The success story of IMA- THE SAGA OF 15YRS'

 

The primary goal of our country is to become a healthy and prosperous nation, with citizens who embody values of morality, hygiene, harmony, self-restraint, and tolerance. This aim is crucial for the overall development and progress of our nation.

IMA being the largest organization representing the stakeholders involved in public health and health care and medical education &research, has immense responsibility to safe guard its members and fulfil the responsibility as health care partners.

The government is constantly attempting to regulate all parties involved. This involves creating policies, which are then transformed into legislative acts. The relevant authorities are responsible for establishing rules and regulations that must be followed by the stakeholders. However, the stakeholders often have concerns, challenges, and demands that they fight for in response to these regulations.

That's why , IMA has to negotiate with -GOI  comprising of legislature, executive authority ,judiciary &law and order' and the media and social organizations and other stake holders in public health like allied health care force, nursing ,pharmaceutical manufacturers & medical device manufacturers &sellers, insurance companies, TPAs,  digital technology partners both in hard ware and software, wearable's &IOT, etc..

1. CPA Versus IMA

IMA SUCCESSFULLY DRIVE THE POINT THAT MEDICAL AND CLINICAL SERVICES are neither straightforward nor predictable& controllable.

IMA is successful in creating an awareness among the govt&judiciary about the uniqueness of the medical profession.-The discussions, appeals, and lobbying prior to the passing of CPA 2019 have brought the attention of the legal community and general public to this matter. The arguments of medical professionals have created awareness and raised legitimate questions about the suitability of the CPA for medical services. 

2. IMA SUCCESSFULLY STALLED THE BRHC.

3. IMA'S WORK-UP  against arrest of doctor's in alleged negligence cases:  IMA Beneficially  worked in liaison with all appropriate authorities to bring some useful protective umbrella regarding Arrest of doctors in alleged negligence cases.

Not only  police authorities in various states like AP,TN,KERALA issued SOPs  but also the apex court delivered the most protective judgment to protect the rights of medical profession.

4. violence on doctors &staff  in hospitals.

IMA WORKED  gainfully &  productively with concerned authorities to get promulgated -"Medical protection acts in 23 states. Here we must appreciate the Team AP IMA for their  fearful fight with AP govt and made it successfully promulgated path breaking &unique act,first time in the entire country-The Andhra Pradesh Medicare Service Persons and Medicare Service Institutions (Prevention of Violence and Damage to Property) Act, 2008, prohibits violent activities and makes them cognizable and non-bailable. The act came into force on December 18, 2007, and applies to the entire state of Andhra Pradesh.

IMA made the issue to be echoed in  Lok Sabha in  various occasions and cajoled and convinced parliamentarians like shashi tharoor to introduce private anti-violence bill in parliament..

Due to IMA's relentless fight, The Epidemic Diseases (Amendment) Ordinance’ Issued in 2020 during covid & The Indian government did draft the ‘Health Services Personnel and Clinical Establishments (Prohibition of Violence and Damage of Property) Bill’ in 2020,which was unfortunately suspended by home ministry.

In fact, the national IMA submitted its own draft of the law “more than five years ago” to the govt. The IMA’s version contained more stringent punishments. It pitched for offenders to be imprisoned for at least six months “but which may extend to seven  years, and with fine, which shall not be less than fifty thousand rupees but which may extend to five lakh rupees.”

IMA pitched for proper grievance redress mechanism(MEDICAL TRIBUNAL ) of everything that goes wrong. 

Due to steadfast fight by kerala IMA, Kerala state tightens law to protect doctors from violence . Kerala has approved new legislation to provide stronger protection for doctors and healthcare workers .Special appreciations to Team Kerala IMA.

 5.IMA  versus Mixopathy:  The Indian Medical Association (IMA) has strongly opposed the policy changes in medical education by the Centre, especially the plan to mix modern medicine with AYUSH. Due to  strong agitation by the IMA, THE INTEGRATION / MIXOPATHY POLICY is now slowed down.

The Indian Medical Association (IMA) has taken a firm stance against the recent changes in medical education proposed by the Centre, specifically the proposal to combine modern medicine with AYUSH. As a result of the IMA's strong protest, the implementation of this integration policy has been delayed.

6. GST ISSUES: IMA is negotiating  with FINANCE MINISTRY to REMOVE ALL MEDICAL AND HEALTH CARE RELATED GOODS AND SERVICES FROM THE AMBIT OF GST.

The Indian Medical Association (IMA) is currently engaged in a Dialogue  with the Finance Ministry to eliminate all medical and health care related goods and services from the scope of the Goods and Services Tax (GST).

