Why doctors are protesting the NMC Bill

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Rajya Sabha, the Upper House of Parliament, passed the National Medical Commission (NMC) Bill 2019, last week. Health Minister Harsh Vardhan termed the NMC Bill as Narendra Modi government’s biggest reform.

The Health Minister assured Parliament that the Bill would improve access to quality and affordable medical education, and ensure supply of adequate medical professionals.

The Bill proposes to replace the Medical Council of India (MCI) with a National Medical Commission -- a central authority responsible for regulating medical education in the country.

The erstwhile MCI was disbanded in 2010 following corruption charges against its President Ketan Desai by the Central Bureau of Investigation (CBI). It was alleged that bribes have become rampant in the approval of medical colleges.

The Bill, among several other changes, proposes a common final-year MBBS exam called the National Exit Test (NEXT), which has to be cleared for practising medicine. The NEXT will also be used as admission test for those seeking entry into post-graduate medical courses, screening test for foreign medical graduates and enrolment into the State or the National Registers.

However, the NMC Bill has sparked protests from the resident doctors across government hospitals in the country, including the premier healthcare institutions like AIIMS, New Delhi.

Why are doctors protesting?

It is because of the constitution of the NMC itself. The protestors say that the Bill will reduce the representation of elected members from 75 percent in MCI to 20 percent in NMC. Also, there was an allegation that the non-elected members will be government officials or those nominated by the government, giving the bureaucrats full control on the functioning of NMC.

The second reason, doctors are concerned about the NMC Bill contains provision under Section 32 which allows community health workers to practice modern medicine. Doctors allege that the provision will institutionalise quackery.

According to the Bill, the Commission may grant limited licence to practice medicine at mid-level as Community Health Provider to such person connected with modern scientific medical profession who qualifies such criteria as may be specified by the regulations. The government intent for having Community Health Providers is to help tackle the disease burden in rural areas.

Section 32 will allow 3.5 lakh Community Health Providers to practise modern medicine.

Doctors have also raised concerns about NEXT -- the single national level exit exam to issue licenses for doctors.

Doctors say that giving single exam too much weightage can have an adverse impact on the career of medical aspirants.

There is also a counter argument that the Bill may not bring down corruption and commercialisation in medical education in any significant way.

The NMC Bill decreases seats under controlled fee structure from 85 percent to 50 percent, helping the private colleges, many are owned by politicians themselves.