Lok Sabha on 29th July passed the National Medical Commission Bill for replacing the corruption-plagued MCI with a new body, in what was described by the government as one of the biggest reforms that will end 'inspector raj' in the medical education sector.

The bill that seeks to repeal the Indian Medical Council Act 1956 was passed by a voice vote, amid a walkout by opposition Congress, DMK and Trinamool Congress. The bill also has a provision for making national standards in medical education uniform by proposing that the final year MBBS exam be treated as an entrance test for PG and a screening test for students who graduate in medicine from foreign countries. This exam, called the National Exit Test (NEXT), would ensure that the proposed National Medical Commission (NMC) moves away from a system of repeated inspections of infrastructure and focuses on outcomes rather than processes, Union Health Minister said.

Opposition members objected to provisions like exit exam and replacing elected members with nominated members in the proposed commission. They alleged that the legislation was against the spirit of federalism. It is like "throwing the baby with the bathwater, the cure seems to be worst than the disease," Congress'

Manish Tewari said during the debate and claimed the bill would end up legalising capitation fee. However, Union Health Minister allayed the apprehensions saying the legislation is "anti-vested interests", will help end 'inspector raj' and increase the number of seats in medical colleges. "NMC will be lean and effective," Union Health Minister said in his reply. He assured the members that genuine concerns of the Indian Medical Association (IMA), which has been protesting against the Bill, have been addressed.

A motion for consideration of the bill was passed by 260-48 votes after a division of votes was sought. Several amendments moved by opposition members, including Congress' Shashi Tharoor and RSP's N K Premachandran, were rejected. "Since the government is not keen on passing any amendment suggested by us, we are walking out as we oppose it tooth and nail," the Leader of Congress party in Lok Sabha, Adhir Ranjan Chowdhury, said as the Bill was passed by voice vote.

Speaking in the House, Union Health Minister termed the legislation as "pro-poor" saying it would bring not only government seats but also 50 per cent of all private seats within the reach of meritorious students belonging to economically weaker sections. The bill was brought in the wake of allegations of corruption against the 63-year-old Medical Council of India (MCI) and shortcomings in the process by which it regulated medical colleges.

Union Health Minister said by bringing the bill the basic intention of the government is to ensure and restore utmost standard of integrity in medical education. He noted that the NMC bill 2019 is an improved version of the one brought in 2017. "Once the NMC Bill is passed by both houses of Parliament, exit examination will be implemented in the next three years," the Minister said. On issues related to federalism, Union Health Minister said, "No medical college will be set up without the state government's permission."

The Minister also added that the government of India will have no role in the day-to-day running of the medical colleges. "Yearly inspections have been done away with. This is expected to do away with inspection raj and foster addition of UG and PG seats in the country," he added. Union Health Minister said the Bill seeks to put in place a new structure to tackle challenges in the medical education sector and is a pro-poor. "When history will be written it (bill) will go down as one of the biggest reforms," he noted.

Participating in the discussion, Congress' Adhir Ranjan Chowdhury said the legislation was against federalism as the body has no representation from the state. Party member Vincent Pala criticised the proposal to "replace elected members with nominated members" on the Medical Council Board. "The new bill lacks vision and lacks structural integrity. You are replacing elected members with nominated members," he said.

Supporting the bill, BJP member Mahesh Sharma said the 1956 India Medical Council Act has completely failed to fulfil aspirations of the people, alleging the MCI had become a "den of corruption" and was "commercialised". Sharma said in the proposed board, out of the 26 members, 21 members would be doctors. The legislation would enhance the number of seats and teachers in medical colleges and have control over the fee structure. "75 per cent seats in medical colleges will be regulated," he said.

Sharma said there has been 25 to 30 per cent growth in country's medical tourism every year and for continuation of this trend, the country needs good doctors and better medical facilities. The bill provides for that, he added. In the last three years, Sharma said as many as 121 medical colleges were set up in the country of which 60 were in government sector.

DMK leader A Raja termed the bill as "anti-poor, anti- social justice, undemocratic and anti-federalism". He said the bill is a "joke" on the people of the country as it would encourage corruption and nepotism in the medical profession. Raja also criticised the proposal of "exit examination" for medical students, saying it would ruin the future of students. He said the government would have full control over the proposed board and allow corrupt people to "loot" people and "suck blood".

Trinamool Congress member Kakoli Ghosh Dastidar said the bill was against the basis principle of federalism and unacceptable as it would jeopardise the future of students. Dastidar also slammed the move to conduct "exit examination" for medical students, saying it would put undue pressure on students. "This is unwarranted and a shame," she said.

Participating in the discussion, Sunil Dattatray Rao (TRS) said that the government should make efforts to fill the vacancies of doctors in primary health centres (PHCs) in different parts of the country. The government, he added, should be more considerate towards the staff of the outgoing Medical Council of India (MCI) who might not have played any role in bringing bad name to the MCI.

Kirit Premjibhai Solanki (BJP) demanded that the government come out with a policy to prevent attacks on doctors. SP member S T Hasan said that the government should remove the provision of exit examination and impose an upper limit on fee to be charged by private medical colleges. Hasnain Masoodi (NC) questioned the competence of the government to extend the legislation to Jammu and Kashmir without the consent of the state. However, in his reply, Union Health Minister pointed out that the IMC Act was also applicable to Jammu and Kashmir. "The NMC bill is a visionary move and will go down in histrory as the greatest reform of the Modi government," the minister said.

Heena V Gavit (BJP) said the bill would introduce transparency and end corruption in medical education system. Opposing the Bill, E T Mohammed Basheer (IUML) said the bill was "not progressive but regressive" as members of the NMC would be nominated and not elected. TDP member Srinivas Kesineni claimed the bill favours private medical colleges and was against the spirit of federalism. Speaking in the same vein, S Venkatesan (CPI) said the bill makes the states "lifeless local civic bodies".

M Selvaraj (CPI) too opposed the legislation on the same grounds. Anupriya Patel (Apna Dal) asked whether there will be any validity period for licences issued to medicos in the country. N K Premachandran (RSP) said under the proposed legislation, the NMC will not have a representative character. He said 20 per cent of the members will be elected while 80 per cent will be nominated by the Centre.