UPSC MAINS 2019 : National Medical Commission (NMC) Bill

National Medical Commission (NMC) Bill

Topic : National Medical Commission (NMC) Bill

Topic in Syllabus: General Studies Paper 1: Indian Society

 

Context:

National Medical Commission (NMC) Bill

Union Health Minister has introduced the National Medical Commission (NMC) Bill in Lok Sabha. The National Medical Commission (NMC) Bill, seeks to replace the 63-year-old Medical Council of India (MCI) to reform the medical sector in India.Once the NMC Bill is enacted, the Indian Medical Council Act, 1956, will stand repealed.

 

Background:

  • The Medical Council of India (MCI) is established under the Indian Medical Council Act, 1956 in order to maintain standards of medical education, give approval to establish medical colleges, medical courses, and recognise medical qualifications.
  • The MCI is also responsible for the regulation of medical practice, including registering doctors in an All India Medical Register.
  • States have their own laws that establish a state medical council to regulate matters related to ethical and professional misconduct of medical practitioners

 

Reasons For replacing  MCI.

  • Over the years, there have been several issues with the functioning of the MCI with respect to its regulatory role, composition, allegations of corruption, and lack of accountability
  • Quality Deficit in Medical Education.
  • Disintegration between Medical education and curricula with the needs of Indian Health system.
  • Ill-equipped medical professionals to serve in poor resource settings.
  • Lack of competence among medical graduates in performing basic health care tasks
  • The Parliamentary Standing Committee (2016), and Expert Committees under the Chairmanship of Prof. Ranjit Roy Choudhary and the NITI Aayog (2016) have suggested legislative changes in order to overhaul the functioning of the MCI.
  • The NITI Aayog recommended changes in the composition of the MCI and creation of several autonomous Boards in order to address different functions such as medical education and qualifying examinations, medical ethics and practice, and accreditation of medical colleges

 

Highlights of the bill.

  • The bill seeks to replace the Medical Council of India with National Medical Commission as top regulator of medical education in India.
  • The bill also seeks to put in place a common entrance exam and licentiate exam, which all medical graduates will have to clear to get practising licences.
  • It would also put in place a four-tier structure for the regulation of medical education. The 20 members National Medical Commission will be at the top of this structure. NMC will be a 20 member body comprising a Chairperson, a member secretary, eight ex-officio members and 10 part-time members.
  • Out of the 8 ex-officio members, four shall be presidents of the boards constituted under the act and remaining four shall be nominees from three ministries viz. Health, Pharmaceuticals, HRD and one from Director General of Health Services.
  • The bill also has a provision for a common entrance exam and licentiate (exit) exam that medical graduates have to pass before practising or pursuing PG courses.
  • For MBBS, students have to clear NEET, and before they step into practice, they must pass the exit exam.
  • The NMC can permit a medical professional to perform surgery or practise medicine without qualifying the National Licentiate Examination, in circumstances that may be specified in regulations.
  • According to the NMC Bill, the Ethics and Medical Registration Board can maintain a separate national register that would have the names of licensed AYUSH practitioners.
  • The government, under the National Medical Commission (NMC), can dictate guidelines for fees up to 40% of seats in private medical colleges. This is aimed at giving students relief from the exorbitant fees charged by these colleges and is a standout feature of the bill.

Medical council of India Vs National Medical Commission

 

The National Exit Test (NEXT)

  • The new Bill has the provision for making national standards in medical education uniform by proposing that the final year MBBS exam be treated as an entrance test for post-graduation
  • It will allow medical graduates to start medical practice, seek admission to PG courses, and screen foreign medical graduates who want to practise in India.
  • Per se, it offers a definite benefit for students who invest much time and energy in five years of training in classrooms, labs and the bedside, by reducing the number of tests they would have to take in case they aim to study further.
  • At present, different medical colleges have different MBBS exam patterns. The NMC’s proposal is to ensure a uniform national pattern for final year MBBS exam so that all medical graduates who get the licence to practise conform to uniform national standards and quality.

 

Changes made to the Original Bill proposed in 2017

  • The government also decided to scrap a proposal in the original Bill to conduct an additional licentiate exam that all medical graduates would have to take in order to practise, in the face of virulent opposition.
  • It also removed, rightly, a proposal in the older Bill for a bridge course for AYUSH practitioners to make a lateral entry into allopathy.

 

Opposition  to the bill.

  • A bridge course allowing alternative-medicine practitioners to prescribe modern drugs is mentioned in the bill. Unscientific mixing of systems and empowering of other practitioners through bridge courses will only pave the way for substandard doctors and substandard medical practice. This will seriously impact patient care and patient safety
  • Indian Medical Association (IMA) opposed the bill that it will cripple the functioning of medical professionals by making them completely answerable to the bureaucracy and non-medical administrators. NMC will become subservient to the health ministry, given that the representation of the medical profession in the new regulatory framework is minimal.
  • The bill takes away the voting right of every doctor in Indiato elect their medical council.
  • The bill allows private medical colleges to charge at will, nullifying whatever solace the NEET brought. The proposed NMC Bill discreetly intends to equate the post-graduate degrees given by MCI or proposed NMC and the National Board of Examination (NBE), which is unjustified too.
  • Standards have been laid down for MCI courses, but not for NBE courses which are often run in private hospitals and nursing homes.
  • It would replace an elected body (Medical Council of India, MCI) with one where representatives are “nominated.

 

Way Forward

  • It is crucial now for the Centre to work amicably with States, and the Indian Medical Association, which is opposed to the Bill, taking them along to ease the process of implementation.
  • At any cost, it must avoid the creation of inflexible roadblocks as happened with NEET in some States.
  • The clearance of these hurdles, then, as recalled from experience, become fraught with legal and political battles, leaving behind much bitterness.
  • NEXT will have to be a lot neater.

 

Sample Question

What is National Medical Commission Bill 2019 why is the medical fraternity opposed to it?

 


 

National Medical Commission (NMC) Bill infograph