The IMA, representing the interests of medical professionals, has been advocating for the removal of medical and health care related items from the purview of GST. IMA argues, that the inclusion of these essential goods and services under the GST regime has resulted in a burden on the common man, as medical expenses have increased significantly.

IMA is for -"Ease of Doing Profession"

7.INSURANCE  ISSUES.: The Indian Medical Association (IMA) and other stakeholders have made significant strides in the healthcare industry, particularly in terms of cashless insurance. However, there are still some obstacles that need to be addressed, such as standardizing prices based on scientific costing and addressing issues related to co-pay and out-of-pocket expenses (OOPE) with the Insurance Regulatory and Development Authority of India (IRDAI) and the General Insurance Corporation (GIC).

8. EXIT TEST.- The recent decision of the National Medical Commission (NMC) to delay the EXIT test is a noteworthy accomplishment and a major triumph for the MSN members and the medical sector. This achievement was made possible due to the efforts and influence of the Indian Medical Association (IMA).

9. PC-PNDT ACT/POCSO ACT ISSUES: IMA LOBBYING WITH MOH FOR RELOOK IN TO THE STRINGENT LAW -PC PNDT ACT AND POCSO ACT  which have been causing lot of trouble and unnecessary frivolous complaints on doctors.

The Indian Medical Association (IMA) is currently lobbying with the Ministry of Health (MOH) and the Home Ministry to review the strict laws of the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act and the Protection of Children from Sexual Offences (POCSO) Act. These laws have been creating numerous difficulties and unwarranted complaints against doctors.

There have been several instances where doctors have been falsely accused under the PCPNDT Act due to minor clerical errors or technicalities. This has caused immense stress and mental trauma for these medical professionals who are dedicated to saving lives and providing quality healthcare. The strict penalties and punishments outlined in the Act have also created a sense of fear among doctors, resulting in a decrease in the number of ultrasound tests being conducted, even in cases where it is medically necessary.

 10. CODE OF CONDUCT ISSUES- The topic of Code of Conduct for doctors has been a subject of much discussion, particularly in regards to three specific issues: sponsorships, live video surgical workshops, and generic drug prescription. These issues have been addressed through purposeful dialogue with members of the National Medical Council (NMC), and thanks to the excellent and timely lobbying efforts of the Indian Medical Association (IMA), they have been resolved amicably.

11. EASE OF BIO-SAFETY REGULATIONS.

Thanks to the efforts and advocacy of IMA, the healthcare sector has been officially recognized as a distinct category separate from industries. In addition, small and medium-sized establishments that do not emit 100KLD (kiloliters per day) are now referred to as the 'orange category.'

Health-care Establishment ( as defined in BMW Rules) in orange category:

 i) without incinerator having Total waste-water generation less than 100 KLD ii) Having Bed capacity 11 to 200.

List of sectors classified under red, orange, green and white categories( year 2023).:

12.PARITY IN STIPEND. this is another success in the annals of IMA that would provide equal stipend to the interns and residents across the country.

In April 2024, the Supreme Court directed medical colleges to provide internship stipends to foreign medical graduates on par with their Indian counterparts. The court has also noted that interns are required to be paid a stipend during the internship period. For example, a private medical college in Delhi has agreed to pay its MBBS interns a stipend on par with what is paid to students in government medical college.

13.  Inclusion of clinical establishments under MSME category:

All medical services, including those provided by clinics, hospitals, and nursing homes, are eligible for MSME registration and can take advantage of the benefits offered to MSMEs. MSME registration has been replaced with the Udyog Aadhar registration.

IMA has been relentlessly pursued with the concerned ministries to get healthcare under the ambit of MSME. The new definition of MSME (micro small and medium enterprises) includes clinics, nursing homes hospitals, and diagnostic centres etc. under service sector category.

Benefits like reduced electricity charges (on duty), loans available at lower rates with moratorium period, timely payments etc. are few of the highlights of this scheme. IMA has been able to successfully persuade the Government in recognizing the need to look at the current categories of MSME and amend it suitably to suit small and medium healthcare establishments so that they are included in the current classifications. 

Due to the requirement of capital investment on land, Infrastructure and equipment most of the units would have surpassed the set limits as defined currently, but now this has been modified in favor of healthcare services. This inclusion will not only help in improving the dwindling resources of small and medium clinical establishments during the pandemic, but also help in building a robust long-term infrastructure.

14.Thumping victory for the IMA on judiciary front against fake ads.On February 27, 2024, the Supreme Court directed Patanjali to stop all print and electronic ads that make misleading claims about its products and their medical efficacy. The court has temporarily banned all forms of advertisements for Patanjali's medicinal products, and refused to allow ads “without adjectives.

