In place of the controversial Bachelor of Rural Medicine and Surgery (BRMS), a short-term rural medical course being introduced by the government to tide over the shortage of doctors in the rural areas, the government should revive the erstwhile short term medical course, Diploma in Modern Medicine and Surgery (DMMS) which was started by government of Orissa and recognised by Medical Council of India (MCI) in the past, opined Dr M C Gupta, medico-legal consultant and a member of the Delhi Bar Council.

It can be a supplement to the proposed health agenda of the Indian Medical Association (IMA), he said and added that in the recent past the union health ministry had also proposed the same course in lieu of the BRMS.

Similarly, a cadre of nurse practitioners should be started in place of the B Sc (community health). A new pattern of training for nurse practitioners must be designed in association with medical colleges and nursing schools. He said admission to all the health related para-medical courses including B Pharm should be made through a common entrance examination.

Dr Gupta, who will submit his proposals to the new health minister in the next government, said that on the lines of IAS, IPS and IFS, a provision should be made for creation of Indian Medical Services (IMS) for the administration of health services in the country. He said a civil service cadre of that kind had existed in India at the time of British rule when the Indian medical services were heavily manned by the British.

Disagreeing with the demand of IMA that the country needs more medical colleges in urban areas, Dr Gupta suggested that each district must have one medical college and no need of more number medical colleges in urban areas. The district medical college, along with other colleges or schools of para-medical sciences, should involve in the training of professionals in the respective areas.

His health agenda suggests that government should increase the health budget to five per cent of the GDP. India’s health budget is one of the lowest. The country falls under countries that spend the lowest on healthcare in the world. In 2011, the government spent a paltry one per cent of its GDP on healthcare. Primary health care should be declared as a fundamental right, and necessary legal and budgetary provisions should be made for the same.

Dr Gupta further suggests that the Clinical Establishments Act, 2010 should be amended in order to provide in section 12(2) that the state would reimburse private clinical establishments for providing emergency services as per the mechanism suggested in Law Commission’s report number 201. A cap should be provided for compensation payable for medical negligence under Consumer Protection Act (CPA) 1986.   Special medico-legal benches with necessary expertise should be established in the consumer courts to deal with medical negligence cases.

He remarked that PNDT act should be radically amended or replaced by another act with the basic concept that rather than criminalise pre-natal sex identification, there should be a mechanism that once the sex so determined must be immediately reported to the appropriate authority. Thereafter, it should be the responsibility of the authority to track the continuance and safe delivery of the female baby and to punish those who perform abortion of the female fetus.

Dr Gupta also proposes that the D&C Act should be strictly enforced with special reference to enforcing the ban on sale of drugs without prescription and also ban on sale of allopathic drugs against prescription issued by Ayush doctors.