The Government of India recently demolished the Medical Council of India (MCI), the quasi-judicial body, which has been in force since 1939. On 30th December 2017, the Central Government announced a bill, the National Medical Commission (NMC) in place of the Medical Council of India.
The new bill got its approval in the Lok Sabha on July 29, 2019 and 3 days after in the Rajya Sabha on August 1. In Lok Sabha – Minister of Health, Dr Harshavardhan assured the house that NMC will start implementing it in the next nine months period.
The Medical Council of India was well known as one of the recognised institutes of India. Established under the Indian Medical Council Act 1939 during the pre-independence period and amended in the post-independence period in 1956, it regulated many activities related to the doctors.
Designing, maintaining, upgrading the Medical Curriculum; granting permission to begin new Medical Colleges of modern medicine, maintaining their work, approving Medical Degrees, maintaining postgraduate higher education status, approving doctors who have graduated abroad, setting up a standard medical education course in India where some of the important jobs.
It also regulated the qualified doctors by keeping a record of registration and keeping an eye on ethics and morality in their Medical Practice.
In the last 80 years, MCI carved the career of millions of Indian doctors, who studied modern medicine in India and served with their knowledge. They provided their service to the patients, not only in India but worldwide. In many countries of the world today, the Indian doctors have high regards due to their clinical acumen, knowledge and skills. MCI has a significant share in it.
However, in 2010, a corruption case against the then president of the MCI caused a paradigm shift. This case changed the views and impressions of the Government, the Supreme Court and the Media. It proved to be a blot on the glorious career of the organization. MCI was dissolved by the President of India on May 3 2011. It was restructured again and restored in 2015.
Unfortunately and surprisingly, this singular case converted the spotless glory of this institution and was stamped as a corrupt body of Doctors. As the consequence of all these happenings the NMC Bill was prepared. It was brought in with the accordance of a decision by the Supreme Court of India and the recommendations of the Parliamentary Committee.
The new NMC bill included numerous clauses that do nothing to curb corruption. However, it shares many sections, which would do nothing but an utter injustice to the students and doctors modern medicine. It defies the principles of democracy, deprives economically weaker and poor students from medical education and promotes facilities only to the rich.
Therefore, the Indian Medical Association, a strong association of 3 lakh doctors of modern medicine across India, has been fighting against it. From January 2, 2018 to date, IMA has been fighting against this draconian, unjust and cruel act.
It will be easy to clarify these clauses and their consequences one by one.
It will have a total of 25 members out of which there will be 16 members appointed by the government and the rest of the 9 members elected by 8 lakh registered modern medicine doctors across India. Earlier, the number of appointed and elected representatives of the government was equal in MCI. It is sure that with more than two-thirds of the government appointed members, it will be nothing but an extension of the Health Department of the Government of India. In the largest democracy of the world, this undemocratic trend is utterly unfair to doctors, who are the citizens of India.
These 9 elected members will be selected from one state at a time and their tenure will be about 4 years. That means, considering the 29 States and 8 Union Territories, each state will have a chance to resolve their problems in the NMC after every 16 years. Earlier in the MCI, every State had its representative every time. Therefore, this clause also violates the principles of democracy and does not provide equal opportunity for all.
Out of the 80,000 seats of private medical colleges, 50% of the students will be charged for their College Fees as per government norms. The rest 50 % will be left to the whims of the private institutions running those colleges and will be charged whatever they feel suitable. This will promote the practice of ‘The Seats for the Management Quota’. Due to this, 50% of the intelligent and talented children of economically middle class and poor sections of the country will be denied medical education. Both these points make the bill support the rich and oppose the poor.
As per NMC Bill the responsibility to give permission to start a new Medical College is given to the State Government and not the NMC body. Today India needs more and more Government Medical Colleges. However, under this section it is most likely that most of the new colleges will be the private medical colleges with the joint efforts of Politicians and the state government.
All MBBS students will have to appear for the National Exit Examination (Next) after completing the four and a half year academic course. Only after passing this exam the students will get registration and will be eligible to begin the medical practice. Those who want to opt for postgraduate education will get admission as per the merit list based on the marks in this exam only. In addition, the students who study medicine in a foreign country will have to take the same exam for their further higher education or medical practice.
In India, every year around 80,000 students go to the medical education course. It is not possible for NMCs to take the examination of all these students at the same time all over the country, considering the resources and the facilities available.
In addition, the medical examination consists of 2 parts a written exam and the oral examination, with 50% marks for each type. It would be impossible to take both types of the exams together in one go. The marks obtained by the students appearing NEXT will not be at the same level across India.
Mid-Level Health Providers – Under this section, B.Sc. Nursing students will be given a six-month training in a medical college and will be appointed as a ‘Community Health Officer’ in a government health sub-centre in the rural area. This idea of catering the people in the rural area will reduce the standard of the medical care.
IMA completely opposes the idea of catering substandard medical service to the masses in the rural area. Instead, it is the government’s responsibility to enhance the medical facilities in the rural health centers and create an environment for MBBS doctors to serve there.
IMA believes that MBBS doctors will surely go there if they get a comprehensively encouraging environment in the rural area. Therefore, from IMA side there is complete opposition to the clause of MID Level Health Providers.
The central government withdrew the bill brought to Parliament last year due to the agitations carried out by IMA. Thereafter an all-party parliamentary committee was formed to give the suggestions to improve the clauses in NMC Bill. IMA has been protesting and giving feedback to take away this Draconian NMC Bill, which is Antidemocratic and Anti poor. IMA has been able to eliminate some of the unjust clauses as a result of all India campaigns and agitations across the country. But the fight will still continue until the unjustified clauses in the currently approved bill are eliminated.
The author is the President-Elect of IMA Maharashtra State