A poor prognosis 

A poor prognosis 

The National Medical Commission Bill is unlikely to provide a dynamic new thrust to medical care in India

Lack of clarity

The fundamental flaw in the proposed Medical Commission is the lack of clarity on its function. 

Complex tasks assigned to the commission

Unfortunately, in the National Medical Commission Bill, 2017 in the chapter titled “powers and functions of the commission”,

• The phrase “lay down policy” occurs repeatedly
• The Commission is also expected to “assess the requirements in healthcare, including human resources…”

Such complex tasks, which require inputs from multiple agencies, will be done poorly, if at all, by the commission

Point of integration

What type of medical practitioners should the country train? This is a matter that the government should decide. 

Failure of the government: created competition among the various streams of medicine in India

The failure of successive governments to promote scientific medicine and integrate the best of indigenous systems into one unified system has led to unhealthy competition among the various streams of medicine in India.

Western vs Allopathy

It would be great statesmanship to move to just one scientific system of medicine in India, combining all that is proven from different streams. 

Members of the Commission

Who should the members of the Commission be?

• The present system of appointing members to the MCI has failed, resulting in rent-seekers repeatedly entering the Council.
• The election process should be reformed, not replaced
• The proposal to have sections of society other than medical professionals in the commission is laudable 

Proposed method wrong

• Having an almost entirely nominated commission, as the present Bill provides, is unhealthy
• It will lead to a collection of ‘yes men and women’ whose chief qualification will be proximity to the existing government.

Medical education

Should private initiative be allowed in medical education?

Too little patients

If the government is sincere in its objective of providing universal medical care, it is clear that high-cost private education will further exacerbate the problem of too many specialists in metropolitan areas chasing too few patients

Problems in process of approving medical colleges

• To start a medical college, State governments first issue a certificate of essentiality
• The MCI then decides whether the proposed college has enough facilities to start the first year. Subsequently, inspections are done every year till the first batch of students has completed the final year
• This has led to problems, as somewhere along the way, the Council finds that some colleges are unable to meet the requirements and withdraws recognition
• This leaves students in a lurch and they then approach the judiciary to solve their unhappy situation
• The proposed Commission has no mechanism to prevent this from happening
• Merely shifting this responsibility to a medical assessment and rating board is no solution.

Problems with the current bill

• It falls between the stools of excessively ambitious objectives and micro-management
• On the one hand the Commission is expected to formulate policy, but on the other it is to decide fee structure
• The government should exhibit statesmanship and form a parliamentary committee to draft a new Bill altogether with clear and workable objectives

Conclusion

In the end, policy decisions should be decided by policymakers, and not bureaucrats