With the arrival of the new year 2018, the union health minister came with the National Medical Bill (NMC) into parliament on January 2. All the happiness and celebrations among the doctors’ fraternity have now been converted into sorrow and grief by the language of this Bill.
This Bill is divided into chapters. The first chapter gives a brief introduction, and the second chapter talks about the constitution of the commission. The commission has 25 members, including the chairman. The selection of chairman and 11 other members of the commission is the job of the search committee, headed by the cabinet secretary. In other words, a bureaucrat will decide the chairman of the commission in consultation with the government.
The Bill in its eighth chapter, under the section “Miscellaneous”, under the heading, “Powers of central government to give directions to commission and autonomous boards”, under clause 44 says, “(1) Without prejudice to the foregoing provisions of this Act, the Commission and the Autonomous Boards shall, in exercise of their powers and discharge of their functions under this Act, be bound by such directions on questions of policy as the Central Government may give in writing to them from time to time (2) The decision of the Central Government whether a question is one of policy or not shall be final.”
Both these clauses pose a serious threat to the functioning of the commission and serious interference from the government. I think this commission will not only act as the puppet in the hands of politicians, but will also open doors for corrupt and influential people. Though the doctors’ fraternity expected this commission to be independent and be the highest authority in medical education, but it turned out to be a mask to cover vested interests of the corporate sector and politicians.
I think it seems fishy that in a country which is the largest democracy, the parliament only talks about nominated members and avoids taking elected ones. Finally, even if the commission has taken any decision for the betterment of medical education, that decision is not authentic unless it is authenticated by the health secretary as mentioned in section 10, “(2) All orders and decisions of the Commission shall be authenticated by the signature of the Secretary.” All and all, I believe this Bill is highly bureaucratized and politicized.
In chapter five of the Bill, under the heading “Permission for establishment of new medical college”, it’s said: “to establish a new medical college and in case the Commission disapproves the scheme, or fails to give its decision within the specified period, the person concerned may prefer a second appeal to the Central Government within thirty days of communication of such disapproval or, as the case may be, lapse of specified period.” The clause specifies that if the commission of experts in the field of medical sciences disapprove the scheme to establish a medical college on the grounds of lack of adequate faculty or lack of adequate hospital facilities or other necessary facilities, a person can apply to the government and may even get permission to establish a medical college. According to me, this completely reflects the dominant nature of government that wants to rule medical education. They see medical colleges as the stock market and want to impose their capitalist thinking onto the public.
The influence of the corporate sector further deepens when we read “Powers and functions of the commission” in which the section 10 clause (i) says, “Frame guidelines for determination of fees in respect of such proportion of seats, not exceeding forty per cent., in the private medical institutions and deemed Universities which are governed by the provisions of this Act.” This means the fees of up to 40% seats (which may be less than that) will be determined by the government – and the rest 60% or more will be in the hands of private medical colleges. This may result in an anarchic fee-hike in private medical colleges and the students can’t even go to court because this Bill permits ungovernable fees. There is no provision for students to put forward their grievances in front of the commission or the board, in case of loot or betrayal by private medical colleges.
Though it was said that all these decisions were taken after repeated consultations with the public and experts, but they will never tell that what public wants. In reality, this Bill is a follow up of two more documents available for open access in the government of India’s web domains, these are the original documents prepared after thorough research and consultations:
(1) Draft: the National Medical Commission Bill 2016
(2) A Preliminary Report of the Committee on the Reform of the Indian Medical Council Act, 1956.
In the draft Bill, Clause 2.3 Para 2 says,“Medical education needs to be reformed in such a manner that the children from the deprived background are able to afford the same. Private colleges with unacceptably low standards have mushroomed, especially in the western and southern parts of India.”
The committee highlighted in Clause 2.3 Para 3, “It is essential to cut down the cost of postgraduate education by eliminating the capitation fees for postgraduate degrees, which runs into crores of rupees for a seat. Once a merit-based transparent admission system (with reservations for the deprived sections as determined by State governments) is in place, there is no need to regulate the fees charged by private medical colleges. Medical institutions may be required to transparently advertise the tuition and any other fees upfront on their websites with no other fees permitted.”
It may be recalled that both the Ranjit Roy Choudhury Committee and the Parliamentary Standing Committee have expressed concerns regarding the high cost of medical education for students and are in favor of capping the fees.
I guess how this pro-people and pro-poor draft Bill and committee’s recommendations has turned into the representative of the corporate sector, is no longer a suspense. It’s because expert recommendations are overruled by the government for their vested interests.