The National Commission for Human Resources for Health Bill, 2011 - Bill Summary

• The National Commission for Human Resources for Health Bill, 2011 was introduced in the Rajya Sabha on December 22, 2011 by the Minister of Health and Family Welfare Shri Ghulam Nabi Azad.  It was referred to the Department related Standing Committee on Health and Family Welfare (Chairperson: Shri Brajesh Pathak), which is scheduled to submit its report within three months.

• The Bill seeks to establish a mechanism to determine and regulate the standard of health education in the country.  It shall repeal the Indian Nursing Council Act, 1947; the Pharmacy Act, 1948; the Dentists Act, 1948 and the Indian Medical Council Act, 1956 on such date as decided by the central government.

• The Bill seeks to set up the National Commission for Human Resources for Health (NCHRH), National Board for Health Education (NBHE), and the National Evaluation and Assessment Council (NEAC).  It also establishes various professional councils at the national and state level and a NCHRH Fund to meet expenses. 

• The NCHRH shall take measures to determine and maintain the minimum standard of human resources in health education.  The measures may include (a) conducting studies to assess the needs of human resources in states; (b) conducting elections in the national councils; (c) providing grants to the NBHE, NEAC and councils, and (d) regulating the entry of foreign institutions in consultation with NBHE and any law that may come into force.

• The permission of NCHRH is required to establish an educational institution.  The person has to submit a scheme for the institution to NCHRH which shall refer it to NEAC.  NCHRH shall give permission based on NEAC’s recommendation.  In case the person is not informed of a decision within one year of submitting the scheme, it shall be deemed to have been approved.  The NEAC shall evaluate every institution seeking permission to operate.

• The central government may appoint national councils such as Medical Council of India, Paramedical Council of India and Nursing Council of India.  Every person who wants to practice medicine, sign a medical certificate or give evidence in a court as an expert has to be enrolled in the national or state registers to be maintained by these councils.

• The NBHE shall take measures to facilitate academic studies and research in emerging areas of health education.  It shall conduct a screening test for medical practitioners before they can enroll in a professional council.(EXIT EXAM )

• An Indian citizen who wants to study medicine abroad has to obtain an eligibility certificate from NBHE, certifying that he fulfils minimum norm of getting admission in an MBBS course in India.  He shall not be eligible to appear for the screening test if he has not obtained this certificate.  A person may be exempted from the test if he is enrolled as a health practitioner outside India for at least three years.   

• Any person who obtains a degree from a government institution and leaves India for higher education, shall endeavour to serve in India for three years.  If he does not do so, his name shall be removed from the register.  If he opts to return to India, he can get his name re-entered after fulfilling such conditions as specified by NCHRH.  Any person who gets a degree from a private institution then goes abroad for higher education has to either return to India within three years or inform the respective council of his whereabouts.  If he does not do so, it shall be construed as professional misconduct. 

• The national and state councils shall have the power to inquire into any complaint of professional misconduct against any person enrolled in the register. If the person is found guilty, the council can impose certain penalties such as a warning, suspension, removal or fine.  The decision of the national council can be appealed to the ethics committee under the NCHRH.  “Professional misconduct” includes allowing any person to practice in his name falsely, revealing information about a patient without consent, and violating certain laws.

• If a person is aggrieved by the professional services rendered by a medical practitioner enrolled in the register, he may file a complaint with the state council within 60 days.  The council shall decide the complaint within 120 days of receiving the complaint.

• The Bill constitutes the National Commission for Human Resources for Health Fund to meet the expenses of the various bodies.  The Bill lists penalties for various offences such as running institution without permission, practicing without being enrolled, and enroling without a screening test.

This proposed National Commission for Human Resources in Health Bill 2011 (LIX of 2011) is unacceptable to IMA  because:-

1.Loss of Autonomy: The proposed law  does away with autonomy of the commission .

As per this bill, All the three bodies viz.

