President Ram Nath Kovind on August 8 gave assent to a key legislation aimed at ushering in mega reforms in the medical education sector and replacing the nearly 63-year-old Indian Medical Council Act.

The National Medical Commission (NMC) Bill, passed by both houses of Parliament, will be notified in the gazette soon, Union Health Minister Harsh Vardhan said. "Once notified, the rules will be framed and the NMC will be constituted for development and regulation of all aspects of medical education, profession and institutions. All these will be done within six months," he added.

The NMC will replace the scam-tainted Medical Council of India. The president dissolved the MCI in 2018 and a Board of Governors was appointed to perform its functions. Terming the NMC Act, a "progressive" legislation, Vardhan said it will ensure probity, quality education and bring down costs of medical education. It simplifies procedures and provides wider access to people for quality healthcare.

Referring to protests against certain provisions of the NMC Bill, Vardhan said, "Medical students and residents doctors had some misunderstandings and misconceptions about some provisions of the bill. I have cleared their doubts." The legislation provides for national entrance test NEET along with common counselling for MBBS, and a common final year MBBS exam, to be known as National Exit Test (NEXT), which will be applicable to all institutes including those of national importance like AIIMS.

The NEXT results would be the base for admission to PG courses and to obtain license to practice. It would also act as a screening test for foreign medical graduates. "This provision will eliminate the need for students to approach multiple colleges and take part in multiple counselling processes for admission. This will save students and their families unnecessary physical and financial trauma," Vardhan said. "Once a candidate clears NEXT, he can register himself and obtain a licence to practice. The Act does not impose any restriction on the number of attempts at NEXT for improving the rank for admission to PG courses," he said.

The NMC will be an overarching body, which will frame policies and coordinate activities of four autonomous boards. These boards will look after the work of UG and PG education, Medical Assessment and Rating and Ethics and Medical Registration. Dismissing fears about NMC being dominated by Central nominees, Vardhan said, "This is not true. There will be 10 vice chancellors of state health universities and nine elected members of state medical councils in the NMC."

"Thus 19 out of 33 members, which is more than half of the total strength, would be from states and only a minority of members will be appointed by the Central government thereby ensuring NMC is representative, inclusive and respecting the federal structure of Indian polity."

The NMC will have eminent medical personalities as members who will be appointed for only one term of four years and will not be eligible for any further extension. "They will have to declare their assets at the time of being appointed and again while demitting office," Vardhan said.

The members will also have to declare their professional and commercial engagement or involvement which will be published on the website of the Commission. It has been further provided that chairperson/member on ceasing to hold office will not accept for a period of two years any employment in any capacity in a private medical institute whose matter has been dealt with them either directly or indirectly, he said.

Refuting allegations that the clause on fees regulation will make the medical education expensive, Vardhan clarified there was no provision to regulate fees in the Indian Medical Council Act 1956. In view of the lack of a regulatory mechanism, the Supreme Court had to pass orders for setting up of fees committees in each state to be chaired by retired high court judges.

Deemed-to-be universities refused to submit before this committee and remained virtually unregulated, the health minister said. "The Act provides for regulation of fees and all other charges in 50 per cent seats in private colleges as well as deemed-to-be universities. Nearly 50 pc of the total MBBS seats in the country are in government colleges, which have nominal fees. Of the remaining seats, 50 pc would be regulated by NMC. "This means that almost 75 pc of total seats in the country would be available at reasonable fees. It must be stressed again at this point that not only fees, but fees and all other charges are being regulated," Vardhan said.

Dispelling fears that clause 32 of the Act will encourage quackery, he said a provision has been made to register Community Health Providers (CHPs) who will be modern medicine professionals and not those dealing with any alternative system of medicine. "Also, they will have limited powers for providing primary and preventive healthcare at the mid-level," he said. He stated that eminent doctors in NMC will decide their qualifications through regulations which will be finalized after extensive public consultation and debate.

"A false impression is being created that the provision for CHPs has been made to legalise quack8/8/2019 8:03:30 PMs. On the contrary, the punishment for quackery has been enhanced to up to one year imprisonment and upto Rs 5 lakhs fine from the existing Rs 1000," he said.