Safety First: 5 Compassionate Fire Norms Ease Burden on Small Hospitals

In a move aimed at balancing patient safety with operational feasibility, the Karnataka government has prescribed proportionate fire safety measures for hospitals that fall below the high-rise category. The decision is expected to bring relief to hundreds of small and medium healthcare facilities across the State that had been grappling with uniform fire safety norms originally designed for large, multi-storey hospitals. Officials said the revised approach was based on risk assessment, building height, and patient capacity, rather than a one-size-fits-all framework.

Clear Categorisation Brings Clarity

One of the key outcomes of the revised framework is clearer categorisation of hospitals based on height and risk profile. Officials said ambiguity over whether certain buildings qualified as high-rise structures had earlier led to confusion and inconsistent enforcement. With defined thresholds and proportionate requirements, hospital administrators now have greater clarity on compliance expectations. This clarity is expected to reduce discretionary interpretation during inspections and create a more uniform enforcement mechanism across districts, benefiting both regulators and healthcare providers.

Emphasis on Staff Preparedness

The new norms place strong emphasis on human preparedness rather than only infrastructure. Authorities have highlighted that trained staff can significantly reduce casualties during emergencies. Hospitals will now be encouraged to conduct regular mock drills, assign fire safety wardens, and ensure that nurses and support staff are familiar with evacuation protocols. Officials said even smaller hospitals must prioritise staff awareness, as quick and coordinated responses are often more effective than sophisticated equipment that may not be used correctly during panic situations.

Support for Older Buildings

Many hospitals operating in older buildings had expressed concern over structural limitations that made compliance difficult under previous norms. The revised measures acknowledge these constraints by allowing alternative safety arrangements where structural modifications are not feasible. Fire department officials said this approach ensures that safety objectives are met without forcing closures of long-standing facilities. This is particularly relevant in dense urban localities, where space constraints and heritage structures limit extensive retrofitting options.

Fire Department’s Advisory Role

The Karnataka Fire and Emergency Services Department is expected to play a more advisory role under the new system. Instead of focusing solely on issuing notices, officers will guide hospitals on cost-effective and practical safety solutions. Officials said inspections will include suggestions for improvement and phased compliance plans. This shift is aimed at building cooperation rather than confrontation between hospitals and regulators, thereby improving overall safety standards through collaboration.

Financial Relief for Small Facilities

Hospital associations have noted that proportionate norms will reduce financial strain on small facilities. Installing high-end fire safety systems often involved heavy capital expenditure that smaller hospitals could not afford. With scaled requirements, resources can be directed towards essential patient care while maintaining baseline safety. Experts believe this financial relief could prevent closures of small nursing homes, especially in tier-two and tier-three towns where healthcare options are already limited.

Monitoring and Accountability

Despite the relaxation in certain areas, the government has made it clear that accountability will not be compromised. Hospitals failing to meet even the revised norms may face action, including penalties or suspension of licences. Officials stressed that proportionate does not mean optional. Regular audits and follow-up inspections will continue to ensure compliance. This balanced approach aims to maintain discipline while avoiding excessive regulatory pressure that could hamper healthcare delivery.

Potential Model for Other Sectors

Policy analysts suggest that Karnataka’s risk-based approach to hospital fire safety could influence regulation in other sectors such as schools, hostels, and small commercial establishments. By aligning safety requirements with actual risk, authorities can improve compliance and effectiveness. If successful, the model may encourage a broader shift in regulatory thinking, where safety enforcement is both practical and people-centric, without compromising on core protection standards.

According to the new guidelines, hospitals that do not qualify as high-rise structures will now be required to comply with fire safety measures proportionate to their scale and risk profile. The government has clarified that while patient safety remains non-negotiable, regulatory requirements must also be practical and implementable, particularly for neighbourhood hospitals, clinics, and nursing homes that play a critical role in primary and secondary healthcare delivery.

Shift From Uniform to Risk-Based Norms

Until now, many smaller hospitals were expected to comply with stringent fire safety regulations similar to those imposed on large corporate hospitals and high-rise medical complexes. Hospital associations had repeatedly flagged this as impractical, arguing that older buildings and small facilities lacked the structural capacity to install advanced fire-fighting systems mandated under earlier norms.

