National Medical Commission Act, 2019

  • On 8th August, 2019, the President gave assent to the National Medical Commission (NMC) Bill, 2019.
  • With this, it repealed the Indian Medical Council Act, 1956 that led to the formation of the Medical Council of India (MCI).

Aim

  • 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.
  • To promote national health goal and equitable and universal healthcare that encourages community health perspective across the country.

Background

  • Medical Council of India (MCI) was dissolved in 2010 following corruption charges against its president Ketan Desai by the Central Bureau of Investigation (CBI).
  • An earlier version of this Bill was introduced in the 16thLokSabha, which got lapsed at the end of the term of the LokSabha.

Key Features of the Bill

  • Establishment of National Medical Commission(NMC): ANMC will be set up in place of MCI that will have responsibilities such as approving and assessing medical colleges, conducting common MBBS entrance and exit examinations and regulating medical course fees. 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
  • State Medical Council: States will establish their respective State Medical Councils within three years. These Councils will have a role similar to the NMC, at the state level.
  • Establishment of Autonomous Board: It proposes to set up four autonomous boards under the supervision of the NMC. Each board will consist of a President and four members (of which two members will be part-time), appointed by the central government (on the recommendation of a search committee).  These bodies are:
    • The Under-Graduate Medical Education Board
    • The Post-Graduate Medical Education Board
    • The Medical Assessment and Rating Board
    • The Ethics and Medical Registration Board
  • National Exit Test (NEXT): It proposes a common final-year MBBS examination, known as NEXT, for admission to post-graduate medical courses and for obtaining a license to practice medicine, which will also serve as a screening test for foreign medical graduates. Currently, foreign students with MBBS degrees are automatically entitled to practice in India.
  • Fee Regulation:It proposes to regulate the fees and other charges of 50 percent of the total seats in private medical colleges and deemed universities.
  • Community Health Providers:It provides for the NMC to grant limited license to certain mid-level practitioners called community health providers, connected with the modern medical profession to practice medicine. These mid-level medical practitioners may prescribe specified medicines in primary and preventive healthcare. 

Need for National Medical Commission

  • MCI not fulfilling its Responsibilities: According to the 92th report (2016) of the Parliamentary Standing Committee on Health and Family Welfare, the MCI has repeatedly been found short of fulfilling its mandated responsibilities.
  • Inefficient Current Model of Medical Education: The current model of medical education is not producing the right type of health professionals that meet the basic health needs of the country because medical education and curricula are not integrated with the needs of our health system.
  • Incompetence Medical Practitioners: Many of the products coming out of medical colleges are ill-prepared to serve in poor resource settings like Primary Health Centre and even at the district level. Further, medical graduates lack competence in performing basic health care tasks like conducting normal deliveries.
  • Increasing Instances of Unethical Practice and Corruption: Be it in urban or rural areas, the malpractices in medical profession in India is continuously increasing day by day. Hundreds and thousands of cases happen every day in Indian medical profession, where doctors, on whom patients blindly trust, make fool out of patients.

Significance

  • Help to Curb Corruption: It may prove helpful in fighting corruption, which had affected MCI.Unlike MCI, the members of NMC will have to declare their assets at the time of assuming office and when they leave. They will also have to submit a conflict of interest declaration.
  • Availability of More Practitioners: Also, the World Health Organization prescribes a doctor to patient ratio of 1:1,000, but as reports indicate, India is far from achieving that target. Allowing Community Health Providers to practise medicine is likely to plug this shortage to some extent.
  • Multiple Benefits: It will help reduce the burden on students, ensure probity in medical education, bring down costs of medical education, simplify procedures, ensure quality education, and provide wider access to people to quality healthcare.

Why is the NMC Act being protested by the Medical Fraternity?

  • The Indian Medical Association(IMA) has raised concerned over license being provided to 5 lakhs non-medical persons or Community Health Providers to practice modern medicine. According to the IMA, this may open the door for persons with inadequate training in modern medicine to practice, putting patients at risk and lowering standards of healthcare.
  • It has been termed as 'anti-poor and anti-public' since making NEXT mandatory before NEET can reduce the chances of people from economically weaker section entering the medical sector.
  • The Act allows the commission to frame guidelines for determination of fees and all other charges in respect of 50 percent of seats in private medical institutions and deemed to be universities. This increases the number of seats for which private institutes will have the discretion to determine fees. At present, in such institutes, state governments decide fees for 85 per cent of the seats.
  • Another objection is regarding the power it grants to the central government to give policy and other directives to the NMC and its autonomous boards which will be binding and final. This is contradictory to the very concept of autonomy of the four boards. The central government has also been empowered to give directives to state governments for implementing provisions of the act, which will also be binding, reflecting the anti-federal character of the Bill.

Source : Civil Services Chronicle Online, 8thAugust, 2019