National Medical Commission Bill 2019: Why doctors are opposing it?

National Medical Commission Bill, 2019 was recently passed in the Rajya Sabha. This bill is under public scrutiny due to its vague and unclear provisions, underrepresentation of the medical community and for not being student-friendly.

What is National Medical Commission Bill, 2019?

  • National Medical Commission bill, 2019 if passed in the parliament, will repeal the existing Indian Medical Council Act, 1956.
  • An earlier version of this bill was introduced in the previous Lok Sabha.
  • This version was sent to the Parliamentary Standing Committee on Health and Family Welfare.
  • However, due to the dissolution of that Lok Sabha, it lapsed.
  • In the current session of the parliament, the revised National Medical Commission Bill, 2019 was reintroduced in the Lok Sabha.
  • After the lower house passed it, it was introduced in the Rajya Sabha with two amendments.
  • Now, this revised bill needs to be passed in the Lok Sabha for it to be implemented.

Why should the Indian Medical Council Act, 1956 needs to be repealed?

  • The Medical Council of India was established in the year 1934 under the Indian Medical Council Act, 1933.
  • Later, the Indian Medical Council Act, 1956 was passed in the parliament to repeal and replace the Indian Medical Council Act, 1933.
  • Under the Indian Medical Council Act, 1956 the MCI has the following functions:
  1. Establishment and maintenance of uniformity in undergraduate medical education.
  2. Accreditation of the medical colleges.
  3. Recognition of medical qualifications granted by University or the UGC in medical institutions in India.
  4. Recognition of foreign medical qualifications in India.
  5. Monitoring Postgraduate medical education in the medical colleges accredited by it.
  6. Registration of the qualified doctors practising in India and maintaining the Indian Medical Register.
  • In short, MCI is a regulatory body in charge of the medical education and practice of India.
  • However, MCI faced widespread criticism on the following:
  1. Corruption
  2. Lacks accountability
  3. Opaque accreditation
  4. Not on par with the time
  • The MCI was accused of accepting bribes from the medical colleges to hasten the accreditation process.
  • This, in turn, compromises the legitimacy of the medical colleges and the quality of medical practices.
  • The Yashpal Committee and the National Knowledge Commission had recommended the separation of the regulation of medical education and medical practice.
  • Also, MCI is solely run by elected doctors. It is essential to include other professionals to ensure that this regulatory body encompasses the wide-ranging concerns of the medical field.

What are the provisions of the bill?

  • National Medical Commission Bill, 2019 seeks to replace MCI with the Nation Medical Commission.
  • As per the bill, the National Medical Commission is in charge at the Central level, while State Medical Councils will be established at the state level.
  • In the previous act, MCI is an autonomous body that has two-third of its members directly elected by the medical fraternity, while National Medical Commission under the new bill will have 25 members who are nominated by the Central government.
  • As per the bill, the functions of the NMC include:
  1. Regulation of the medical institutions and professionals across the country.
  2. Determining the requirements for the health-care related infrastructure and manpower.
  3. NMC must provide a framework to determine the fees for up to 50% of seats in the private medical institutions and deemed universities.
  4. Coordination with the State Medical Councils.
  • This bill establishes four autonomous bodies under the NMC. They are as follows:
  1. Under-Graduate Medical Education Board (UGME): It is in charge of monitoring and setting standards to medical education at the undergraduate level.
  2. Post-Graduate Medical Education Board (PGME): It is in charge of monitoring and setting standards to medical education at the post-graduate level.
  3. Medical Assessment and Rating Board (MARB): It is in charge of inspection of the medical institutions and rating them according to their performance and infrastructure. It also has the power to levy fines on the medical institutions if they are not on par the minimum standards of the UGME and PGME. This autonomous body is also in charge of permitting the establishment of new medical colleges, courses or increasing the number of seats.
  4. The Ethics and Medical Registration Board: This autonomous body is in charge of the regulation and promotion of professional conduct and medical ethics. It also maintains a national register of licensed medical practitioners and register of Community Health Providers (CHPs).
  • Community Health Providers (CHPs): Under this bill, certain mid-level practitioners will be given limited licenses to practice medicine as Community Health Providers. These practitioners will be given licenses only in primary and preventive healthcare. As per the bill, the CHPs will be allowed to prescribe medicines independently only in primary and preventive healthcare. In cases other than primary and preventive healthcare, the CHPs should prescribe medicine only under the supervision of the registered medical practitioners.
  • NEXT: This bill also proposes the National Exit test that is to be conducted for all the candidates completing their course in the medical institutions for obtaining licenses. The NEXT will also be treated as an entrance exam for the PG medical programs and screening test for the foreign students.
  • Uniformity in evaluation: Currently, each medical institution has its own examination pattern and evaluation method. There is no uniformity in the evaluation of medical students. MNC bill seeks to establish a single national curriculum for the final year MBBS. This will provide standardization of the quality of the medical practitioners in India.

What are the advantages of this bill?

  • Medical specialization and skills on par with the demand: The MNC has the potential to access the diseases that are affecting the nation and the skills and specialization available in the country.
  • Uniform medical standard: As the bill prescribes for the NEXT, the admissions and licenses provided are in a standardized manner. This allows uniformity of the medical practices and skills across the country.
  • Grievance Redressal: The State Medical Council will look into any complaints arising within the States related to ethical misconduct or unprofessional medical practices by the medical practitioners. This assures accountability and prevention of negative implications of commercialization of the medical services.
  • Equal opportunity to all in the medical education: MNC’s determination of the fees up to 50% of the seats ensures that the economically weaker section of the society is provided with the opportunity to undertake the medical education.

What are the concerns with regards to the bill?

  • “Community Health Provider” meaning is unclear and vague: This bill allows certain alternate-medical practitioners to prescribe drugs for primary and preventive health care. It is estimated that about 3.5 lakhs non-medical persons or Community Health Providers will be given licenses to practice modern medicine under section 32 of the NMC bill. However, there isn’t any exact definition for the CHPs. This paves the way for poor medical practices in the country. This may lower the quality of health care and endanger the lives of the people.
  • Unfair appointments in NMC: As per the bill, the Chairman of the NMC will be nominated by the government. The other members will be appointed by the committee which will be headed by the Cabinet Secretary. This bill opens the doors for nepotism, bureaucratic interference and other biased practices while appointing the members of the NMC.
  • Increases the burden of fees: While the fees for 50% of the medical seats are under the guidelines of the MNC, the rest are under the management quota. Those under the management quota will be burdened to pay increased fees.

Way Forward

  • The National Medical Commission Bill assures standardization of medical education and practice in India.
  • However, it is essential to rethink the provisions of this bill with consideration to the current demands of those criticizing the bill.
  • This is of the essence because, under the current bill, the demands of the medical community will be under-represented.

Article by: K.G.Karishma

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