Whether co-operative housing society can refuse to have nursing home or hospital in the Society on the ground of causing nuisance;  has become debatable and controversial subject of some of the Co-op. housing Societies in Mumbai.
In life everybody during the time of emergency wants Doctor or Hospital nearby when he or member of his family suffer from heart attack or such other sickness but when it comes to allotment of premises to Dispensary, some of the members raise objections on the ground of nuisance and it starts litigation.

  Recently definition of flat is enlarged in new model bye-laws of housing societies. According to the New bye-laws definition of flat means is separate and self contained set of premises used or intend to be used for Dispensary or Consulting Room or Clinic etc.

  One Dr. Sandeep G. Kasbekar was allowed to run nursing home in his residential flat No.2, Charkop Bageshree Co-operative Housing Society Ltd at Kandivli (West), Mumbai that he will be permitted to have clinic and he is required to invest more than Rs.15 lacs for the cost of the flat, Stamp Duty, Registration Charges and for the cost of equipments. New objections were raised by some members, if Dispensary is allowed it will cause nuisance. According to New Bye-Law, definition of flat includes Dispensary by getting permission from appropriate authorities.

  According to Mr. Mahabaleshwar N. Morje, the Secretary of Flat Owners' Association, certain Buildings in Bombay has allowed to run Nursing Home including Avanti Co-op. Housing Society in Dadar where Dr. Nerkar has a Clinic. Dr. Thakkar having hospital at Shilpa Co-operative Housing Society, Prabhadevi, Ashirwad Co-op. Housing Society at Lokhandwala Complex at Andheri and many other Co-op. Housing Societies where Poly Clinic or Hospitals in the Building.

  No doubt, the Doctor is suppose to be like member of family and should take maximum precaution about infection or epidemic. If existing bye-law the Society allows nursing home, then members cannot object nursing home or hospital. However, the existing bye-law do not include Dispensary then the members may object for the Dispensary. If the bye law do not object the society cannot prevent maternity home, nursing home or hospital. (T.N.Karuneshudas Vs Mrs.Sarshamma Somasundaram (1989) CTJ 131)


Important Questions and Answers

Q.10 What precautions are to be taken regarding electric supply to Nursing Home ?
Q.15 What are the parking rules for hospitals and medical institutions under Development Control Rules ?

Q.1 What is the relation between Law and Medicine ? What should be their approach in changing Society ?
Ans.   The Law and Medicine are considered as two important foundations of a welfare society. the law and medicine are considered as instruments of serving humanity and providing solution in the context of increasing complexity of the modern technological age. Both sciences aim at furthering peace, protecting human dignity and harnessing the unlimited human potential. Law and medicine are expected to have common pilgrimage towards the regulation, protection, preservation and care of pervasive welfare of human life. These two sciences must evolve new ideas and ideals to face the problems of 21st century.


Q.2 What is the object of Bombay Nursing Home Registration Act, 1949 ? What is meant by Nursing Home ? Can Nursing Home be started without registration ? What is the penalty for non registration ? What are the penalty for offences if committed ?
Ans.     The object of Bombay Nursing Home Registration Act, 1949 is to make provisions for supervision and inspection of Nursing Home in order to see that Nursing Homes are properly maintained.

  The Nursing Home is defined in clause (4) of Section 2 as it means any premises used or intended to be used for the reception of persons suffering from any sickness, injury or infirmity and the providing of treatment and nursing for them, and includes a maternity home; and the expression "to carry on a nursing home" means to receive persons in a nursing home for any of the aforesaid purposes and to provide treatment or nursing for them. The maternity home defined in clause (3) of Section 2 any premises used or intended to be used, for the reception of pregnant women or of women in or immediately after child birth. The section 3 of the act state that no person shall carry on a nursing home unless he has been duly registered in respect of such nursing home and the registration in respect thereof has not been cancelled under Section 7.

  The local supervising authority may refuse to register the applicant if it is satisfied.

a) that he, or any person employed by him at the nursing home, is not a fit person, whether by reason of age or other wise to carry on or to be employed at a nursing home of such a description as the nursing home named in the application; or
b) that the nursing home is not under the management of a person who is either a qualified medical practitioner or a qualified nurse and who is resident in the home, or that there is not a proper proportion of qualified nurses among the persons having the superintendence of or employed in the nursing of the patient in the home; or
c) that in case of the maternity home it has not got on its staff a qualified midwife; or
d) that for reasons connected with the situation, construction, accommodation, staffing or equipment, the nursing home or any premises used in connection therewith are not fit to be used for a nursing home of such a description as the nursing home mentioned in the application or that the nursing home or premises are used or are to be used or for purposes which are in any way improper or undesirable in the case of such nursing home.
Whoever contravenes any of the provisions of this Act or of any rule shall, if no other penalty is elsewhere provided in this act, or the rules for such contravention or conviction, be punished with fine which may extend to fifty rupees and in the case of a continuing offence to a further fine of fifteen rupees in respect of each day on which the offence continues after such conviction.


