New Delhi: Lok Sabha on Tuesday sent the National Medical Commission (NMC) Bill 2017 that has angered the medical fraternity to a standing committee and asked it to submit its report before the end of the budget session.

The NMC Bill aims to overhaul medical education and replace the Medical Council of India (MCI) which has faced allegations of corruption. The Indian Medical Association (IMA) says replacing MCI with another body may attract new forms of corruption.

Section (15) of the NMC Bill makes a licenciate examination mandatory after acquiring MBBS qualification. This will be the first time such a provision is being introduced in any field of higher education in the country. Without qualifying the examination, no person will be enrolled in the National Medical register for practitioners and would be entitled to practise and do further post graduate courses.

“As per 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’. Such sweeping powers are not only illegal but will give ample scope of manipulation and corruption," said K.K. Aggarwal, former president, IMA.

The NMC Bill aims to end heavy-handed regulation of medical education institutions and make a shift towards outcome-based monitoring. The bill also calls for better coordination with AYUSH systems of treatment, which has got contradictory responses from medical fraternity or modern medicine doctors.

According to bill, the Ethics and Medical Registration (EMR) Board shall maintain a separate National Register including the names of licensed AYUSH practitioners. The names of BAMS (Bachelor of Ayurveda Medicine and Surgery) and BHMS (Bachelor of Homeopathic Medicine and Surgery) graduates are already registered with their respective councils.

On availing of a bridge course, they would be incorporated in a separate register maintained by medical commission, which would mean that they would be having duel registrations with two registering councils, which is neither open nor permissible, as per Medical Council Act.

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, health education experts claim.

“As such, these are the flood gates that have been opened up in terms of the statutory provisions for back door entry into medical profession entitling practising modern medicine. The move seems to be giving a free hand to persons studying alternative systems of medicine for practising modern medicine even without qualifying for it. The modern medicine and traditional medicine are different and should be practised differently. This may start more corruption and risk to patients’ lives with more and more BHMS and BAMS persons trying to invade the specialised modern medicines," said Rajeev Sood, dean, Ram Manohar Lohia Hopsital.

The NMC has a provision that the government can fix fee for only 40% of the seats in private medical colleges. “No medical college will survive if there is state-Centre dispute in the fee structure. Up to 40% will give a wide margin for corruption," said Sood.

There are apparent hitches in terms of composition of NMC as the body will have an effective membership of 25 of which only 5 members (part time) will be elected. These elected members will not be a part of any board and hence will not have any say or check on any unethical practices. As per Section (10) of the Bill, the commission will have only appellant authority.

A recent paper by Brookings India, a policy research institution titled—Restructuring the Medical Council of India— stated that the National Medical Commission Bill introduces much needed reform to the Indian accreditation system, however, it lacks in structural integrity, structural vision, and institutional vision. “We recommend tackling structural integrity by removing/limiting the members of the National Medical Commission in the Medical Advisory Council. To improve structural vision, we recommend the creation of Regional Medical Councils as the compliance wing of the Medical Assessment and Rating Board, and creating a fifth sub-board to set standards for both individual medical professionals and professional medical affiliations," Shamika Ravi, from Brookings India, and author of the research paper said.

Union health minister J.P.Nadda had introduced the bill in the House last Friday amid protests from Congress members, who had demanded that the bill be sent to the standing committee. The budget session is expected to start by this month end, as a new law has to be brought at the earliest, following an order of the Supreme Court and a standing committee report.

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