The revised guidelines mark a shift towards a risk-based regulatory model. Officials said parameters such as building height, number of floors, bed strength, type of medical services offered, and patient mobility have been factored in while prescribing safety measures. Hospitals below the high-rise category will still be required to maintain essential fire safety infrastructure, but without being burdened by requirements disproportionate to their size.

Relief for Small and Medium Hospitals

Healthcare providers have welcomed the move, saying it would reduce compliance stress without compromising safety. Many small hospitals had faced notices and penalties in recent years for failing to meet norms they said were financially and structurally unviable. With the revised measures, hospital managements are hopeful of achieving compliance through affordable upgrades and better internal preparedness.

Doctors and hospital owners noted that smaller facilities often cater to low-income populations and operate on thin margins. “Excessive regulatory pressure can force small hospitals to shut down or reduce services. Proportionate norms help ensure safety while keeping healthcare accessible,” said a senior hospital administrator. The new framework is expected to particularly benefit clinics and nursing homes in older urban areas and semi-urban towns.

What the New Measures Include

Under the updated guidelines, hospitals below the high-rise category will be required to install basic fire detection and alarm systems, maintain clear evacuation routes, and ensure availability of portable fire extinguishers. Staff training and periodic fire drills have been emphasised as critical components of preparedness. However, requirements such as large-scale sprinkler systems or complex smoke management infrastructure will be mandated only where risk assessment justifies them.

Officials said that special attention has been given to facilities with immobile patients, such as maternity hospitals and centres offering post-operative care. Even among smaller hospitals, additional safeguards may be prescribed depending on the nature of services provided. The government has stressed that relaxation does not mean dilution of safety, but rationalisation based on actual risk.

Learning From Past Incidents

The policy shift comes against the backdrop of several fire-related incidents in hospitals across the country, which exposed gaps in preparedness and enforcement. In Karnataka too, fire safety lapses in healthcare facilities have periodically triggered public concern and administrative action. The government said lessons from such incidents had informed the new approach, highlighting the need for realistic yet effective safety frameworks.

Officials pointed out that non-compliance often stemmed from confusion, lack of clarity, and impractical norms rather than deliberate negligence. By clearly defining obligations for different categories of hospitals, the government aims to improve compliance and reduce fire-related risks through achievable standards.

Coordination Between Departments

The revised norms are the result of consultations between the Health Department, Fire and Emergency Services, urban development authorities, and hospital associations. Officials said inter-departmental coordination was crucial to ensure that safety regulations aligned with building by-laws and healthcare licensing requirements.

Fire department officials will continue to conduct inspections, but with a renewed focus on guidance and corrective measures rather than punitive action alone. “Our goal is prevention. If hospitals understand what is expected of them and why, compliance will naturally improve,” a senior official said.

Impact on Licensing and Renewals

The new guidelines are also expected to streamline hospital licensing and renewal processes. Earlier, delays in obtaining fire safety clearances had slowed down licensing, leading to legal disputes and uncertainty for hospital operators. With proportionate norms in place, authorities believe clearances can be processed faster and more transparently.

Health officials said hospitals would be given reasonable timelines to upgrade facilities in line with the revised norms. Awareness programmes and technical guidance are also being planned to help smaller hospitals understand and implement required measures effectively.

Balancing Safety and Access

Public health experts have described the move as a necessary balance between safety and healthcare access. They noted that overly rigid regulations can inadvertently reduce the number of functional healthcare facilities, particularly in underserved areas. At the same time, any dilution of safety standards could have serious consequences.

By adopting a differentiated approach, Karnataka aims to strengthen fire safety culture across healthcare facilities without undermining service delivery. Experts say the success of the policy will depend on consistent enforcement, regular audits, and continuous training of hospital staff.

Way Forward

The government has indicated that the new fire safety framework will be reviewed periodically based on ground-level feedback and emerging risks. As hospital infrastructure evolves and urban landscapes change, officials said regulations must remain dynamic and responsive.

For now, the move is being seen as a pragmatic step that acknowledges the realities faced by smaller hospitals while reaffirming the State’s commitment to patient safety. If implemented effectively, the proportionate fire safety measures could serve as a model for other States grappling with similar regulatory challenges in the healthcare sector.