• The National Commission
• National Board of Health Education
• National Evaluation and Assessment committee

shall be constituted by appointment; 

• each appointee to remain in office till the pleasure of the Central Government. 
• The National Councils like MCI,DCI,RCI- proposed in the bill shall also have more than half the numbers of total members as appointees, sufficient in strength to obstruct  the voice of democratically elected members.
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• A. All the bodies formed under this bill shall be duty-bound to implement the govt policies ( like BRHC course etc.)formulated by the government.No independent views can be expressed  or heard for fear of obvious repercussions, eliminating a healthy dialogue.

B.The health education policies will keep changing with the change of power at the Centre, thus lacking Consistency in the overall approach to healthcare resource management.
C. Lacking automomy, the evaluation by the National Evaluation and Assessment committee, shall simply echo the official stand thus lacking any objectivity and credibility.
D.These bodies shall not be answerable to the public and become open to favouritsm, corruption and inefficiency  as they  are  prevalent in other government departments and undertakings.

2.Multiple Registration: This shall create more problems than it shall solve.

3.Bar of Jurisdiction:(Clause 100,101) It is a direct attack on the fundamental rights of the citizens who take it upon themselves to take care of the ailing humanity.

4. Proffessional Misconduct: 

In the seventh schedule,Part I clause 18 & 20 is highly ambiguous.

A health practitioner shall be deemed to be guilty of professional misconduct, if he–fails to disclose a material fact known to him in his report or diagnosis, fails to report a material mis-statement known to him,  fails to obtain sufficient information ,fails to invite attention to any material departure from the generally accepted procedure and fails to keep moneys of his patient other than fees.

Part II clause 21 &22  shall discourage doctors from joining Govt.Health services.- A health professional shall be deemed to be guilty of professional misconduct, if he-is found absent on more than two occasions during inspection

5.Following points in the NCHRH bIll 2011 are highly objectionable and should be put across forcefully and every effort should be  made to get these deleted /modified 

1. The autonomy of the various bodies to be constituted under NCHRH Bill 2011 be ensured by deleting sections. 12,86,87 and 93 
2. The punishment u/s 81 for violation of section 33 ( that's obtaining Medical  degree from abroad without permission ) amounting to one year imprisonment and Rs. 5 lakh fine for first offence and 3 yr imprisonment with Rs.25 lakh fine be deleted . It is unimaginable that just getting a degree from abroad can put one in jail. It is just unthinkable . Studying abroad ( may be without permission ) is not such a big crime .
3. Bar on engaging in any other profession  other than health without permission from National Commission   should  be done away with  ( Clause 10 part I of  7th Sch) . It is fundamental right of every Indian citizen to engage in any profession without any hindrances as long as he meets the legal requirements for that 
4. Section 100 should be deleted . It is unconstitutional .It says that  any order of National /state councils to refuse enrolling of the name in the register  can't be questioned  in the court of law .

Therefore, IMA  strongly opposes the said NCHRH Bill 2011 and requests a personal hearing in this matter.

Please see below the provisions of NCHRCH Bill 2011 about formation of  various councils
41. (1) On the commencement of this Act, there shall be constituted, from such date
as the Central Government may, by notification, appoint, such corresponding new National
Councils as are specified in the First Schedule.
(2) On the commencement of this Act, the Central Government shall, by notification,
constitute the Paramedical Council of India for the disciplines of paramedics:
Provided that the Central Government may, by notification, constitute National Council
for any other discipline of health as may be notified by it under clause (k) of section 2.
Section 41(2) provides constitution of Paramedical Council of India and it can include Physiotherapists or if need be there can be another council for "health professionals" which again can be physiotherapists. read under definitions  Section 2(k) and 2(s) ( given below) read together will make it clear that physiotherapists will be "health professionals" and will have a separate council may be under Paramedical Council of India or  another one specifically dealing with them as the Act will give power to Govt  under section 41(2) to constitute one .

2(k) “discipline of health” includes medicine, dental, nursing, pharmacy,
paramedical or any other discipline as the Central Government may notify in this
behalf;

2(s) “health professional” means any person possessing the recognised
qualification who is eligible to be enrolled in the National Register or the State Register
in any of the discipline of health and the expression “health practitioner” shall be
construed accordingly

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