By Akhil Kumar:
“ESIC should exit the field of medical education entirely as it is not the core function of the ESIC…” says the first point of a memorandum served to “Deans/Medical Superintendents of ESIC Medical Colleges/Dental Colleges/PGIMSRs/Nursing Colleges/Para-medical Institutions” across the country. This memorandum (a copy of which is with Youth Ki Awaaz) has triggered massive protests from students of ESIC colleges across the country.
What is the ESIC, and why does it run medical training institutions?
The Employees’ State Insurance Corporation (ESIC), which functions under the Ministry Of Labour & Employment, was set up by an Act of Parliament (1948 ESI Act), and is considered ‘the first major legislation on social Security for workers in independent India’. The ESIC plays a vital role in our country where the poor working class population lacks easy access to good quality medical care.
The ESIC decided to enter the field of medical education “with a view to improve the quality of services provided under the ESI scheme” to the Insured Persons, i.e., the Factory Labourers and small scale employees. Through the ESI (Amendment) Act, 2010, a new section (59B) was inserted after section 59A of the principal Act, which enabled the ESIC to set up its own medical training institutions. Public funded hospitals that have educational and research centres attached to them tend to provide better medical facilities. It is mandatory for the doctors, nurses and other medical personnel trained by the ESIC medical colleges to serve in the ESI hospitals for five years, thus ensuring smooth availability of quality skilled medical professionals in these hospitals.
ESIC had started setting up 12 Postgraduate Institutes (known as PGIMSRs), 18 undergraduate Medical Colleges and 09 Dental Colleges all over India. Among which, state of the art infrastructure have nearly been completed in 13 Institutes.
A Memorandum (No. L-11/12/3/20-(Corporate Cell)/ ME Cell dated 05th January, 2015) announcing ESIC’s exit from the field of medical education has put a question mark on the careers of around 1400 students enrolled in 13 ESIC colleges across the country. Copies of the memorandum were burned by the protestors outside Constitution Club in Delhi (where the 164th board meeting of the ESIC was taking place) as a mark of protest.
What the students allege
I was present at the protest in Delhi and spoke to the students who had gathered from across the country to stage a protest demonstration in front of the Constitution Club. Here’s what they had to say –
“When confronted by students, faculties and parents, the administration of the ESI Corporation has stated that setting up and running of Medical Colleges is a cost intensive proposition in r/o capital cost, recurring cost, loss of revenue etc., and it was a mistake to set up the Medical education projects. They have also falsely stated that based on their current projections, the surplus funds of the ESI corporation are likely to be negative by 2016-17.
We would like to state that, for setting up the Medical Education projects, the initial funding of 12,000 crore rupees from the corpus reserve funds were already allotted since 2007 to 2013, and according to ESI Corporation’s own calculation, the annual budgetary requirement for the 08 existing and almost completed projects are rupees 80 crore per institute, that sums up to 640 crores.”
Quoting data from a meeting of the standing committee of the ESI Corporation held on 30th January, 2015, at the ESIC headquarters office, they say that “ESI Corporation is one of the wealthiest authorities with a whopping 34 thousand crore rupees surplus fund with an yearly additional contribution of nearly 14 thousand crore rupees by its insured labourers and employers (which is increasing substantially each year). Though, essentially a non-profit organization and a statutory body under the Govt. of India, it has no substantial explanation to the motive behind its idle surplus generation.”
“The Central Govt., has launched an all-out attack on all social sector schemes. In the financial year 2014-15, health sector budget has been slashed by 20%. that is, by more than 6000 cr.! Now the central government must not be allowed to play with the future of medical students and teachers of ESIC medical colleges,” added Ashutosh Kumar, President, JNUSU.
The move poses a serious threat to students, faculty, and staff of the concerned colleges. It also raises questions on what will happen to the massive college infrastructure built with public money. Reportedly, more than 5000 Crore Rs. of public money has already been spent on the infrastructure!
A press release by the All India Students’ Association (AISA) highlights some pertinent issues – “The 2 batches of students already enrolled in these colleges have an uncertain future. They are being given the option of completing their 5 year course at the present colleges or get transferred to medical colleges run by the respective state govts., both of these options have been rejected by most of the students. Transfer to state medical colleges will mean that the present batch of students would lose one or two years as they have to restart their education. Such an adjustment will also mean a cut in the number of seats for the state level students in the respective state level medical colleges for the next two years. The second option of continuing in the same institution till the present batches finish their education and then shut them down is also not viable because the Medical Council of India (MCI) grants recognition only to those institutions that have batches in all five years. Since the ESIC Medical Colleges will have only two batches it is obvious that their degrees will not be recognised by the MCI.
Also, the medical faculty and other technical staff face the danger of being downgraded, pushed out or adjusted in administrative/bureaucratic positions not commensurate with their specialised knowledge and skill in health care.
The Draft National Health Policy clearly admits that the private medical education institutions have failed to produce good well-trained doctors. Why then is the govt. contradicting its own findings and dismantling the already established institutions of public funded quality medical education?
If the Labour Ministry is ‘unable’ to fund the ESIC medical colleges, the govt can make the logical arrangement of a takeover of the ESIC Medical Colleges by the Union Health Ministry.”
1. Immediate rejection and reversal of the Memorandum No. L-11/12/3/20-(Corporate Cell)/ ME Cell dated 05th January, 2015, sd/- Dr. Vivek Handa, Dy. MC (ME-II), and continuation of all the running courses, including students’ admission in the coming academic sessions.
2. Immediate issuance of a circular / order on behalf of the ESIC to continue all the existing courses (maintenance of status quo), assuring the future and career of the students and faculties, as well as continuation of admissions in all these already built-up infrastructure.
3. Continuation of Infrastructure development, faculty recruitment, and renewal of permissions for the recognitions from Medical Council of India, Dental Council of India and Nursing Council of India in all the currently running Teaching Institution, for the interest of recognition and validation of the students’ degrees and the Faculties’ experiences.
4. If ESI corporation fails to run the teaching institutions due to any reason, then to initiate handing over all the ESIC-run Medical, Dental, Paramedical and Nursing Institutions to the CENTRAL MINISTRY of Health and Family Welfare, Govt. of India without any attempts towards privatization, or forcing the states on the basis of the essentiality certificates, as the state governments have already expressed their inability to take over the Institutes as per the clauses of huge monetary demand placed by the ESI corporation, and as the states are already 1/8th contributor of the entire ESI scheme, whereas the Central Govt. is not a contributor of a single penny into the scheme, and plays the role of a moral guardian to the scheme, without any responsibility.
5. The teaching Doctors with specialization and teaching experiences are not to be forced to enter a non-teaching role, as this would lead to a huge loss in trained and experienced human resources in a field already scarce in the era of commercialization of healthcare.
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