First step in a long journey

First step in a long journey

Context

The National Medical Commission Bill seeks to make structural changes in an exploitative health-care system

Some Problems that NMC bill seeks to address

• India needs 3,00,000 more doctors in order to meet the World Health Organisation standard of the ideal doctor-population ratio.
• There is an 81% shortage of specialists in community health centres (CHC), the first point of contact for a patient with a specialist doctor.
• Those most affected by this are poor and rural patients who are then forced to consult quacks. Another fact is that 82.2% of providers of “modern medicine” in rural areas do not have a medical qualification and only 21% of the country’s doctors serve them.

Solutions offered by the bill

• Monetary Penalty: The Bill puts in place a mechanism to assess and rate medical colleges regularly, with a high monetary penalty for failure to comply with standards.
• De-recognition: Three such failures will result in the de-recognition of a college.
• Regulation of fees by the government: There is also an enabling provision for the government to regulate the fees of up to 40% seats in private medical colleges.
• Relaxation of criteria for setting up of new colleges:
• The Bill goes a step further with a relaxation of the criteria for approving a college in specific cases.
• Currently, there is a blanket standard for establishing a medical college in India, which disregards the contextual realities in some areas such as difficult terrain or a low population density.

Example: Arunachal Pradesh, Mizoram, and Nagaland do not have a single medical college.

Strengthening Primary Centres

Strengthening primary centres can ensure that patients who can be treated at the “base” (SCs or PHCs) are treated there only.

Utilising AYUSH practitioners as mid-level providers

With the government now planning to revamp 1,50,000 sub-centres into health and wellness centres by 2022, there is need for an equivalent number of mid-level providers

For this, India’s 7,70,000 AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) practitioners can be tapped

• Bridge Course: The Bill has facilitated this by providing for a bridge course for AYUSH/non-allopathic doctors
• This course, to be designed by a joint sitting of all medicinesystems, will ensure that non-allopathic doctors are trained to prescribe modern medicines in a limited way, within the scope of primary care.

Preventing cross-pathy

An added measure in the Bill prevents “cross-pathy” or the unqualified cross-over of health-care providers from one system to another

• The Bill provides for two separate national registers – allopathic doctors, and AYUSH doctors who complete the bridge course, respectively.

Conclusion

In the end, the Bill seeks to make structural changes in a stagnant and increasingly exploitative health-care system. While it is no magic bullet, it should be looked at as a step in the right direction.