Q.3 What are the provisions for constructing the building for Nursing Home or Hospitals under the provisions of Bombay Municipal Corporation Act and Development Control Rules, etc. ?
Ans.     When we refer to the Co-operative Housing Societies it must be noted that the object of the Housing Society is to have the better living and better management within the frame of Co-operative Societies Act and rules thereunder. There is no profit motive in the Management of the Co-operative Housing Society.

   What happens is that the promoter in total disregard to the NOC which be obtained under the Urban Land (Ceiling and Regulation) Act which may be basically for the purpose of residential purpose, changes of the user of the premises without written consent of the purchasers of the flat and/or allow to change the user for the non residential purpose by starting not only the dispensaries, but at times Liquor Bars and Night Clubs for the purpose of making profit.

   The management of the Co-operative Housing Society, therefore required to object the change of user if it was not permitted under the NOC or originally approved plan. However, sometimes there is a tendency of objection for the shops and Surgical Clinic even if they are permitted under the Municipal Corporation Act and Development Control Rules. This practice should be discouraged.


Q.4 What precautions should be taken at the time of purchase of premises for Nursing Home or Surgical Clinic etc., and What kind of documents should be entered into and with what provisions ?
Ans.     Before purchasing the premises it should be seen 
(a) Whether the bulding that is going to be constructed is a commercial complex or a residential complex 
(b) If it is a Commercial Complex, whether it permits Surgical Clinics, 
(c) He must see that the Hospitals, Surgical Clinic should not be above the ground floor or 1st floor of the building 
(d) He must also see that the builder or promoter has submitted the plan to the Municipal Corporation, which specifically refers to the hospital or Surgical Clinic. 
(e) And that the bye-law of the Society do not prohibit the same.
Q.5 What problems are faced by the Doctor when they start Dispensary or Nursing Home in the Co-operative Housing Society ? What measures should be taken to avoid such harassment ?
Ans.     The promoter is bound to annex a copy of the plan along with the agreement. The promoter is also bound to give the specification of the building built or to be built on the land. Such a plan and specification should have been approved by the local authority. The promoter cannot make any alteration in the structure described in the plan in respect of the flat without the consent of the purchaser of the flat. Such act will be contrary to the provisions of Local Authority's Act. Such act would also be liable for punishment as per provisions of section 13 of the Maharashtra Ownership Flats Act.


Q.6 What are the nature of problems faced by the Doctors in the different types of premises ?
Ans.    The problems can be divided into four categories, viz. 
(a) starting of surgical clinics in residential premises under the private landlords; 
(b) Surgical Clinics in the commercial premises 
(c) surgical clinics in the proposed co-operative societies before registration and 
(d) Surgical clinics in the Societies Registered under the Co-operative Societies Act.

   While referring to the first category in respect of the premises owned by private landlords the question would arise whether the premises were let out for the purpose of surgical clinics or for the residential purposes. The question of breach of tenancy would arise only if the tenant has changed the user of the premises without the consent of the landlord. While referring to the second category of the premises in commercial complex, the question of raising any objection by the adjoining owners of the premises on the ground of insanitation and nuisance etc. does not arise because all are commercial premises. There are no residential premises. In case of 3rd  category where the premises were given for surgical clinics by the promoter or builder before formation of the society, it will depend upon the agreement entered into between the promoter/builder and the purchasers of the flat subject to the provisions of Maharashtra Ownership Flat Act, Maharashtra Co-operative Societies Act, Bombay Municipal Corporation Act and Development Control Rules. In the 4th category of the Surgical clinics in a Society which is duly registered, the purchaser of the flat who has subsequently become the member of the society is bound by the provisions of the Co-operative Societies Act and the rules thereunder and by the bye-laws of the Society.


Q.7 What are the Rules for Water Supply to the Nursing Homes ?
Ans.     The water is considered as the essential supply under the provisions of Bombay Rent Act, and also under the Maharashtra Ownership Flat Act. It is well-known that these supplies cannot be withheld or cut off without any reasonable cause. However, when the supply to be made the hospital or Medical Centres since they need more water and therefore it is expected that should have a separate water connection so that regular common supply is not excessively used by them.


