Background

According to the World Health Organisation standards, the ratio of doctor to population should ideally be 1:1000, but India has a ratio of 1:1456. The doctors are easily available in the urban areas, but they are rarely willing to reach out to the rural areas because of a lack of infrastructure and other basic amenities. The urban to rural doctor density ratio is 3.8:1 in India.

Therefore, most of the rural population is denied good medical treatment. This has led to the upsurge of quacks practicing medicine. 57.3% of allopathic medical practitioners lack the required medical qualifications.

Considering the lack of quality healthcare in rural areas, there was a dire need to bring reforms to the health sector and introduce the National Medical Commission (NMC) Bill.

Features of the Bill

Within three years of the passage of this legislation, a state and central level medical commission will be set up with 25 members appointed by the central government on the recommendation of a committee.

The centre will also set up a Medical Advisory Council, which will act as a channel for better communication of views between states/union territories.

Earlier, the states conducted their own medical entrance exams, making it difficult for students to appear for so many exams of different states. Even if the students managed to clear those exams, the counselling dates for the allotment of medical seats often clashed with each other. This legislation accords for the conduction of a uniform National Eligibility Cum Entrance Test (NEET) for admission to various medical institutions for undergraduate level courses throughout India.

A National Exit Test will also be conducted for medical graduates to obtain the licence for practice. The scores of this test will be used for granting admissions to postgraduate courses.

Moreover, the government can dictate guidelines for fees for up to 50% of the seats in the privately-owned medical institutions. The private medical institutes charge exorbitant fees from the students, making it difficult for the students to pursue a career in medicine.

The bill aims to curb red-tapism to account for the excessive rules, regulations, and paperwork delaying the process of decision making, development, and reforms. The bill will empower recognised medical institutions to add more seats or start a postgraduate course. Earlier, the process needed multiple approvals.

The NMC can grant a limited licence to mid-level medical practitioners connected to modern medical professions, enabling them to practice medicine.

Functions of the National Medical Commission

The commission will improve the medical education avenue in the country by framing policies for the regulation of institutions. It will ensure the availability of adequate and high-quality medical professionals and assess the performance of medical institutions periodically.

It also aims to adopt the latest medical research.

One of its major tasks is to assess the requirements of human resources and health care infrastructure and set up an effective grievance redressal mechanism.

Why This Bill?

The NMC bill scrapped the 63-year-old Medical Council of India Act founded in the year 1956. The MCI was found short of fluffing its responsibilities.

The current model of the health education system was not producing the right kind of medical professionals according to the needs of our country. India is facing an acute shortage of doctors, not able to meet the set standards by the World Health Organization.

The Medical Council of India has been accused of corruption in granting recognition to medical colleges. The Health Ministry was not empowered to remove a member of the Medical Council even after he/she has been proved corrupt.

Private medical colleges exploit the students by charging exorbitant fees, and the MCI was often found to support it. Now, the NMC bill enables the government to intervene in 50% of seat allotments in private medical colleges, giving more weight to the merit of the students rather than their financial background.

Increased involvement of medical graduates in unethical practices and lack of competence in performing basic health care tasks further downgrade the quality of medical healthcare.

This plight of the medical health care system in the country compelled the government to pass the NMC bill.

Challenges

Many doctors that graduate from medical colleges find attractive packages and salaries in metros and therefore are not willing to serve the remote areas where trained and qualified specialists are most needed. Thus, the availability of doctors is a big issue in rural areas.

Also, the execution, transparency, and design of the bill, which seeks to standardise medical education, is not very clear to the medical fraternity.

The conduct of the elected members of the commission on syllabus, curriculum, accreditation, and medical ethics still remains skeptical.

The bridge course that allows alternative medical practitioners to prescribe modern drugs may lead to unscientific mixing of drugs, having serious implications of patient health and safety. Therefore, it may lead to the legalisation of quacks practicing medicine in the country.

Need of the Hour

To curb existing corruption in the health sector of India, the government needs to frame stronger policies and ensure their effective implementation. The emigration of doctors is a major concern in rural areas; therefore, it should be limited for newly graduated doctors. A minimum number of years should be fixed by the government for the newly graduated doctors to serve in rural areas.

In a few states, like Bihar and the northeastern states, there is an acute shortage of doctors. For the improvement of the rural health sector, stress should be laid upon strengthening the paramedical facilities. Nurses and midwives must be trained in primary health care, and the complex cases should be referred to specialised doctors. This model has been adopted by various countries and has yielded good results in the past.

The primary healthcare providers should undergo a minimum number of years of training so that they become experts in dealing with the primary healthcare issues. A moral code of conduct should be put up to curb the unethical practices by the doctors.

To conclude, the NMC bill tries to improve the standard of medical healthcare in India and bring reforms. It is a ray of hope for the students and the poor people of the rural areas.