7 PM | Does the Medical Commission Bill encourage quackery? | 9th August, 2019

Context: National Medical Commission Bill, 2019 and the reasons of medical fraternity being against the bill.

More in News:

• The National Medical Commission Bill, 2019 was introduced by the Minister of Health and Family Welfare, Dr. Harsh Vardhan in Lok Sabha on July 22, 2019.
• President Ram Nath Kovind has given his assent to the National Medical Commission Bill, 2019.

The National Medical Commission Bill, 2019:

The Bill seeks to repeal the Indian Medical Council Act, 1956 and provide for a medical education system which ensures:

• availability of adequate and high quality medical professionals
• adoption of the latest medical research by medical professionals
• periodic assessment of medical institutions
• An effective grievance redressal mechanism.

 Key features of the Bill:

• Constitution of the National Medical Commission:  
  • The Bill sets up the National Medical Commission (NMC). 
  • The NMC will subsume the MCI and will regulate medical education and practice in India. 
  • Within three years of the passage of the Bill, state governments will establish State Medical Councils at the state level. 
• Functions of the National Medical Commission:  
  • Framing policies for regulating medical institutions and medical professionals.
  • Assessing the requirements of healthcare related human resources and infrastructure.
  • Ensuring compliance by the State Medical Councils of the regulations made under the Bill.
  • Framing guidelines for determination of fees for up to 50% of the seats in private medical institutions and deemed universities which are regulated under the Bill.
• Medical Advisory Council:  
  • Under the Bill, the central government will constitute a Medical Advisory Council. 
  • The Council will be the primary platform through which the states/union territories can put forth their views and concerns before the NMC. 
  • The Council will advise the NMC on measures to determine and maintain minimum standards of medical education.
• Autonomous boards:  The Bill sets up autonomous boards under the supervision of the NMC.  Each autonomous board will consist of a President and four members, appointed by the central government.  These boards are:
  • The Under-Graduate Medical Education Board (UGMEB) and the Post-Graduate Medical Education Board (PGMEB).
  • The Medical Assessment and Rating Board (MARB).
  • The Ethics and Medical Registration Board.
• Community health providers:  Under the Bill, the NMC may grant a limited license to certain mid-level practitioners connected with the modern medical profession to practice medicine.  These mid-level practitioners may prescribe specified medicines in primary and preventive healthcare.
• Entrance examinations:  There will be a uniform National Eligibility-cum-Entrance Test for admission to under-graduate and post-graduate super-speciality medical education in all medical institutions regulated under the Bill.  The NMC will specify the manner of conducting common counselling for admission in all such medical institutions.
• Exit test: The Bill proposes a common final year undergraduate examination called the National Exit Test for the students graduating from medical institutions to obtain the license for practice.  This test will also serve as the basis for admission into post-graduate courses at medical institutions under this Bill.

Why is medical fraternity against NMC Bill?

• No second chance:
  • The standing committee had opposed the National Exit Test (NEXT). According to the Bill, it would serve three purposes:
• Final-year MBBS examination.
• A licentiate exam for getting permission to practice.
• Entrance exam for admissions to PG courses.
  • The Bill has no scope for improvement if a student fails. Earlier, there existed an improvement exam for those who failed the final-year test.
  • The Federation of Resident Doctors Association (FORDA) and the United-RDA (Resident Doctors Association) in a joint statement said, ‘’The provisions of the said bill are nothing short of draconian and promote gross incompetence and mockery of the professionals currently working day and night’’.
• Unbridled fees

Another controversial clause of the Bill is regulation of fee of more than 35,000 seats in private medical colleges. The Bill says the proposed NMC can frame guidelines on fees determination of only 50 per cent of seats in private medical colleges. The recommendation of the committee was however, that it must be regulated for at least 50 per cent of the seats.

• Quack doctors

According to the Bill, 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. The term Community Health Provider has been vaguely defined to allow anyone connected with modern medicine to get registered in NMC and be licensed to practice modern medicine. This means persons without medical background are becoming eligible to practice modern medicine and prescribe independently. This law legalizes quackery. This provision and the other controversial provisions can never be accepted by the medical fraternity of the country.

Conclusion: Perceptions of patients are changing, preferences are changing, people are not willing to settle even for a nurse. In a State like Kerala, they’re not willing to look at even MBBS doctors, they only want specialists. So, these partially trained people may not get preference and may fall by the wayside. A continuous redesign, actually having a strong evaluation framework, a strong regulatory governance framework is extremely important. However, if the experiment fails, it should be abandoned before the number of these providers is too high.

Source: https://www.thehindu.com/opinion/op-ed/does-the-medical-commission-bill-encourage-quackery/article28917369.ece