How much regulation is too much? That is the question that will be hotly debated by the medical fraternity, when the proposed National Medical Commission Bill, 2016 (NMC) is tabled in Parliament in the upcoming winter session.
The draft of the NMC Bill was released in August by the Niti Aayog, and was open for public opinion till the end of the month. September saw the Niti Aayog discuss the Bill with healthcare secretaries of various states as well.
Most associations of doctors, like the Indian Medical Association (IMA) and The Alliance of Doctors for Ethical Healthcare (ADEH) were unanimous in their rejection of the Bill, which seeks to replace the Medical Council of India (MCI). While IMA representatives dubbed it “old wine in a new bottle”, ADEH termed it “even worse than the disease it is supposed to remedy.”
Among the various points of contention is the fact that the Bill seeks to govern the medical community, as an extension of the Ministry of Health & Family Welfare (MoHFW) without understanding the nuances of medical practice and education. But there has been ample evidence that self regulation efforts via the MCI have been flawed, spawning corrupt practices when it came to recognising medical colleges. But MCI officials point out that they are overseen by the MoHFW, as are other self regulatory associations of professionals like dentists, nurses and pharmacists but these are not facing the axe, unlike the MCI.
The proposed NMC Bill does has imperfections. For instance, even after the hue and cry about the lack of ethics, there is no separate board of medical ethics. Instead this duty is proposed to be clubbed with the medical registration. So also, the NMC Bill, possibly in an attempt to add to the number of medical staff, is apparently proposing that even if anyone does not pass the exit test post the MBBS, they can still get registered in the Medical Registry and continue to practice. Is this a backdoor entry for practitioners from other systems? This angst is also a sign of the ongoing rivalry between allopathic practitioners and other systems, wherein the former would like to keep out the later from the Medical Registry. The Niti Aayog’s proposed National Exit Exam for MBBS students, in addition to an entry exam, too has come in for a lot of flak.
Also, while it is common knowledge that admissions to medical colleagues command huge premia, euphemistically called donations, the NMC Bill has proposed to make it more transparent by allowing private medical colleges to fix the fees for 60 per cent of its seats. But isn’t this simply institutionalising the corrupt practice of ‘selling’ medical seats in what is presently called the ‘management quota’?
Some experts feel the Niti Aayog is being too naive when it assumes that private medical colleges will stick to the declared fees or to the 60 per cent limit. The 40 per cent of seats which are supposed to be reserved to deserving meritorious students at lower fees, will simply have so many qualifying criteria attached to them that few will end up being used.
While the Niti Aayog has a commendable objective, how will this be implemented and monitored? This will end up being a hollow promise on paper, just like beds reserved for economically weaker
patients often go unused due to convoluted qualifying criteria and lengthy procedures. The medical fraternity is very vocal and have threatened to take to the streets if the Bill does get tabled in Parliament in this winter session. Will the Niti Aayog have to back down?
Meanwhile, Express Healthcare crossed another milestone as the inaugural Healthcare Senate was judged a super success. Over three days, healthcare senators, the stalwarts in the sector came together to discuss challenges facing the sector as well as celebrate the vision and good work done. Supported by the Ministry of Health and Family Welfare as well as the Government of Telangana, Healthcare Senate had just the right mix of management mantras at the conference and breakaway breakfast meetings and techspeak one-on-ones at the adjacent medtech expo.
The Summit saluted individual passion as well as team spirit. Four healthcare pioneers were honoured with Citations for forging new paths while eight teams made it through an exhaustive nomination and Jury round, to bag Healthcare Excellence Awards for outstanding work in CSR, HR, patient care and marketing practices. Healthcare Senate 2016 was everything we hoped for and more, and for that, a big thanks to our speakers, panelists and delegates. For indepth coverage, see pages 18-36 in the October issue of Express Healthcare. We hope to make the next edition even more relevant so do send us your feedback.
Viveka Roychowdhury
Editor
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