Recently, the Madras High Court released a set of 12 recommendations that will be included in the new rules that will be formed under the National Medical Council (NMC) Act to ensure the appropriate processing of complaints against medical practitioners.

Justice R Mahadevan issued the directions in reversing the May 4th judgement of the Tamil Nadu Medical Council suspending Dr P Basumani's registration as a gastroenterologist for six months. The ruling asserted that the doctor lacked the integrity and behaviour required of a medical practitioner, in addition to undermining the public's faith in the medical profession.

Recommendations put forth to the NMC

According to the court, the code/regulations shall enumerate the broad obligations imposed by law on a certified medical practitioner. These obligations and responsibilities are minimum requirements that must be fulfilled by all medical practitioners.

Following an enumeration of the general duties and responsibilities expected of a physician, certain specific duties and responsibilities, the violation of which would result in disciplinary action, would be interpreted as 'professional misconduct' and would be identified in a list of illustrative instances.

1. Additional advice will be provided in the regulations about which additional instances of misbehaviour may be regarded as 'professional misconduct' by the disciplinary board or higher courts, resulting in disciplinary action against medical practitioners.
2. Following that, a comprehensive set of stage-by-stage guidelines/mechanisms is to be incorporated into the code/regulations, ranging from the time an aggrieved person files a complaint to the time the complaint is registered with the appropriate medical council, as well as the procedure to be followed thereafter. After receiving a complaint from an aggrieved party, the State Medical Council/Ethics and Medical Registration Board, as applicable, may issue a show-cause notice to the offending medical practitioner, annexing a copy of the complaint and requiring the medical practitioner to provide a detailed explanation within a time period determined by the council.
3. The medical practitioner may submit an explanation within the time period specified, and the State Medical Council/Ethics and Medical Registration Board, after considering the medical practitioner's explanation, may convene an enquiry committee comprised of experts in the field with particular reference to the medical field with which the medical practitioner is attached.
4. After the committee is formed, notice is to be served on both the medical practitioner and the complainant, and both parties shall be heard in person and pertinent oral and documentary evidence shall be recorded, with sufficient opportunity for both parties to be present.
5. Natural justice norms, which are necessary for quasi-judicial processes, must be fulfilled since the proceedings may result in sanctions with civil implications for either side.
6. After concluding the investigation, the enquiry committee is required to submit a detailed report encompassing all evidence presented to it by both parties and reach an informed decision on its recommendation to the State Medical Council's Disciplinary Board/Ethics and Medical Registration Board.
7. The enquiry committee must provide its conclusion about the validity or otherwise of the complaint, as well as whether the medical practitioner committed 'professional misconduct' in violation of the regulations/code.
8. To ensure that disciplinary processes are devoid of loopholes and to minimise duplication of proceedings, the report of the investigation committee should be rendered final and binding on the State Medical Council/Ethics and Medical Registration Board's disciplinary board.
9. After receiving the report of the enquiry committee, the Disciplinary Board of the State Medical Council/Ethics and Medical Registration Board, as applicable, may decide on a proposed punishment and issue a show-cause notice to the medical practitioner on the sole basis of the proposed punishment, solicit his comments, and then issue orders imposing the proposed punishment on the medical practitioner.
10. The State Medical Council/ Ethics and Medical Registration Board's disciplinary board will be a permanent tenured, three-member body (elected by the Commission from among its members) that will serve as the disciplinary authority for licenced medical practitioners who violate the code/regulation.
11. The enquiry committee must be appointed unanimously by the members of the State Medical Council's Disciplinary Board/ Ethics and Medical Registration Board, as the case may be. The composition of the enquiry committee, on the other hand, will vary depending on the field of medicine with which the delinquent officer is associated.
12. Complaints filed with the State Medical Council/Ethics and Medical Registration Board must be resolved within six months.

To provide the inquiry committee with sufficient and comprehensive powers, reference may be made to Section 42 of the Advocates Act, 1961, which vests the disciplinary committee of the Bar Council with substantial authority over conducting inquiries, recording evidence, and so forth.

The code of ethics, which now requires the preservation of medical papers and records for a period of three years under Regulation 1.3, may be extended to ten years since the full record can be digitalised and the same may be needed for handling complaints.

The council may establish a time limit for filing a complaint against a medical practitioner while leaving the disciplinary board free to waive it if the case warrants it, the court stated.

Disclaimer- The views and opinions expressed in this article are those of the author's and do not necessarily reflect the official policy or position of M3 India.

The author is a practising super specialist from New Delhi.