National Medical Commission Bill 2019

Recently, the National Medical Commission Bill, 2019 has been passed by the Parliament. A National Medical Commission (NMC) will be formed through this bill. This commission will act as the principal unit for regulation of medical education. In addition, the NMC will also incorporate the powers and functions of the Medical Council of India (MCI), as well as the NMC to regulate and improve the medical education and medical system of India.

Issues related to Medical Council of India

The Medical Council of India (MCI) was formed under the Indian Medical Council Act, 1956. This council is the main unit for the regulation of medical education and medical system till the NMC comes into effect.

Since its formation, many issues have arisen on the responsibility of MCI, corruption and its role in organization and regulation.

  • In the year 2009, Yashpal Committee and National Knowledge Commission have already recommended to bring medical education and medical system under separate regulation framework.
  • The MCI is an elected entity elected by the physicians themselves. Which creates a conflict of interest situation.
  • The MCI predominantly dominates the doctors. But in the long term, medical education has diversified. In such a situation, it is necessary that the MCI also includes public health experts, social sector savvy and economic analysts related to health services.
  • The General Medical Council of Britain, which is equivalent to India’s MCI, is composed of 12 physicians and 12 other members. These other members are community health members and local government officials.
  • According to MCI rules, a new college needs to be inspected 25 times before it is formed and this type of situation gives rise to Inspector Raj.

Features of NMC Bill

National Medical Commission Bill
National Medical Commission Bill

  • The bill provides for the constitution of the National Medical Commission (NMC) at the central level and also directs the states to constitute the State Medical Commission within three years.
  • The NMC will consist of 25 members partly nominated by the central government.
  • NMC will discharge the following obligations-
    • Regulating medical institutions and medical professionals.
    • Assessment of health related human resources and infrastructure requirements.
    • Implementation of various provisions of the Bill by the State Medical Commissions
    • Preparation of guidelines for determination of fees up to 50% in private medical institutions and deemed universities.
  • The Bill provides for the formation of autonomous boards under the supervision of NMC-
    • Board of Graduate Medical Education (UGMEB) and Postgraduate Medical Education Board (PGMEB): These boards will be responsible for providing standards, curriculum, guidelines and recognition of medical qualifications at the undergraduate and postgraduate levels.
    • Medical Evaluation and Rating Board (MARB): This board will act to impose monetary penalties on medical institutions that fail to implement the standards set by UGMEB and PGMEB. Also, this board will also allow for increasing the number of seats, starting new postgraduate courses and setting up new medical colleges.
    • Board of Ethics and Medical Registration: It will create a national register of all licensed practitioners and also regulate professional conduct in the respective institutions.
  • Community Health Providers: Under the Bill, the NMC may grant limited licenses to some middle level physicians associated with the modern medical profession for the medical field. These middle-level physicians may in some cases provide services related to primary and preventive health care.
  • Eligibility Test: All the regulated medical institutions will have uniform National Eligibility-cum-Entrance Test (NEET) for admission to undergraduate and postgraduate medical education. The bill proposes an examination called NEXT (National Exit Test). The NEXT exam will be taken in the final year of the undergraduate course. Through this, after the completion of the undergraduate course, the student will be licensed to practice.

Benefits of National Medical Bill, 2019

National Medical Commission Bill
National Medical Commission Bill

  • NMC has the ability to encourage specialization according to various diseases, that is, if the prevalence of a disease is high, then it has the ability to increase the number of doctors in that area to deal with it. For example, in Britain, the government determines how many doctors are required in which field. The UK Medical Council implements its order according to the government’s directive. But currently MCI operates autonomously. NMC can be helpful in filling this gap.
  • Through qualification exams like NEET and NEXT, NMC can bring uniformity in standards of competence and skills. This will reduce the weight of many exams as well as determine the minimum level of science in the students. Apart from this, it will also reduce corruption by ensuring admission of only those students who have passed the qualifying examination.
  • The State Medical Commission will also act as a grievance redressal mechanism. A complaint can be made before this commission for professional or moral misconduct of any doctor. Thus it will protect the interests of the patient and also prevent the negative effects of commercialization of medical services.
  • Differential costs for medical education can benefit the economically weaker sections of the society as the final decision on fees for 50 percent seats in private medical institutions and deemed universities will be decided by the NMC.
  • The NMC may make a pre-requisite rule for research in medical colleges to encourage innovation and promote research.

Apprehensions

  • Some members in the NMC will be nominated by the government. These members can promote favoritism and bureaucracy in the commission.
  • Broad discretionary powers provided by the government can reduce the accountability of the NMC and make it an advisory body.
  • The NMC Bill grants licenses for modern medicine to 3.5 lakh non-medical people.
  • This may adversely affect the medical field. Also the community health provider is not clearly defined.
  • The Bill empowers the NMC to fix fees on only 50 percent seats in private medical colleges, while the other 50 percent seats can be given under extremely high fees.
  • This will completely remove these seats from the economically weaker sections.

The conclusion

India has been grappling with the problem of shortage of skilled doctors for a long time. There are only a few medical institutes in India that manufacture top quality physicians. The Mudaliar Committee report in 1959 indicated that physicians in India were not able to deal with primary health and infectious diseases which were the major concerns of the time. Presently, the doctors’ extreme reliance on clinical trials indicates their scant knowledge and commercial interests. The NMC may focus on improving medical education and the medical system in India, but the government needs to focus on some of the bigger things like antibiotic resistance and reduction in government spending.

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