NMC Bill In the doc

SANGEETA YADAV speaks to doctors to bring you a report on the the good, bad and ugly of the National Medical Commission Bill

The entire medical fraternity stands against the Government for bringing the National Medical Commission (NMC) Bill, 2017 which seeks to replace the Medical Council of India (MCI) and, doctors insist, has a lot of loopholes.

In a three-hour meeting held recently with Health Minister JP Nadda, experts from the apex medical body Indian Medical Association (IMA) discussed why the new amendment would not strengthen the medical healthcare sector. Though the Government has agreed to reconsider and remove a few provisions, the IMA has decided that if NMC is forced on the fraternity by the Lok Sabha, it will declare a nationwide strike of doctors.

“The NMC Bill is anti-community and anti-poor and it will damage the health system of the country. The  Government is not considering how we can improve the health of poor people. Rather, they are only bothered about the 10 per cent of the one per cent of the national population. Such a bill is going to help only the rich and not the poor and the lower middle class at all,” Dr RN Tandon, Secretary-General of IMA, says.

Agrees Rajeev Sudan, MD, RR Eye Care Laser Clinic: “The NMC Bill is a major amendment in healthcare education since 1956. Before this, there was nothing. The Government has systemically neglected medical healthcare education for very long. But now it is good that the Government is taking initiative to build a National Health Policy and National Medical Education. We have an increasing number of hospitals and medical institutions, but unfortunately, we don’t have enough medical health faculties. So much so that 50 per cent of the new AIIMS are falling short of medical college faculty in the Central premium institutions.”

One of the provisions in the NMC Bill which the Government has agreed to drop is the final MBBS examination which was to be held as a common exam throughout the country and serve as an exit test to be called the National Exit Test (NEXT). Under this, the students would not have had to appear in a separate exam after MBBS to get a licence to practice. The test would have also served as a screening test for doctors with foreign medical qualifications in order to practice in India.

“The Government decided to make all students undergo NEXT to certify them as being eligible as per the standards of a particular country. The aim was to ensure the same medical quality exit across India. But that is impossible because the physical infrastructure in the medical colleges differs a lot. Within the State Medical College, there are only a handful of medical colleges that are good. By doing this, we will have a shortage of faculty as not more than 15-20 per cent doctors would pass NEXT.

“So, what the Government must do is launch urgent steps to improve the medical health education in colleges. Moreover, it is will very difficult to judge the complete range of theoretical and practical knowledge,” he adds.

But Sudan adds that had the medical colleges all over the nation had the same infrastructure and teaching faculties, NEXT would have been a positive step. “Even if it stressed doctors in short term led to scarcity of doctors, in the long term it would increase sincerity among graduates,” he opines, adding that this could be a good move as a large numbers of doctors are not skilled enough and the exam would filter them out, keeping only the quality medical healthcare professionals in the business.

Another provision which the Government has agreed to scrap is the Bridge Course for Ayush Experts feel that the provision of Bridge Course for Ayush practitioners to practice modern medicine would destroy both the systems.

“You can’t use Ayurveda by promoting modern medicine. Through the Bridge Course, anybody would be able to become a doctor by going through the six-month course. The policy is going to destroy both the systems. Modern medicine doctors will not be available for some services. It will enable a lot of backdoor entry. Also, how will you regulate their quality?,” Dr Tandon asks.

The Government has decided to reconsider the fee regulation for 50 per cent seats in private medical institutions and deemed universities. “In private medical colleges, the Government will regulate 50 per cent seats on fee grounds. What will happen to the other 50 per cent? The unregulated seats will be up for sale. If the Government has to regulate the fees, it should be for 100 per cent, why only 40-50 per cent of seats. They are doing this because most of these private healthcare organisations are run by political trusts and they they don’t want to touch politicians. Rest of the per cent of seats will be decided by the Board,” Dr Sudan points out.

The meritorious students from lower socio-economic starta will not be able to pursue medicine if the present 50 per cent quota of private colleges is allowed.

“In many States, the fee of around 85 per cent of medical seats is fixed by  them. The NMC will increase the quota of the private colleges by 50 per cent.  It is a dichotomy that, on one hand, the Government speaks of doctors for rural areas and, on the other hand, the same Government provides increased quota for the urban rich.  The NMC Bill will push medical education completely away from the reach of the common man,” Dr Ravi Wankhedkar, National President of IMA, insists.