In the Sunday series, we bring to you from our archives most read section, an article by Dr. A.P. Setia, Past President, IMA Haryana, expressing his views and concerns regarding the NMC bill.

The National Medical Commission Bill 2017 was introduced in the Parliament a few days ago; with the objective being- 'Regulation of all aspects of medical education, the medical profession, medical institutions, and thus improving the quality of health services in India'. But the majority of medical professionals have a perception that a good number of its provisions are self-defeating. The Indian Medical Association (IMA) the largest organisation of qualified doctors with life memberships of over nearly 2,79,000 voiced a nationwide protest call against some of the bill's provisions on 2nd January, 2017.

Young medicos in colleges across the nation, as well as government doctors, joined the protest on the day the bill came up for discussion, post which it was referred to the Standing Committee for a revisit on certain sections; as objected by IMA.

Dr Setia says,

"The Section 49 (4) dealing with approval for specific bridge courses, for the practitioners of Homeopathy and of Indian systems of Medicine to enable them to prescribe modern medicine is the one which has raised  eyebrows. Such provision shall mean 'MIXOPATHY'. 

These alternative systems of medicine have neither a common basis nor any other meeting ground with Allopathy. The bridge courses could lead to multiple complications. Registrations in two or more streams of medicine and prescribing medicines from two contradictory systems to the same individual could lead to serious consequences.

Also, making medical education more expensive in private medical institutions by providing flexibility to management, to 'fix' the tuition fee for the 60% seats as per Section 10(i), and also providing flexibility to provide adequate faculty and other necessary facilities within a time-limit as per Section 29(b) may lead to poor-quality medical education.

The vicious cycle of invest and recover, a ground reality and philosophy of the materialistic era leads to poor quality treatment from doctors of private institutions who would provide costlier treatment to the masses, to recover the cost of their medical education at the earliest.

By making medical education a 'purchasable commodity', we are certainly heading towards a more stressed and low-quality healthcare system.

The NMC bill (in section 15) also closes the gates for Indian Medical Graduates by making the National Licentiate Examination compulsory to practice medicine as practitioners. It does however, open the gates for foreign doctors (section 33(1)), registered in their home country, to practice with a temporary registration in India for a period of time.

The inclusion of three members (as per Section 4(4)(a)) other than medical professionals, who have experience in management, law and consumer rights advocacy, science, technology and economics, in the 25-member body is a novel concept. However, the medical professionals perceive it as an intrusion of sorts to their highly sophisticated professional matter. On social media, they have termed NMC as a misnomer, because it is not totally medical. The number of elected representatives who are doctors, in the NMC is limited to 5. The IMA is of the view that medical professionals should have been given more places in a policy-making body that concerns medical education and healthcare delivery.

Only 5 States will be represented in NMC at any point in time. The other 24 will be unrepresented thereby denying them their privileges. Social media buzz is that this is not truly national in essence. The State Medical Councils which operate as sovereign bodies through the enactment of State legislatures, will come directly under the control of the NMC. The Medical universities do not have a representation in the NMC.

A Medical Bill like NMC that does not act in concurrence with the Medical Association could be a disaster in waiting. Even qualified doctors who are available are not keen to serve in the rural area or government sector for lack of incentives and unavailability of proper infrastructure. A better alternative would be to create a 'special' category of postgraduate speciality seats for those who are willing to serve in rural areas for a period of at least three years after graduation. A good number of fresh graduates spend two to three years preparing for competitive examinations, time which could be put to good use rather by serving the rural masses.

The infrastructure of primary healthcare centres needs to be strengthened to provide health services more conveniently to poorer masses rather than having them visit a district hospital even for minor ailments. Increasing the allocation of health budget could also pave the way for better resources. Government medical institutions need to be promoted more often and a proper referral system from PHC to medical colleges needs to evolve. First-aid or mini trauma centres at newly-built toll gates on rapidly expanding road networks and national highways are needed to serve during emergencies and save lives.

From the arguments presented above, it can be concluded that the National Medical Commission Bill is NOT the solution for all the issues stemming from healthcare services in India. A humble appeal to the lawmakers would be to give the bill a second thought before it is too late.

Disclaimer-The information and views set out in this article are those of the author(s) and do not necessarily reflect the official opinion of M3 India. Neither M3 India nor any person acting on their behalf may be held responsible for the use which may be made of the information contained therein.