The apex court, which was hearing a petition by the Indian Medical Association, criticised Patanjali for 'misleading' advertisements and banned the company from advertising any product related to diseases or other medical conditions.

The court also came down on the Centre and asked why it 'chose to keep its eyes shut' when Patanjali claimed that allopathy medicine offered no protection against Covid-19

special appreciations to relentless fighter and socio-medical activist DR.KV BABU of Kerala.

15.Notable agitations:

A. IMA calls for medical bandh on June 25-2012.  Indian Medical Association has called for a nation-wide medical bandh on June 25 to protest against NCHRH Bill and BRHC course. However, emergency services in government hospitals will be spared.Indian Medical Association has given a call for a dharna at Jantar Mantar in New Delhi on June 18 and nation-wide medical bandh on June 25 in protest against the Centre's ‘unilateral' decisions on NCHRH Bill and introduction of BRHC course.

The IMA is protesting three things: the Clinical Establishment Bill, that prescribes certain standards for all small and big clinical establishments; the proposed National Commission for Human Resource of Health (NCHRH), which will subsume the medical, nursing and pharmacy councils; and the proposed shortening of medical degree course for rural doctors.

The Supreme Court  issued notice to the Indian Medical Association (IMA) on a plea by a non-government organisation seeking to declare as illegal the day-long doctors' strike.

B.  16-11-2016 :  Actually this is not a success. but for the grit& determination displayed by relentless and steadfast fight against NMC that had teached few lessons to the organization and enriched with wisdom. Indian Medical Association organized  a nationwide Satyagraha against the proposed NMC Bill across its 1700 branches.The ‘IMA Stop NMC Satyagraha’ was  held between 11:00 am - 1:00 pm on Wednesday, 16th November 2016 on the occasion of International Tolerance Day.

 IMA agrees with the views of the Central Government that Non-MBBS & Non-BDS doctors cannot prescribe Scheduled H, H1 & X-Drugs but the same also needs to be enacted and followed by the State Governments through appropriate amendments. The NMC Act if introduced will nullify this clause as it has a provision allowing the registration of non-MBBS doctors to the medical profession.

The Union Health Ministry has formed a special working committee to evaluate the demands of the Indian Medical Association (IMA). The committee should not be recommendatory, but should have the power to implement its suggestions. The committee should also consult with ministries and departments whose business may be affected by the proposal. The committee should also indicate the dates on which the sponsoring ministry or department receives comments. 

it's small success that inculcated huge confidence in the ranks of IMA,that we could fight on high &larger platforms.

C. “Dhikkar Diwas” (shameful day):12-hour nationwide strike on(July 28)-2018 protest against the “anti democratic and anti poor” National Medical Commission Bill, 2017

15. Respectful Homage to all IMA  covid warriors who sacrificed their life for the greater cause of well being of others.

16. Social responsibility WORK of the IMA :

• ANEMIA ERADICATION
• ORGAN DONATION
• BETI BACHAO-BETI PADAO
• AAO GAON CHALEN
• SAFE SOUND
• SAFE VISION.

 & SO MANY INITIATIVES...

slogans i like : 

• Beti bachao beti padhao
• Save girl child, save tomorrow.
• Save the saviors
• Stop violence / zero tolerance to violence
• Stop Mixopathy
• No to EXiT
• Save Small Hospitals
• Prohibit Crosspathy

IMA IS WORKING STEADFASTLY ON- 

A. Removal of medical services from the ambit of CPA

B. RELAXATION for small and medium size hospitals from  the ambit of CE ACT

C. CENTRAL MEDICAL PROTECTION ACT WITH NEEDY AMENDMENT TO  SECTION 106/1 of BNS ACT. (both imprisonment and fine are prescribed in this new act,where as in 304/A, It's either fine or imprisonment.

D. ALL REMNANT ISSUES  OF THE ABOVE.

E. ADDRESSING THE UNEMPLOYMENT &UNDER-EMPLOYMENT OF MBBS GRADUATES&SPECIALIST RESIDENTS.

F. SAFETY&SECURITY OF THE IMA  MEMBERS.

G. QUALITY MEDICAL EDUCATION & CLINICAL RESEARCH.

H . SAFETY,SECURITY AND MENTAL SUPPORT TO MEDICOS&PG RESIDENTS.& 8hrs WORK.

Kudos and big thanks to all Teams led superbly by stalwart leaders as national presidents  along with the Guidance of  most dynamic &inspiring leader Dr. DESAI KETAN DHIRAJLAL , who contributed their might and time for the betterment of the medical fraternity of the nation and best practices in health care and health of the nation.