The Hindu Editorials Notes- Mains Sure shot (14^th august 2019)

GS-2 Mains (Health section)

Question – what is the National Medical Commission Bill and why is it being opposed by the medical fraternity? Explain (250 words)

Context- the National Medical Commission Bill, 2019.

Background:

• As per 2019 data, in India, there approximately is one government doctor for every 10,189 people, while the WHO recommends a ratio of 1:1000. So, according to our population there is a shortage of 6 lakh doctors, and the nurse: patient ratio is 1:1483; implying a shortage of two million nurses.
• There is also a difference between the northern and southern states, with some southern states performing better. For example – there is adequate number of doctors in both Kerala and Tamil Nadu, whereas in Bihar and the Northern states, there is an acute shortage.
• There is also a substantial difference between rural and urban areas, as large number of doctors tend to cluster in urban areas.
• There are also states like Andhra Pradesh and Telangana but that is not very positive because it is just not the numbers, but the quality of the doctors also matters.
• Also, even in these states where there are adequate doctors it is difficult to find doctors in tribal areas.
• Also, there is a huge shortage of specialists. So, we have doctors but they cannot adequately address certain diseases.
• So, keeping all these factors in mind we need certain reforms in the present system.
• And to address all these issues the National Medical Commission Bill has been brought.

What is the National Medical Commission (NMC)?

• The NMC seeks to replace the Medical Commission of India, to regulate all aspects of medical education, profession and institutions.
• The NMC seeks to bring in transparency, good management and end arbitrariness.
• It will be comprised of 25 members who will be appointed by the Central government on the recommendation of a committee.
• There will be one chairperson who should be an academic and a medical practitioner with at least 20 years of experience. There will also be 10 ex-officio members and 14 part-time members.
• The NMC will frame policies and lay down several regulations regarding the medical professionals, health-care related infrastructure and oversee compliance of the norms by the State Medical Councils.
• It will also frame rules to determine the fees of up to 50 percent seats in private medical colleges and deemed universities.

The main provisions are as follows:

• Setting up a medical commission at national and state level within 3 years of the passage of the Bill.
• Setting up a Medical Advisory Council at the Centre through which the states and the UTs will be able to convey their suggestions to the NMC.
• Conducting a uniform National Eligibility-cum-Entrance Test (NEET) for admission to under-graduate course in all medical institutions under the Bill.
• It also proposes to conduct National Exit Test (NEXT) for final-year students graduating from national medical institutions for obtaining license for practice and it will also allow students to take admission to post-graduate courses through the exam.
• The NMC will also have the authority to grant a limited license to certain mid-level practitioners connected with the modern medical profession to practice medicine. This step is to fill the shortage of doctor to patient ratio in our country and to increase rural availability of doctors.

The positive aspects:

1. Focus on examination- at present there are separate entrance exams for under-graduate admissions like NEET, AIMS and JIPMER. This Act consolidates multiple exams under at under-graduate level with a single NEET and in turn avoids multiple-counselling processes.
2. At present there is also separate NEET exam for admission to under-graduate and post-graduate exams. The Act introduces NEXT exam which will act as a single test for final year MBBS examination across India, and an entrance test to post-graduate level and a licentiate exam before doctors can practice. This will also reduce disparities in the skill set of doctors passing out from different institutions.
3. It will also be a single licentiate exam for graduates across the world wanting to practice in India. So overall it can be said ‘One-Nation-One-Exam’ in medical education.
4. It will also provide limited license to practice for community health providers other than doctors. This will help to some extent bridge the gap between the ratio pf doctors to population. Evidence from China, Thailand and the U.K. have shown positive results in this model. Chhattisgarh and Assam have also experimented with community health workers.
5. The Indian Medical Council Act, 1956, has no regulation for fee regulation. This Act will allow NMC to regulate the fees of 50% seats in private medical colleges. This will support poor but meritorious students.
6. There is also a link between the unethical practices in this profession and the high fees in some medical colleges this will reduce.
7. The act also provides for rating of colleges.
8. It is also expected to bring transparency in electoral process in appointing regulators at the top posts.
9. Also, according to the Act NMC opinion has to be sought by the state level councils before issuing any directions. This will promote uniformity.
10. There are also provisions for the ‘quacks’ to face imprisonment and be fined.
11. It also ends inspector raj.

Conclusion:

• The Act is an answer to many long-standing reforms needed in the medical sector, but whether it brings the desired outcomes or not is for time to say.

Way ahead:

• It is good that the reforms have been introduced but regular evaluation and monitoring is needed.