualified professionals. This has led to persistent vacancies in several institutions. Linking these posts to academic designations, the AHA argued, would improve recruitment and retention while fostering a culture of evidence-based management.

The Association has further called for the sanctioning of additional faculty posts, including Assistant Professors and Senior Residents in hospital administration, in proportion to hospital bed strength. Such a framework, already followed in institutions like AIIMS New Delhi, would ensure adequate manpower for both academic and operational functions.

Amid rising reports of patient-doctor violence in hospital premises across the country, the AHA emphasized that professionally trained hospital administrators bring a distinct set of competencies, including expertise in operations management, quality assurance, patient safety, legal compliance, logistics, and human resource management.