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National Medical Commission (28 September 2020)

National Medical Commission (28 September 2020)

Why in News:

The National Medical Commission (NMC)has come into existence from Friday, as the country's apex regulator of medical education and profession.

Context:

The National Medical Commission will come into force from 25 September and the six-decade-old Indian Medical Council Act 1956 has been repealed. It will also dissolve all the bodies such as the Medical Council of India and the Board of Governors in Supersession of the MCI. As a result, the NMC will start to function effectively from Friday onwards to bring reforms in the medical education sector.

Background:

The Medical Council of India (MCI) was established under The Indian Medical Council Act, 1956, was responsible for regulating medical education and practice.

In 2016, the first draft of the NMC bill was prepared by the NITI Aayog.

The National Medical Commission Act 2019 was passed by both houses of Parliament in 2019.

On August 2019, the President gave his assent to the NMC bill and it became an Act.

With the NMC coming into being, the Board of Governors (BoG), which superseded the Medical Council of India (MCI) on September 26, 2018, to perform its functions, will get dissolved and the nearly 64-year-old Indian Medical Council Act will stand abolished.

Summary of the Debate

About NMC:

  • NMC came in to force on September 25th. On the night of September 24th, Centre notified the constitution of this commission.
  • NMC will consists of 33 members, out of whom, 11 will be full time members and 22 part-time members appointed by the Central government and there will be 4 autonomous boards to look after UG (Undergraduate) medical education, Post-Graduate education, medical assessment and rating and ethics and registration of medical institutions.
  • The four autonomous boards under the NMC Act are:
    • The Under-Graduate Medical Education Board (UGMEB)
    • The Post-Graduate Medical Education Board (PGMEB)
    • The Medical Assessment
    • Rating Board and the Ethics and Medical Registration Board
  • Four boards which has been constituted, they have got single task; one for UG, one for PG, one for registration, one for ethics.
  • Dr. Suresh Chandra Sharma, the HoD of E&T, AIIMS, New Delhi has been appointed the chairperson for a period of three years and 4 people have been appointed as the President of 4 autonomous boards which will look after different verticals of medical education.

Key focussed areas in the NMC Act:

  • It is proposed under the NMC Act that a national ranking of all medical institutions in India will be done.
  • The most important reform this particular commission is expected to execute is to reduce the burden on the students of medicine and improve the quality of Indian medical graduate.
  • The NMC will developed a uniform MBBS final exam which it will call the National Exit Test. Right now, the NMC is going to focus on the quality of the MBBS graduate who is going out of college and that is the objective and wisdom behind the National Exit Test.
  • The National Exit Test is going to serve three purpose:
    • The MBBS graduates will be given a license based on the performance in this test.
    • This exit test will also serve the entrance test in future for postgraduate courses and the standalone NEET PG exam will stand abolish in due course of time after the structure have been put in place.
    • It proposes to end the standalone examination conducted right now for the foreign medical graduates. Indian medical students who go abroad to take foreign medical degrees and come back, they need a license to practice in India. Right now, they set for a separate examination, once the National Exit Test modalities are ready, only one test will be required for three purposes.
  • Other most important reform NMC is going to propose is the regulation of fees in all private colleges and deemed university. This is for the first time in the history of medical education that all 50 percent seats in all private medical colleges and deemed university, the government is proposing some sort of fee regulation, that has to be done in consultation with state governments.
  • At this moment, NMC is restricted to only two category of paramedics which can be trained very shortly in a short time to be some use of the society:
    • Nursing Medical Practitioners-The graduated can be specifically trained in certain areas and can be given legitimate powers to practice.
    • Pharmacist- if they given the clinical knowledge of pharmacology, a large amount of dispensing for smaller ailments can be taken care of. That would reduce the burden on medical practitioners, if it is done so.
  • NMC has proposed a ‘Community Health Provider’ which is proposed to have limited rights to dispense medicines.

