A Bill that will bring to an end the current system of regulation of medical education through the Medical Council of India (MCI) has been finalised and sent to the Cabinet. The National Medical Commission Bill envisages a four-tier structure for the regulation of medical education, with a 20-member National Medical Commission (NMC) at the top. The commission will perform overall supervision over four autonomous boards that will deal with undergraduate and post-graduate education, assessment and rating of medical institutions and registration of medical practitioners and enforcement of medical ethics.
There will also be a Medical Advisory Council, constituted by the central government, like the commission and the boards. The council, which will be advisory in nature, will meet at least once a year. It will serve as the primary platform through which states will put forward their views and concerns before the NMC and help shape the overall agenda in the field of medical education and training.
As a concept, the NMC has been in the making for years, given the perception of corruption in the MCI and recommendations from many committees including the Ranjit Roychowdury Committee and Parliamentary Standing Committee for Health and Family Welfare. The standing committee said in its report: “The Committee observes that the main objective of the regulator of medical education and practice in India is to regulate quality of medical education, tailor medical education to the healthcare needs of the country, ensure adherence to quality standards by medical colleges, produce competent doctors possessing requisite skills and values as required by our health system and regulate medical practice in accordance with the professional code of ethics. The Medical Council of India, when tested on the above touchstone, has repeatedly been found short of fulfilling its mandated responsibilities.”
The draft sent to the Cabinet incorporates two significant changes from what the Health Ministry had proposed — only five members of the NMC will be elected while the others will be nominated by the government, and the government will be the second appellate authority in case disputes arise. The first change was made after the PMO sought a reduction in the number of elected members. It would, Health Ministry officials said, ensure that the government has more leverage and prevent the system from descending into the present state, where the MCI and government are often at loggerheads on many issues. There are also ex-officio members in the commission that include nominees from the Ministry of Health, Department of Pharmaceuticals, Human Resource Development and Director General of Health Services. It was the Niti Aayog that pushed for a change in the appeal structure.
The Bill has already been cleared by a Group of Ministers, so it is unlikely to face major problems in clearing the Cabinet. The real challenge for the government will be in pushing it through in Parliament, where medical education has always been a touchy subject across party lines. With the finalisation of the Bill being closely followed by Health Secretary C K Mishra moving to the Environment Ministry, there is already speculation about whether the two events are connected, given the track record of officers who have attempted to effect changes in MCI.