Questionable Remedy: National Medical Commission Act, 2019
The National Medical Commission Bill, 2019 received the assent of the President on the 8th August, 2019 and it seeks to replace the Medical Council of India Act, 1956.
- The Medical Council of India was established under the Indian Medical Council Act with the main function of establishing uniform standards of higher qualifications in medicine and recognition of medical qualifications in India and abroad. However, issues of corruption and nepotism along with non-accountable administration highlighted the need for a nomination based authority to overhaul the regulation of medical education system and its practice. Towards this end, the Act repeals Indian Medical Council Act, 1956 and dissolves the current MCI.
It is an Act to provide for a medical education system that improves access to quality and affordable medical education, ensures availability of adequate and high quality medical professionals in all parts of the country; that promotes equitable and universal healthcare that encourages community health perspective and makes services of medical professionals accessible to all the citizens; that promotes national health goals and facilitates maintenance of a medical register for India and enforces high ethical standards in all aspects of medical services.
The Act repealed the Indian Medical Council Act, 1956 and provides for a medical education system which ensures: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.
- Effective grievance redressal mechanism.
1. Constitution of the National Medical Commission
The Act requires the setting up of the National Medical Commission (NMC). It also requires constitution of State Medical Councils at State level within 3 years.The NMC will consist of 25 members, appointed by the central government.A Search Committee will recommend names to the central government for the post of Chairperson, and the part time members.The Search Committee will consist of seven members including the Cabinet Secretary and five experts nominated by the central government (of which three will have experience in the medical field).
The Commission shall consist of the following persons to be appointed by the Central Government, namely:
- A Chairperson
- Ten ex officio Members
- Twenty-two part-time Members
Functions of the NMC include:
- Laying down of policies for regulating medical institutions and medical professionals.
- Assess the requirements in healthcare related to human resources and healthcare infrastructure.
- Ensuring coordination among State Autonomous Boards and compliance by the State Medical Councils of the guidelines made under the Act.
- Frame guidelines for determination of fees of fifty per cent of the seats in private medical institutions and deemed universities.
2. Medical Advisory Council
The central government will constitute a Medical Advisory Council which consists of chairman and members of NMC as ex officio members and vice chancellors of States/UT as members. The Council will be the primary platform through which the States/UTs may put forth their views and concerns before the NMC. Council will advise the NMC on measures to determine and maintain minimum standards of medical education, training and research.
3. Autonomous Boards: Autonomous boards are set up under the supervision of the Commission. Each autonomous board will consist of a President and four members (two full-time and two part time). These boards are:
- Under-Graduate Medical Education Board (UGMEB) – It will determine standards of medical education at undergraduate level, design curriculum and oversee all other aspects.
- Post-Graduate Medical Education Board (PGMEB): it will determine the standards of medical education at the postgraduate level and super-speciality level in accordance with the regulations made under this Act and oversee all aspects relating to curriculum etc.
- The Medical Assessment and Rating Board (MARB): It will determine the procedure for assessing and rating the medical institutions for their compliance with the standards laid down by the Under-Graduate Medical Education Board or the Post-Graduate Medical Education Board in accordance with the regulations made under this Act and will grant permission for establishing a new medical college, or increasing the number of seats.
- The Ethics and Medical Registration Board: it will maintain National Registers of all licensed medical practitioners and regulate professional conduct and promote medical ethics in accordance with the regulations made under this Act.
4.Community Health Providers: The Commission may grant limited license to practice medicine at mid-level as Community Health Provider to person connected with modern scientific medical profession who qualify the criteria specified by the regulations.
5.Entrance Examinations: There will be a uniform National Eligibility-cum-Entrance Test for admission to the undergraduate and postgraduate super-specialty medical education in all medical institutions which are governed by the provisions of this Act.
A common final year undergraduate medical examination, to be known as the National Exit Test will be held for granting license to practice medicine as medical practitioners and for enrolment in the State Register or the National Register.
Medical Council of India had allegations of corruption and a non-accountable attitude, NMC paves way of an integrated institution in medical oversight.
- Curriculum and healthcare professionals are not in line with the current demand in the country and lacked competency skills, thus boards created in the ACT will serve the required purpose.
- Unethical behavior of healthcare professional was a menace in the system which threatened the life of the patients, thus a separate The Ethics and Medical Registration Board was the need of the hour.
- Lack of oversight by the health ministry resulted in malfunctioning of the MCI, thus NMC will have ministry oversight.
- Shortage of healthcare professionals especially in primary care was a problem; therefore the provision of granting of license to mid-level will serve the purpose.
The Act authorizes the government to allow non-medical degree holders to practice medicine as community health providers which may encourage quackery in the country.
- Meagre 20 per cent members of the NMC will be elected representatives.
- Single exam (NEXT) is being given too much weightage which can have an adverse impact on the career of medical aspirants.
- There are protests against the Private Education fees, as medical fraternity wants capping on the fees charged by the unaided medical institutions. The current system allows to cap only 50% of the private seats. However some experts contend that capping of fees would discourage the entry of private colleges.
- NMC Act allows the central government to remove the chairperson or any other member of the commission
- Medical system in India needs quality across the spectrum. Thus, the need of the hour is to experiment with the new changes proposed by the bill specially related to community health providers (Chattisgarh has similar 3-year course). However, it is pertinent to move forward with adequate planning and evidence based processes.