Explainer | Why the medical fraternity is wary of National Medical Commission Bill, 2019

Introduced in Parliament by Union Minister of Health and Family Welfare Dr Harsh Vardhan, the Bill seeks to repeal the Indian Medical Council Act, 1956 to replace the 85-year-old Medical Council of India (MCI) with the NMC.

This followed a wave of doubts raised over the functioning of the MCI over the years. Allegations of corruption, inadequate fulfilment of its regulatory role and instances of compromised individuals being given positions on the body were among other criticisms.

Why the opposition

Several portions of the Bill did not fare well with medical professionals, who wanted those parts altered or removed. However, the government retained these clauses after minimal window-dressing, thereby ignoring their demands.

One such provision is the proposed six-month-long bridge course for para-medical professionals, and AYUSH and homoeopathic practitioners.

AYUSH is an acronym for the non-allopathic, alternate systems of medicine that are practised in India. To ensure the propagation of such indigenous practices, the Centre set up the Ministry of AYUSH in November 2014.

The course is aimed at granting 'certain mid-level practitioners connected with the modern medical profession' limited license to prescribe medicines and work in rural healthcare centres.

Despite concerns raised by doctors that the clause would promote quackery, the government retained it. Moreover, a Parliamentary Standing Committee that examined the Bill had also asked the Ministry to drop the provision.

However, minor alterations were undertaken to change the language but retain the original idea, pushing it forward with the explanation that it is a move aimed at bridging the gap in the existing doctor-patient ratio.

An earlier version of the Bill had suggested a two-year bridge course for AYUSH doctors to be permitted to prescribe modern medicine, which was met with vehement opposition from doctors.

The clause empowers an individual, who has taken the six months training, with rights similar to those of a licenced doctor (who holds five years of rigorous education and training), including prescribing medication.

Another problem with the Bill is the reduced autonomy vested in the proposed replacement commission, which will not be an elected body.

This is intended to reduce the monopoly of doctors who place personal vested interests above public interest, the PRS Legislative Research observed.

However, the counter-argument put forth is that this would subject the medical regulator to excessive bureaucratic control, with major decision-making powers in the hands of the Centre.

Calling the Bill anti-poor, Dr Sanjiv Singh of the IMA told The News Minute, "It not only impinges on the rights of doctors, but it impacts the rights of patients as well and will definitely affect poor patients."

The clause which provides for fees to be capped for only 50 percent of the seats in private medical colleges and deemed universities has also added to the anti-poor nature of the Bill.

This, doctors have said, would push fees to several institutions through the roof, making medical education more inaccessible to many.

On the decision to have a unified medical entrance test, Dr Santanu Sen, national president of the IMA told news agency PTI, "The decision to couple the National Eligibility cum Entrance Test (NEET) and the National Exit Test (NEET) lacks clarity and is absurd. While the licentiate examination will give license to the minimum qualified person to practice medicine, NEET will be selecting the best students aspiring for postgraduate medical education."

What this will do, he added, is serve as an entry barrier for more than 50 percent of qualified MBBS graduates.

Meanwhile, the IMA's demand for the implementation of the Medical Protection Act (MPA) in all state hospitals at the earliest has been ignored.

The clause would have provided recourse especially in light of the recent cases of vandalism and assault of doctors at the hands the family and kin of the deceased.