By Aman Bagaria
The National Medical Commission Bill, 2017 is an attempt to separate the regulation of both medical education, and practice, in India from a new perspective. For that purpose, it repeals the Indian Medical Council Act, 1956. It also dissolves the Medical Council of India (MCI) that presently handles all matters in relation to medical education and practice.
The first draft of the bill was created by a committee set up under the NITI Aayog and has been introduced in the Lok Sabha during this year’s winter session. The bill, however, has been referred to the Parliamentary Standing Committee after widespread protests were held against its passage. The objections and shortcomings of the bill were summarized in Dr Ravi Wankhedkar’s statement in which it was called anti-poor, anti-people, anti-representative, undemocratic and anti-federal in character.
Changes in the appointment of members of the new committees
One of the major changes the bill seeks to bring about is the complete overhaul of the present system of monitoring medical education and practice. This involves dissolving the central MCI and similar bodies at all State levels and replacing them with a National Medical Commission and such similar state bodies, with a major change in the appointment of its members.
The Central and state governments would have major powers in the appointment of the members of the new bodies. This change is motivated by personal benefits and seems to clearly be a move that would only encourage corruption. Such autonomy is also available when it comes to the removal of such members. This will definitely act as a determinant in the performance of the committees that have been given umbrella powers in dealing with all issues related to medicine. All members of the autonomous bodies formed for administration shall also be appointed by the Central government. It is certainly a retrograde move as a democratic institution has been replaced by a body in which a majority of the members are nominated by the government.
Composition of the Medical Advisory Council
Moreover, the proposed Medical Advisory Council, which is to act as a check on the powers of the Commission and to advise them, is to be presided over by the Chairperson of the Commission itself, with all Commission members being ex-officio members of the Council too. This makes no sense, as instead of creating two bodies to watch and observe each other, an effectively single and potentially corrupt body has been established. The changes as proposed in the bill shall also make all medical professionals answerable to the bureaucracy and non-medical administrators.
Scope for exercise of arbitrary power
The National Medical Commission has also been given excessive powers in relation to other actions, like permitting a medical professional to perform surgery or practice medicine without qualifying the necessary examinations, which is again a potential floodgate for corruption. The Medical Assessment and Rating Board (MARB) may also give permission for educational institutions to increase the number of seats or for the incorporation of such institutions. The MARB is another body in which the Central government exercises significant control and there is a complete absence of impartial medical administrators. The bill also allows for private colleges to decide the fees for sixty percent of their seats. Initially, the number was limited to only fifteen percent. Private colleges may also increase the number of undergraduate and postgraduate seats without approval from the Commission. Both these changes shall certainly cause an increase in the tuition fee that a student has to pay and is hence anti-poor in nature.
Underqualified practitioners entering the fray
The final objection that has been raised against the bill is that it allows for practitioners of Ayurveda, homoeopathy and other alternative medicines to enter the field of modern medicine after completing a bridge course. This might result in under-qualified practitioners offering services to the people that might be substandard in character. Better checks need to be established to ensure that a certain quality of services is available to the common public.
The Parliamentary Committee is set to look into all of these matters and hopefully, proper checks shall be established to ensure that the government does not exercise sweeping control over all matters.
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