The Indian Medical Association (IMA) has opposed the revised National Medical Commission (NMC) bill which was introduced in the Lok Sabha on July 22, 2019, and claims the proposed bill only favours the rich and promotes quackery.

The IMA has a problem with three major provisions in the existing bill: the 50% capping of fees in private medical colleges, the common exam for both licensing and post-graduation, and ambiguity over the definition of ‘Community Health Providers’.

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Doctors and medical students, who are members of the IMA, protested against the NMC bill by burning copies of the bill outside the All India Institute of Medical Sciences (AIIMS) on July 24. The IMA – a voluntary registered body for doctors in India, has been opposing the bill since 2016.

BOOM contacted Dr. Asokan, secretary general, IMA to understand the reasons for their opposition.

Private medical education: Further out of the reach of the poor?

Currently, there are 506 medical colleges and 68,000 medical seats in India. The division of these into private and government is shown below:

Dr. Asokan said the new clauses could lead to complete deregulation of the private medical sector.

“In the earlier version, the clause mentioned regulating 50% of the fees in the private colleges,” Dr. Asoka told BOOM.

“They have now changed that term to provide guidelines. Providing guidelines means it is not mandatory to follow them. The private colleges are now free to decide their own fees. The government is robbing seats from the middle and lower classes and making them more accessible for the rich”, he added.

The current breakdown of fees at private medical colleges is attached in the figure below.

The fees for the seats allocated through the government process are around 1.5-3 lakh rupees, for management seats are around 15-18 lakh rupees, and for intermediary seats are around 8 lakh rupees.

The new mechanism will skew this proportion in the favour of the rich according to Dr. Asokan. Deregulation might lead to the loss of the existing 50% seats whose fees are fixed.

Community Health Providers: Promoting Quackery?

The definition of the community health providers mentioned in the bill is very ambiguous. Dr. Asokan feels that this could allow pharmacists and other less qualified professionals to prescribe medicines.

“The Bhore Committee in 1946 stated that MBBS is the least qualification necessary for prescribing medicines. Then, we had fewer colleges and medical professionals. After 70 years, why are we trying to overturn it?”, opined Dr. Asokan.

The association feels that the committee has just revamped the AYUSH bridge course without making any significant changes to the clause.

The IMA also fears that this could lead to an increase in quackery- enabling unqualified professionals to practice medicine.

One exam: Cause or cure of problems?

The association has demanded a better explanation on the proposed common entrance exam in the bill, if introduced, will allow students to practice medicine as well as pursue higher medical education.

The association thinks that this one exam cannot be used as a parameter to determine both who will practice medicine and who will pursue a specialisation.

“We believe the current method of having a separate exam is the best way to continue with things,” stated Dr. Asokan.