Observations on the
National Medical Commission Bill 2017
1.
Composition of the
National Medical Commission:
It is a three tier composition:
a)
As per section (4) of the Bill, Composition of the
National Medical Commission, which will have an effective membership of 25 of
which only 5 members(Part Time) will be elected.
b)
As per section (11) of the Bill, Composition of an
Advisory Body to be known as the Medical Advisory Council. Totally Medical
advisory council shall consists of about 60 members.All are nominated members.
c)
As per section (16) of the Bill, Composition of 4
autonomous boards to be known as the UGME Board, PGME Board, MAR(Medical
Assessment and Rating) Board and EMR(Ethics and Medical Registration) Board.
Each board consists of 3 members only and all these members will be nominated
by Central Government.Totally these four boards shall consists of 12 members.
They will constitute further sub committees to assist them.
As such it is evident that the proposed commission
will have 10% elected members(part time) and 90% nominated members. It is for
this reason it will not have a desired ‘representative character’ with
reference to ‘elected and nominated / appointed members’ whereas present
Medical council of India has 75% elected members and 25% nominated members.
2.
Functions of the
Commission:
As per section (10)
of the Bill,the functions vested with the Commission under the Act are generic
and cosmetic in character. There under it is to exercise appellate jurisdiction
with respect to decisions of the autonomous boards.
As per section 10(1)(i)
of the Bill, commission would be framing guidelines for determination of Fee in
respect of such proportion of seats not exceeding 40% in the private medical institutions.
This operationally means that the fee regulation would be limited to a maximum
of 40% seats in the private medical institutions, which is difficult to
understand as to why such a ceiling and further more it could be anything from
nil up to 40% which is paradoxical in nature.
It also brings into fore as to what would be the
chargeable fee for those percentage of seats for which no guidelines would be
framed by the commission. This operationally will mean that the present 15%
which is available to private institutions including deemed universities for
charging higher fee, would stand augmented to the entire remainder which could
be anything between 60% or more which is a real travesty of its type.
3.
Functions of the
Autonomous Board:
As per section 26(1)(b)
of the Bill, all permissions to start medical college/PG/superspeciality courses
or increase in seats in MBBS/PG/superspecility courses will be granted by MAR
board directly which will be having only 3 members and all are nominated by
central Government.
4.
licenciate examination
As per section (15)
of the Bill, provision is made for introduction of licenciate examination
mandatory after acquiring MBBS qualification. Without qualifying licenciate
examination no person will be enrolled in the National register and would be
entitled to practise and do further post graduate courses. Further the standard
and level of licenciate examination would be such that the students belonging
to backward communities would find it great difficulty to clear the same easily
and handily. This would cause a great harm to them because they would neither
be able to practice nor would be able to take admission to PG courses. In
addition even the students learning in medical colleges situated in remote
areas as well as backward areas/states they will also suffer in a similar
manner. This handicap would be equally applicable to the students passing out
from north-east region as well. The net result would be that thousands of
students passing their MBBS examination belonging to backward communities
learning from backward areas including north-east region would not be able to
practice timely and also seek admission to PG courses for want of clearance of
the licenciate examination because of its higher standards.
As per provisio 2,section 33(1)(d) of
the Bill, it stipulates that ‘the commission may permit a medical professional
to perform surgery or practice medicine without qualifying the National
Licenciate Examination, in such circumstances and for such period as may be
specified by regulations’. This operationally means that without ascertaining
of the required levels and certification thereto the commission would be
permitting people to practice surgery and medicine in an open ended manner is
nothing less than legalizing quackery in an operational sense and playing with
lives of the people at large. Such sweeping powers are not only illegal but
will give ample scope of manipulation and corruption.
5.
Separate National
Register :
As per section 55(2)(zl)
of the Bill, the EMR Board shall maintain a separate National Register
including the names of licensed Ayush Practitioners who qualifies the bridge
course devised by commission. By an explanation, Ayush Practitioner has been
defined as a person who is a practitioner of Homeopathy or a practitioner of
Indian Medicine of the Indian Medicine Central Council Act, 1970.
This act contemplates bridge courses even for the
practitioners of homeopathy to enable them to prescribe such modern medicines
at such level as may be prescribed. It is worthwhile to note that the names of
the BAMS and BHMS graduates are already registered with their respective
councils. On availing the bridge course they would be incorporated in a
separate register maintain by medical commission, which would mean that they
would be having duel registrations with two registering councils, which is
neither open nor permissible. Further, the disciplinary jurisdiction on such
persons with reference to breach of ethics is not indicated in the proposed
bill as they have duel registrations to their credit. In a way a classical
privileged group would stand created by virtue of the proposed Bill.
