National Medical Commission (NMC) Bill

Why in news?

The National Medical Commission (NMC) Bill was recently introduced in the Lok Sabha.

What is the Bill about?

• Once the NMC Bill is enacted, the Indian Medical Council Act, 1956, will stand repealed.
• The existing Act provides for the Medical Council of India (MCI), which is the medical education regulator in India.
• An earlier version of this Bill was introduced in the last Lok Sabha. Click here to know more.
• It had passed the scrutiny of the Parliamentary Standing Committee on Health and Family Welfare.
• However, that Bill lapsed at the end of the term of the last Lok Sabha.
• The present Bill has made some changes to the earlier version.

What are the shortfalls with MCI?

• The MCI is primarily intended to producing competent doctors, ensure adherence to medical education quality standards, etc.
• The Parliamentary Standing Committee on Health and Family Welfare examined the functioning of the MCI in its 92nd report (in 2016).
• It noted that the MCI has repeatedly been found short of fulfilling its mandated responsibilities.
• Resultantly, the quality of medical education in India is at its lowest ebb.
• The current medical education model is not producing the right type of health professionals that meet the basic health needs.
• This is because medical education and curricula are not integrated with the needs of the country’s health system.
• Those coming out of medical colleges are ill-prepared to serve in poor resource settings like Primary Health Centre and even at the district level.
• Medical graduates lack competence in performing basic health care tasks like conducting normal deliveries.
• Consequently, instances of unethical practice continue to grow and the respect for the profession has diminished.
• Besides these, inefficient individuals have been able to make it to the MCI.
• But, the Ministry is not empowered to remove or sanction a Member of the Council even if s/he has been proved corrupt.

What are the key provisions of the Bill?

• NMC - The Bill provides for the constitution of a 25-member NMC to replace the MCI.
• The members will be selected by a search committee headed by the Cabinet Secretary.

• Advisory Council - A medical advisory council will advise and make recommendations to the NMC.
• It will include -
  1. one member representing each state and Union Territory (vice-chancellors in both cases)
  2. chairman of the University Grants Commission
  3. director of the National Accreditation and Assessment Council

• Autonomous boards - According to the proposed legislation, NMC will have four autonomous boards to regulate the sector.
• These are:
  1. 1. Undergraduate Medical Education Board
     2. Postgraduate Medical Education Board
     3. Medical Assessment and Rating Board
     4. Ethical and Medical Registration Board
• The structure is in accordance with the recommendations of the Group of Experts headed by Ranjit Roy Chaudhury.
• It was set up by the Union Health Ministry to study the norms for the establishment of medical colleges.

• Test - The Bill provides for just one medical entrance test across the country, the National Exit Test (NEXT).
• The NEXT would serve as -
  1. the final MBBS exam, which will work as a licentiate examination
  2. the screening test for foreign medical graduates
  3. the screening test for admission to PG medical courses

• [NEXT is different from the NEET which is to be taken before joining UG course.]
• Fees - The Bill proposes to regulate the fees and other charges of 50% of the total seats in private medical colleges and deemed universities.

• Regulation - The Bill marks a radical change in regulatory philosophy.
• Under the NMC regime, medical colleges will need permission only once - for establishment and recognition.
• There will be no need for annual renewal.
• Also, colleges would be free to increase the number of seats on their own, subject to the present cap of 250.
• They would also be able to start postgraduate courses on their own.
• Fines for violations, however, are steep at 1.5 times to 10 times the total annual fee charged.

What are the key changes in the 2019 Bill?

• There are two key changes, following the recommendations of the Parliamentary Standing Committee on Health and Family Welfare.
• One, the Bill has dropped a separate exit examination.
• Two, it has dropped the provision on a bridge course.
• [It allowed for AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy) practitioners to prescribe allopathy medicines after a bridge course.]
• Besides, the Bill has also removed the exemption hitherto given to Central institutions, the AIIMS and JIPMER, from NEET for admission to MBBS and allied courses.
• Notably, there was resentment and a charge of elitism at the exclusion of some institutions from an exam that aimed at standardizing testing.

What lies ahead?

• It is crucial now for the Centre to work amicably with States, and the Indian Medical Association, which is opposed to the Bill.
• At any cost, it must avoid the creation of rigid roadblocks as happened with NEET in some States.

Source: Indian Express, The Hindu