Q.8 What is the exact application of Minimum Wages Act for the Nursing Homes ?
Ans.     The concept of minimum wages has undergone a progressive change from time to time. It is no longer based on subsistence theory on the basis of cost of commodities, necessary for food and cloth to a worker and his family. Minimum wage now includes not only the bare physical necessities but of comforts otherwise known as conventional necessities. The minimum wage must therefore, provide not merely of bare subsistence of life but also for preservation of deficiencies of workers. For this purpose the minimum wage must also provide for some measures of education, medical requirement and amenities. While referring to some of the judgements of Supreme Court it has been held that minimum wages must be paid irrespective of the extent of profit, financial conditions or the availability of workmen at the lower wage. (AIR 1967 SC 1175)


Q.9 What are the provisions regarding the minimum wages in respect of employment in the dispensary in Greater Bombay ?
Ans.     Under Minimum Wages Act, 1948, several notifications are issued from time to time referring to the classes of employees and basic rate of minimum wages per month, and special allowance at the rate to be adjusted in such intervals. To consider this committee was appointed by Government of Maharashtra. After considering the advice of the said committee wages were fixed with effect from the 15th January 1977

   The wages which are to be paid to the employees in case of dispensary in Greater Bombay

i) Qualified Compounder    Rs.325/-             Non qualifed Compounder    Rs.250/-
ii) Qualifed Nurses     Rs.300/- to 375/-          Non Qualified Nurses            Rs.270/-
iii) Dresser                        Rs.240/-
iv) Clerk                            Rs.250/-
v) Telephone Operator     Rs.270/-
vi) Motor Driver                Rs.325/-
   There is a separate notification, which refers to the minimum wages paid for employment in hospitals in Greater Bombay.

   This is divided broadly into category of unskilled staff - (Sweepers, watchmen, peons wardboys, cook-mates, laundry boys, servants, barbers, etc.) normally who are paid about basic salary of Rs.120/- + D.A Second category of nursing staff who is provided with rent free quarter and without quarter were approximately paid between 155 to 205. Then supervisory staff, which consists of Matrons, sister, tutors, sisters etc. were broadly between 225 to 455 and others. The wages payable in Greater Bombay and other cities in Maharashtra including Pune are different. There are separate schedules for Pune Division.


Q.10 What precautions are to be taken regarding electric supply to Nursing Home ?
Ans.     It must be noted that electric supply is treated as essential supply. No landlord or even the Managing Committee of the Housing Society can cut off or withhold the electricity supply without any reasonable cause. While referring to the electric supply be the electric company they are expected to give the reasonable notice when the repairs are going on. Not only that, since the doctors are concerned with some critical operations concerning life of a person in cities like Bombay, it is now suggested that the hospitals should have their own Electric Generator or common Generators. Some of the Private Hospitals like Jaslok Hospital, Dr.Hingorani Hospital etc. can also have the benefit of this scheme. It is suggested that electric charges for the Nursing Home should be at the rate of commercial rate but on economic rate.


Q.11 What is the amendment in respect of nursing home/ hospital / sanatorium in Bombay Rent Act? Whether it continues in New Act?
Ans.     This clause was inserted by Maharashtra Act 31 of 1979 in the Act of 1947 and was intended to affect persons who were given any accommodation for rendering or carrying on medical or praramedical services or activities in or near a nursing home, hospital or a sanatorium.  The object was to exclude such persons from claiming protection as protected licensees and not vacating the accommodation given to them for the aforesaid purposes. As the same definition of "licensee" is copied in this Act, this clause has also continued to remain in the definition.

   The expression "any accommodation" is of wise amplitude. Such accommodation may or may not, be exclusive. It may consist of a room, a cabin, quarters, bungalow or even a shed. It may be  accommodation for which a fee or charge or compensation is charged. A free or gratis accommodation is obviously excluded by the first part of the definition of a licensee.


Q.12 What are the problems faced by the Nursing Home ?
Ans.     The owners of the Nursing Homes face various problems 
(a) Acquiring premises for nursing home; 
(b) Getting necessary latest equipments and machineries; 
(c) Getting necessary registration for Dispensary or hospital; 
(d) Getting necessary skilled and unskilled staff; 
(e)Getting necessary water supply, electric supply and other amenities; 
(f) labour problems
   In the city of Bombay the Doctors are required to make huge investments which may be not less than 25 to 30 lakhs in posh localities and not less than 10 to 15 lakhs in the middle-class localities. Even after securing the premises, the doctors are required to face further problems. At present the doctors are facing problems from some of the hospitals and nursing homes as mentioned below.

   Some of the doctors are facing problems of Occupation Certificates through the buildings are already occupied and the hospitals or Nursing Homes are started. Some of the Hospitals are facing problems of withholding of water supply or cutting of electric supply. Some of the doctors are facing the problems on account of payment of wages. While  referring to the first problem of not getting the Occupation or Completion Certificate and objections to start Polyclinic the suits and counter suits are filed by the doctors and purchasers of flats in respect of the Ashirwad Nursing Home in Lokhandwala Complex. The suits and counter suits are also filed in proposed society. According to the Doctor though the promoter/builder has entered into an agreement representing to the doctor that it is a commercial complex, now Occupation certificate is withheld without reasonable cause.