Need to abolish the MCI:

  • In 2016, a very important report by the Parliamentary committee on Health was submitted. It was the 92nd committee report and it had come out with very stern and very major observation against the MCI.
  • The committee has gone on to say that MCI is ridden with corruption and the systems are beyond repair. Therefore, a new legislation was recommended by the Parliamentary committee
  • With most members of the MCI being elected, there was a conflict of interest between the members because MCI was an elected body where its members are elected by medical practitioners themselves.
  • The current model of medical professionals was not producing the right type of health professionals to meet the basic health need of the country.
  • The required medical education and the curriculum was not integrated with the need of health system in India.
  • Most qualified doctors tend to serve in the urban areas, whereas rural areas are at the mercy of poorly functional public healthcare systems.
  • To ensure the maintenance of required standards by medical colleges, inspections was carried out by the MCI and they were alleged of promoting Inspector Raj.
  • MCI was handling everything pertaining to medical education for example, UG education, PG education, registration of Doctors, medical rating and there was a lot of complain that it has become a superpower in itself.

Major concern regarding NMC Act:

  • It is an advisory body.
  • Members of NMC are to be nominated by the Union government, it can possibly lead to favouritism and bureaucratic interference.
  • Absolute control of the government of the NMC, threatens its autonomy.
  • The absence of clarity on Community Health Provider.

Conclusion:

  • India is facing an acute shortage of human resources and health and we need to improve our Doctor Patient Ratio and that is the larger objective of the NMC which has also been mandated to rank colleges for the first time.
  • After the NMC, Act come in to operation, the burden on students is going to come down, cost of conducting examination is going to come down. The holistic governance reforms in the medical sector are the need of the hour, so as to instill the medical ethos of transparency, equity and accountability.

Important points made by the Guests

Dr. Rajendra Pandey, Member, National Medical Commission   

  • Going by the task given to it, the consensus should be first to map out human resource gap and then trying to bridge the gap between the requirement and what we presently having and what relaxation can be appropriately made, maintaining the quality of education so that the number of doctors that can be produced can be increased in shortest possible time.
  • Inspecting those areas and finding the gaps in infrastructure and the timeframe with talking to states where it can be developed further.
  • Paramedical personnel who are working with doctors, their gap also need to be ascertain.
  • Most important task of NMC is, weeding out the corruption in terms of registration of the colleges and then keeping a proper vigilance on this.
  • A large number of students are being forced to go abroad in order to become a doctor from India and this should be ascertained and find out that each people get trained in India and they should appropriately trained as per the need of India society whether they are being trained in the foreign medical college.

Aditi Tandon, Special Correspondent, The Tribune 

  • It was last year that the Union Cabinet finally approved this particular commission after a lot of stakeholder consultation.
  • The idea was to altogether to repeal and abolish MCI and set up a new medical regulator with greater focus.
  • The MCI Act, came in to force in 1956 but the MCI in some form has been functional since 1933. At that time, it was a body of eminent Doctors and specialists.
  • Over the years, MCI became ridden with corruption, it was an elected body, there was many question marks raised on the way they used to license the colleges, serious charges of corruption were labelled against the former President of MCI, Mr. Ketan Desai.
  • It is going to rank the colleges based on the students performance who appears in Exit Test.

R.K Srivastava, Former Chairman, Board of Governors, MCI

  • The structural changes which has been integrated in the MNC are giving feeling that the NMC may be able to do a better transparent job to produce required need of India.
  • A unitasking board with an independent aid will take call in more holistic manner, transparent manner and focused manner.
  • This was the one charge which was put up on the previous Medical Council that all the boards function under the President and follow the commands of President which ultimately result in corruption and lack of transparency.
  • The NMC is coming at the time when lot many reforms has already been brought in by the board of governors. The first and the foremost important thing is the competency based undergraduate curriculum.
  • It is a very holistic task which has been completed by the previous board of the governors which ultimately aim at only one thing that you should have a measurable competency when you qualify as MBBS degree holder and that competency should match to the requirement of the need of the public seeking healthcare.
  • That curriculum has been made mandatory. Now the undergraduate board will have to ensure the single task moving forward in this direction.
  • It has tries to create a single benchmark for the doctors who ultimately go in to the practice. 

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