As such these are the flood gates that have been
opened up in terms of the statutory provisions for backdoor entry into medical
profession entitling practicing modern medicine.
6.
Imposition of Penalty.:
As per section (26)(1)(f)
of the Bill It is provided that MAR Board take such measure, including
imposition of monetary penalty, against a medical institution for
failure to maintain the minimum essential standards specified by the UGME Board
or the PGME Board, as the case may be.
The material point for consideration is that all
the three monetary penalties are not to be less than one half and not more than
ten times the total amount charged by such institution for one full batch of
students of undergraduate course or postgraduate course as the case may be.It
yields such wide period and discretionary power to the Board and in the name of
charging fine the permissibility of the period turns out to be substantial
before the closure is invoked meaning that during the impending period the
learner would be taught and trained in compromised ambience resulting in
impoverished teaching and ending up in generation of half-baked health
manpower, which would be ill conducive to the healthcare delivery system.
7.
Discretionary Powers for
relaxing prescribed regulatory conditions:
As per section 29(b)
of the Bill, the MAR board is to look into ‘whether adequate faculty and other
necessary facilities have been provided to ensure proper functioning of the
medical college or would be
provided within the time limit specified in the scheme’ while granting
permission to start Medical college or PG courses.. This vests the board with a
wide discretionary power to accord approval on a hypothetical assumptive
presumption that the stipulated minimum requirements would be completed in due
course of time. This by itself entitles the MAR Board to permit learners to be
taught and trained in compromised conditions impacting and prejudicing the
desired quality of medical education.
Added to this isas per provisio 2,section 29(d) of the Bill,the MAR Board can relax the criteria for opening
of the medical colleges at its discretion with the previous approval from the
Central Government which yields not only a wide authority but also provides
adequate scope for availing the discretion for extraneous considerations. Moreso the regulatory stipulations which are
mandatory in nature and binding in character cannot be open for any concession
or condonation vide discretionary authority.
The said discretionary authority is not only vested
with the autonomous board but also is with the Central Govt. as well. Such duel
/ double discretions to waive the applicability of statutory stipulations
governing prescribed requirements perse bad in the eyes of the law and end up
in providing ample scope for a free flowing corruption to dwell and get deep
rooted.
8.
Central Govt. empowered to issue directions :
As per section 44(1)(2)
of the Bill, although, autonomy is expected to be a hallmark of the National Medical
Commission Bill, 2017 and the Boards thereunder are called as, “Autonomous
Boards” in reality the same is a misnomer as in the said proposed Bill the
Central Govt. would be entitled to give directions to the Commission and autonomous
boards on all the questions of policy which would be binding for the commission
and autonomous Boards to comply. Further
it is clearly stipulated that the decision of the Central Govt. whether
question is one of the policy or not
would be final and is not open for any require of any type.
As per section 45
of the Bill, the Central Govt. would be within its rights to give such
direction it may deem necessary to the State Govt. for carrying out all or any
of the provisions of this Act and State Govt. shall comply with such directions
is also undermining the authority of the State Govt. and is inconsistent with
the cardinal principles governing the federalpolity as stipulated in the
Constitution of India.
Similarly as per section 10(1)(f) of the Bill, state medical councils also have to comply
all such directions/policy of the National medical commission.
9.
Impact on employees of the Medical Council of India
As per section 58(3)and
provision thereto of the Bill, under the caption repeal and saving at its
sub-section 3 clearly brings out that ‘on the dissolution of the medical
council of India the person appointed as Chairman of the Medical Council of
India and every other person appointed as the member and any officer and other
employees of the that council and holding office as such immediately before
such dissolution shall vacate their respective offices and such chairman and
other members shall be entitled to claim compensation not exceeding three
months pay and allowances for the premature termination of term of their office
or of any contract of service.
This clause impacts the employees of the council in
a very substantial manner in regard to their full time salaried status and
permanence of employment in character. It impacts their future in a big manner
by rendering their permanent employment to a nullity in a sudden manner and
renders them to a struggle for their lives and living as a whole. As such, it
has human angle specially in the context of Article 21 read with article 12 of
the Constitution of India, in as much as article 12 vests entitlement to decent
life and living as a fundamental right to every citizen and article 12 mandates
a state (in the instant case Medical Council of India) to be an ideal employer.
IMA strongly opposing this bill since its drafting stage.But the govt doesn't heed to the demands and concerns of the largest stakeholder-IMA!
Is it autocracy?Is it modocracy? Definitely its not Democracy!
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