   The disputes are going on in many other buildings where dispensaries, hospitals or surgical clinics are started. The some of the clinics in the multi storeyed buildings are suitable at following places;

(1) Dr.Bhatia's Clinic, Sion 
(2) Dr.Gondhalekar's Children Hospital, Sion. 
(3) Dr.Katdare's Pathology and Infertility Clinic, Sion. 
(4) Dr. Geeta Bhatia's Malbar Hill Clinic, Malabar Hill
(5) Dr.Parulekar's Surgical & Maternity Hospital, Worli Naka. 
(6) Dr.Kranti Heart Clinic, Worli Naka. 
(7) Dr.S.S.Thakur's Hospital, Shivaji Park, 
(8) Dr. Mathure's Surgical Clinic, Matunga, 
(9) Dr.Shah's Gynaecological Hospital, Matunga 
(10) Dr.Pendse's Children Hospital, Dadar. 
(11) Ashirwad Nursing Home, Lokhandwala Complex, 
(12) Nerkar Nursing Home, Dadar 
(13) Dr.Gupta's Hospital, Malad, 
(14) Jogeshwari Hospital, Jogeshwari.
Q.13  What should be new approach to avoid disputes in future ?
Ans.     The methods of Science and Technology are changed. On the basis of which precautions are taken to prevent insanitation and unhygienic conditions. In fact it is said that in a building like New Empire Building in Manhattan New York, all kinds of amenities and facilities are available which include the restaurants, cinemas but also hospitals and surgical clinics. At present unfortunately several disputes are going in respect of polyclinic or nursing homes in Greater Bombay. The medical association therefore should come together and take necessary steps and take delegations to the Chief Minister, Health Minister, Municipal Commissioner and other authorities to make suitable changes, if necessary. The law should be such which would take into account the difficulties of the patient. Then only the law and Medicine would succeed in achieving the object of serving the humanity in the Welfare Society. 


Q.14 Whether the persons having any accommodation in a nursing home, hospital or sanatorium is protected under Maharashtra Rent Control Act, 1999 ?
Ans.    The previous clause applied to the personnel rendering medical and paramedical services or activities. They may be either employees of the licensor or conductors of the licensor's business. This clause applies to patients and inmates admitted as patients. The purpose is different but the object is the same, so that by claiming protection such persons should not disturb or destroy the objective with which such institutions serve the community.


Q.15 What are the parking rules for hospitals and medical institutions under Development Control Rules ?
Ans. One parking space for every 300 sq.m of total floor area, except that it would be one parking space for every 600 sq.m of the total floor area in the case of Government and municipal hospitals and medical institutions. In addition, on parking space for ambulance parking measuring 10 m x 4 m for hospitals or medical institutions with bed strength of 100 or more.


Q.16 What is the aim of Nursing Homes or Hospitals ?
Ans.     The aim of any hospital planning is undoubtedly to offer, the best medicare to the patients and best working conditions for the staff. While planning a hospital one ought to create appropriate spaces and environmental conditions for the treatment of patients, efficient working conditions for the doctors and nurses who treat for the technicians who maintain and operate certain machines and for the staff who handle the various hospital as well as engineering services.


Q.17 What are the standard for Medical Care ?
Ans.     The Indian Standard was adopted by the Indian Standards Institution on 15th March 1984, after the finalized by the functional requirements in buildings sectional Committee has been approved by the Civil Engineering Division Council.

  Construction of a large number of hospitals having different bed strength is being planned in the country both in public as well as in the private sector. These hospitals must provide certain basic needs to the patients as well as create a good working conditions for doctors, nurses and technicians. Optimum utilization of the national resources also demands that these hospitals should be placed and constructed in such a manner that wastage towards space and circulation can be brought down to a minimum but at the same time they function in manner for which it is intended. With this object in view, this standard has been developed to lay down rational norms and requirements for efficient planning and construction of general hospital building in the country.The purpose of this standard is not to offer design solutions for a medical care facility, but to day down optimum requirements for both spatial and environments needs of the various sections of the hospital building.

  The considerations in planning a hospital building should no doubt ensure the design of each section for its individual efficiency. Nevertheless the hospital building as a whole, would function efficiently and economically only if all the sections are coordinated by arranging them in appropriate places based on their functional relationships. This could be achieved by compact and efficient planning, functionally correct and operationally efficient, economical relationship and distribution of various compartments, functionally logical internal detailing of departments to save on time, money and efforts. This standard, it is hoped will be help to architects, engineers and authorities concerned in fulfilling the dual objectives of economy and optimum utilization of space.


    In case, one need further guidance please contact the Secretary, Flat Owners Association, at the address given below:

Gen. Secretary.

© Copyright 2002, The Flat Owner's Association, Mumbai.
Updated on 29th November 2002

23, Hamam Street, 3rd Floor , Above Quality Machine Tools , Fort , Mumbai - 400 023
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