The Indian Medical Association called for a nationwide 12-hour shutdown on Tuesday, affecting OPD services across the country. With 2.77 lakh members, IMA is the largest medical body in India. While the shutdown didn’t affect government hospitals, patients at private hospitals suffered the brunt of the shutdown. Member hospitals and health institutions of IMA withdrew OPD and elective surgery services between 6 am and 6 pm on Tuesday. The protest stems from a string of issues that the medical community at large in India has been raising and new legislative developments triggered the nation-wide shutdown.
IMA president Ravi Wankhede said, “The IMA strongly opposes this Bill and has no option but to take the issues to our patients and the people. To register our protest, routine medical services like OPD and elective surgeries across the country have been withdrawn between 6 am and 6 pm at our member hospitals and health institutions.”
Doctors in several states took to the streets in protest against the National Medical Commission Bill, 2017 that seeks a replacement of the Medical Council of India. The IMA has described the bill, slated to be tabled in Parliament on Friday, as “anti-people and anti-patient” as well as being “anti-poor” claiming that it will render the system prone to corruption. The bill empowers the Centre to appoint members of the Commission which will constitute the Cabinet Secretary as the chairperson, 12 ex officio members, 11 part-time members and an ex officio member secretary from the Ministry of Health and Family Welfare.
Similar nationwide protests were called in 686 districts of the country during November and December in 2016 against the government’s proposal to dissolve MCI and replace it with the NMC. The accountability to non-medical administrators and the bureaucracy was a major issue and the IMA had demanded amendments to the MCI Act if changes were indeed necessary to make the medical system more transparent and self-sufficient.
Dr KK Aggarwal, then the president of IMA, had said, “It will cripple the functioning of the medical profession by making it completely answerable to the bureaucracy and non-medical administrators.”
Another bone of contention for the IMA is the pro-private management clause and bridge courses. “The bill allows ayurvedic as well as homoeopathic doctors to practice allopathy after a six-month bridge course,” said Wankhede. IMA raised demands like no separate registrations for AYUSH, minimum qualification of MBBS for a doctor seeking to practice modern medicine, and no provision for any bridge courses.
MCI sets binding rules and guidelines for medical colleges to regulate the number of MBBS graduating each year. IMA has claimed that the Bill seeks to do away with the permissions which will create a situation where private medical colleges will be able to increase undergraduate and postgraduate seats without seeking the approval of a regulator. Section 26 (1)(b) of the Bill says that the permission to start medical colleges, post graduate, and superspeciality courses would directly be granted by the Medical Assessment and Rating Board. The Centre will nominate three members to the MARB as well.
At present, a doctor needs to qualify the National Licentiate Examination to perform surgery or practice medicine. Section 33 (1) (d) of the Bill allows a doctor to bypass this requirement in certain circumstances. Also, Section 55(2)(zl) of the Bill allows registration of a medical practitioner into registers of two different medical councils which could possibly result in confusion or impediments in terms of disciplinary jurisdiction.
“The disciplinary jurisdiction on such persons with reference to breach of ethics is not indicated in the proposed Bill as they have dual registrations to their credit. As such these are floodgates that have been opened up in terms of the statutory provisions for backdoor entry into medical profession entitling practicing modern medicine,” said Dr SS Utture, president of Maharashtra Medical Council, in statement issued on Monday.
Section 53 of the Bill also allows the Centre to supercede the NMC in its authority and can at any point in time take over the responsibilities of the NMC if it feels the Commission is not performing its functions properly.
Union Health Minister JP Nadda defended the government’s proposal and said in Rajya Sabha on Tuesday that bringing the NMC will “benefit the medical profession.” On talks with the IMA over the NMC issue, the minister said, “Spoke to Indian Medical Association yesterday, we have heard them and put forth our perspective as well.”