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Spin doctors

The health minister is right about distortions in medical regulation. But tough talk is not enough.

By: Express News Service | July 21, 2014 12:30:11 am

The health minister is right about distortions in medical regulation. But tough talk is not enough.

Since assuming charge almost two months ago, Union Health Minister Harsh Vardhan has twice lambasted the Medical Council of India (MCI). In June, he referred to it as a “big source of corruption” in the medical industry, and last week he accused it of weakening “the very edifice of medical education”. Aware that he has “inherited a poisoned chalice”, he promised that a “revolution” is in the offing. But as previous attempts to take on this medical-industrial complex have revealed, identifying the dysfunction is far easier than dismantling it.

The MCI, the regulator that oversees medical education and practice, has long been responsible for creating an artificial scarcity of doctors and other healthcare practitioners by preventing new medical institutions from being set up. It has subverted attempts to create alternative courses to plug the urgent demand for medical professionals in villages and small towns. As recently as last month, Harsh Vardhan clashed with it over its decision to scrap over 6,000 existing MBBS seats while denying permission to set up 50 new medical colleges.

This is a new, supposedly untainted MCI, reconstituted after it was dissolved in the wake of its president, Ketan Desai, being booked by the CBI for alleged corruption in 2010. In a symptom of how deep this malaise runs, Desai has mounted a comeback, once again nominated as a member to the MCI by Gujarat University. It has been clear that vested interests within the government are as resistant to real reform as those outside it.

According to the annual National Health Profile released last week, 2013 saw India’s doctor (allopaths plus AYUSH professionals) to population ratio decline to one in 1,200 people, well below the WHO-recommended one per 1,000. While public spending on healthcare has stagnated at about 4 per cent of GDP, per capita private spending on health now accounts for almost two-thirds of overall health expenditure.

India faces huge healthcare challenges — limited numbers of doctors per capita, a rural population that cannot easily access specialists and a significant communicable disease burden — which means the minister’s assurances of reform are welcome. Hopefully, he will back his words with action and use his government’s big mandate to initiate the overhaul that the health sector desperately needs.

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