IMA opposes Community Health Providers clause in NMC Bill

The National Medical Commission Bill (NMC) 2019 is likely to be another stand-off point between the doctors and the union government. And, this time the point of stalemate would likely be, granting limited licenses to practice medicine at mid-level Community Health Providers


The proposed provision of Community Health Providers has not gone well within the doctor’s fraternity across the country. The NMC Bill which aims to bring a wide range of changes in the structure of medical education in India was introduced in the parliament on Monday, July 22, by Union Health Minister Dr Harsh Vardhan.

The National Medical Commission Bill 2019 draft states,

‘The Commission may grant limited licence to practice medicine at mid-level as Community Health Provider to such person connected with the modern scientific medical profession who qualify such criteria as may be specified by the  regulations

Provided that the number of limited licence to be granted under this sub-section shall not exceed one-third of the total number of licenced medical practitioners registered under sub-section (1) of section 31.

The Community Health Provider may prescribe specified medicine independently, only in primary and preventive healthcare, but in cases other than primary and preventive healthcare, he may prescribe medicine only under the supervision of medical practitioners registered under sub-section (1) of section 32.’

But, health experts across the country have raised certain apprehensions on the revised draft and the proposed Community Health Provider clause.

Experts opined that the clause has a very vague terminology. By appointing a mid-level community health provider, the government is treating the rural people as secondary citizens. Why compromise on the health of poor and needy rural people? Rather, the government must build more medical colleges and create more qualified doctors.

Dr Suhas Pingle, Secretary, IMA, Maharashra, “The Indian Medical Association is shocked to see how smartly the government is circumventing the terminology of the bridge course. This is horrible. The term Community Health Provider is a vague concept. If this is implemented, even the nurse and alternative medicine practitioners can claim that he/she is associated with modern medicine.”

“The bridge course was vehemently opposed by the Indian Medical Association in the past. And, we will surely oppose this too,” added Dr Pingle

Dr Anil Pachnekar, IMA, Vice President, said, “The Indian Medical Association will oppose this clause. This is like giving a backdoor entry for nurses, pharmacists, and Ayush practitioners to practice modern medicine.”

“The government has smartly not used the word ‘AYUSH’ in the draft. But, now, the government has introduced a concept of Community Health providers. This is nothing but a gateway for doctors practising alternative medicine to practise modern medicine,” said a doctor on the condition of anonymity.

The newly amended draft also states that the common final year MBBS examination to be known as the National Exit Test (NEXT) shall be held for granting a licence to practice medicine as medical practitioners.

This exam will be the basis for admission to the postgraduate broad-speciality medical education in medical institutions.