Hyderabad (Telangana): There have been several drastic changes in the world’s medical field during the past decade. Medical education domain too is rapidly changing in several ways in tune with them. The establishment of private Medical University and Teaching Hospitals is ample proof for this. But it is a bitter truth that having sanctioned them, the Medical Council of India (MCI) has failed in monitoring them.
Undoubtedly, it is also a fact that the Council has become a haven for corruption and dented medical education standards. The National Medical Council brought in by the central government in its place has become very controversial even before it took off.
Touted as one of the biggest reforms in medical education in India, the National Medical Commission (NMC) Bill, 2019, is facing major resistance from the medical fraternity. Junior doctors (Judas) have taken up agitation, strikes against this After getting it passed in both the houses and having received the assent from the President too, it has now become a legal act.
- Several Doubts
Union Health Minister, Dr. Harsh Vardhan declared that the bill can impact the country’s medical field and galvanize it to new vistas.
Had it been so well-conceived, how is it, so many are opposing it?
On the other hand, the government argues that the bill was introduced as a draft two years ago and taking into consideration a number of suggestions, several changes were incorporated and it emerged in the form of the present bill.
India has produced several top doctors. They have a high reputation in India and abroad as expert medical professionals. Under that background, just because of the support of some politicians, illegal activities are going on. As such, when the government is overhauling the total system and bringing in a new order, some doctors are opposing it. But the adversaries argue that how can only government nominated members, function corruption free and with transparency in accordance with the aspirations of people and bring in an alternate structure which was imposed. With the new structure, the importance of states would have dwindled because some members are appointed alternately in an alternate way by rotation.
They argue how can it stand as a viable body. How is such a body, which changes once in two or three years, without representation from some states, is justified? It is argued that with the implementation of this act, the representation of the state governments would be reduced and this distorts the federal spirit.
All the members, including the Chairperson of the body, should declare their income and property details. This act also stipulates that subsequent to working in the Council, members should not work in any private teaching hospitals or organization. With this, they say, there is a scope for NMC, functioning as a corruption-free body.
In decision-taking bodies, the members will not be just doctors, but also will be nominees from IIT (Indian Institutes of Technology), IIM (Indian Institutes of Management) and other bodies and fields. It is also being argued that with such composition, the representation of medical fraternity would be reduced and it becomes potpourri. It is notable that in anybody, there will not be a representation of persons from different fields. If it is the intention of collaborating with four autonomous bodies, there is no need to totally abolish MCI (Medical Council of India).
It would be too ambitious for us to expect higher standards in the background of importance being given to corporatization. If the management quota, which has so far been 15% is hiked to 50%, the participation of private partnership would increase. Of the 536 existing medical colleges in the country, there are about 80,000 MBBS seats. Of these, 38,000 seats are in the control of private medical colleges. Now, 20,000 seats are being filled in management quota. Thus, medical education gets out of reach to commoners.
The government should encourage talent; instead, if it encourages taking over of medical education by private bodies, the consequences would be disastrous.
In fact, the allegation is that a large scale of corruption had taken place in MCI at the time of the approval process. The newly formulated bill has not shown any corruption-free viable alternative for this. Can education acquired by pumping in crores of rupees, provide good for the society and succour to the common man? It would be Utopian to expect good results from such an ill-gotten system.
How many of these doctors emerging from private medical factories would be able to work in the villages?
It is doubtful that the well-meaning intention of the government to churn out a greater number of doctors in a short span of time would be in the direction of providing proper medical aid to the common man. Mere enhancing the number of doctors in the country would not result in providing health and safety to common men.
Corporate doctors, who are already facing the criticism that ethics are totally compromised, also are the products of government medical colleges. Social values do not just depend upon the college they have studied. They depend upon good family background, upbringing and the influence of teachers and above all, sticking to certain ideals. Therefore, there is no need to be suspicious of all private medical colleges.
The obligatory National Exit Test (NEXT), after completing MBBS is a very critical test because the standards of medical education in the country are not uniform. As such, people wonder as to how a uniform multiple-choice type questions tests, will balance all the regions. Further, in this, items on ‘clinical skills’ are missing.
Already, there is an allegation that the present system is turning out doctors who cannot give injections and minor surgeries. People are apprehensive that the problem will intensify and gets complicated jeopardizing public health. Then, what about those who are not able to clear the National Exit Test? Should they go back to intermediate level or when should they appear for the test next? How many times would they be permitted to take the test? There are no clear answers to these questions.
- Optimistic Outlook
It will surely take some more time to understand the nature of the new Act. Some of the apprehensions may be cleared. Unexpected developments too may crop up.
A sensible society always looks for change. If the change is for good, the society will be enlightened. The society will be charged with enthusiasm and imbibes the change and moves forward towards development.
What is notable is even those who criticize the new act do not totally oppose the change.
The big challenge before the government to evolve this organization corruption-free. Not just experts but also righteous persons should be appointed; otherwise, it would be like ‘old wine in a new bottle’.
An impartial policy should be evolved for according permission to private medical colleges and assessing their standards. State governments should render cooperation in providing experts for government medical colleges.
“Proper treatment on time” is people’s primary right. Healthy citizens will become part of the country’s development. The result of gaining independence is evolving disease-free India.
- Lack of Facilities
Through this act, “Community Health Providers” have been introduced for village level. It is expected that after receiving training for six months, those “Community Health Providers” will be able to render primary health in the villages. This is the alternative solution to the problem of experts not going to villages.
Doctors feel that this would lead to several questions. There will not be proper facilities in primary health centers. Since the opportunity to provide quality treatment to the patients is less, more facilities should be created.
A number of doctors are looking forward for government jobs. In several states, unfilled vacancies are high. They say that without providing adequate facilities, it would not be proper to blame the doctors that they render inadequate treatment.
Several questions that how can rural people receive better treatment who already receive scanty treatment with RMP (Registered Medical Practitioner) doctors. It is very interesting to see, how Community Health Providers would be facing the RMP doctors set-up who have political support.
Also read: Chhindwara: Place where Gandhiji laid foundation stone of non-cooperation movement
