The Association of Hospitals (AOH), a representative body of 52 public trust hospitals in Mumbai, has taken objection to the Union government's decision to scrap Medical Council of India (MCI) and form National Medical Commission (NMC) as was proposed in the National Medical Commission Bill, 2016. One of the major objections of Association is that there is no adequate representation to doctors in the proposed Commission.

“The decision to replace MCI with NMC is debatable. Just because MCI was mired in controversy and there were accusations of corruption for years cannot be a justification for replacing it with a new body. Possibly such accusations are there against several organisations including government departments. Are we going to replace them? The issues in MCI should have been addressed and strict action must have been taken against the guilty. MCI is a body managed by doctors. In the new council, their representation is minimal. Is there any other professional body which is not managed by their own professionals?”, asks AOH president Dr PM Bujang.  

Instead of scrapping the MCI, efforts should have been made to address unethical practices of the medical body and strict action must have been taken against the guilty, opined Dr PM Bujang adding that abolishing MCI, a self-regulatory body with members elected by doctors, based on malpractices is an unsound decision.

As per the proposed National Medical Commission Bill, 2016, the Commission shall comprise a chairperson, a member secretary, 8 ex-officio members and 10 part time members. Of the ex-officio members, four shall be the presidents of the Boards constituted under this Act; and the remaining four shall be nominees–one each of the ministries of health and family welfare, department of pharmaceuticals and human resources development and one of the Director General of Health Services. Nominees of the ministries shall be officials not below the rank of joint secretary and the nominee of Director General of Health Services shall not be an official below the rank of deputy director general.

Of the part-time members, five shall be persons to be appointed by the central government from diverse backgrounds including management, economics, law, consumer or patient rights advocacy, health research, science and technology.

The remaining five part-time members shall be from amongst the nominees of the states and Union Territories in the Medical Advisory Council, who shall be appointed on a rotational basis for two-year terms by the central government.

Meanwhile, establishing National Medical Commission seems to be a reality. Besides having certain good provisions in National Medical Commission which is well structured and is proposed to have separate entities under its fold to maintain doctors’ registers, undergraduate medical education, post-graduate medical education (norms, recognition, monitoring) ethics, attending to complaints against the doctors and grade the medical colleges, one shortcoming is large number of non-medical persons in the various committees. How NMC is going to function is yet to be seen, he opined.

Expressing uncertainty over National Medical Commission's capability to check commercialization of medical education, Dr Bhujang said “On paper it looks quite nice. It is only when the norms are laid down and other rules and regulations are finalized one can comment whether the proposed National Medical Commission will be capable of reigning in commercialization of medical education and other malpractices faced by MCI. Eventually it depends on how it functions though the objectives seem to be good. A stringent criteria for eligibility and transparent mechanism of selection of members to the NMC is also critical.”

Once again whether NMC will be able to address the ghost teaching faculties in private medical colleges and ushering in transparency is medical education depends on how it implements its policies. However one should accept the fact that there is shortage of qualified full time medical teachers, especially in non-clinical subjects. The shortage is there even in some government medical colleges. Accepting the reality that doctors prefer clinical practice compared to teaching, the policy regarding norms of medical teachers should be pragmatic to address the problem of ghost teaching faculty, he added.

The draft bill seems to address the challenges of medical education and practice, though there is no adequate representation of doctors. It remains to be seen how it is going to be when it starts functioning.

The merger of National Board of Examination (NBE) with Post Graduate Medical Education Board (PGMEB) under NMC and allowing the PGMEB to add into its fold the courses conducted and qualifications offered by NBE is not a good move as it was providing parallel additional post graduate doctors. The bill has to state how the state councils are going to function and what is going to be their relationship, concluded AOH president.