National Medical Commission is an Indian regulatory body of 33 members that regulates medical education and medical professionals.....
Oct 04, 2020 12:33:08
National Medical Commission: A shot in the arm for medical education
The NMC Act will bring in much-needed reforms in the medical education sector by ensuring probity, bringing down costs, simplifying procedures, and enhancing the number of medical seats in India.
The National Medical Commission (NMC) has come into force from September 25, 2020, thereby repealing the nearly 64-year-old Indian Medical Council Act, 1956. All its bodies such as the Medical Council of India and the Board of Governors, which superseded the MCI on September 26, 2018, have also been dissolved.
National Medical Commission (NMC) is simply a regulatory body of India consisting of 33 members which regulate medical education and medical professionals. It replaced the Medical Council of India on 25 September 2020. This is the National Commission which grants recognition of medical qualifications, gives accreditation to various medical schools, grants registration to the medical practitioners, and monitors medical practices and assesses the medical infrastructure in India.
It was earlier established for 6 months by an ordinance in January 2019 and later became a permanent law passed by Parliament of India and later approved by President of India on 8 August 2019.
As a result, the much-awaited NMC will start to function effectively soon to bring reforms in the medical education sector. Last year, the National Medical Commission (NMC) Act 2019 was passed by both Houses of Indian Parliament.
A gazette notification by the health ministry read: “The Indian Medical Council Act, 1956 (102 of 1956) is hereby repealed with effect from September 25. The BoG had been appointed under Section 3A of the Indian Medical Council Act, 1956 (102 of 1956) in supersession of the Medical Council of India constituted under sub-section (1) of section 3 of the said Act shall stand dissolved.”
Dr Suresh Chandra Sharma, former Head of Department, ENT, All India Institute of Medical Sciences, has been appointed the chairman of NMC for three years, while Dr Rakesh Kumar Vats, ex-Secretary General, Board of Governors, MCI, has been appointed Secretary of NMC for three years. Apart from the Chairman, the NMC will consist of 10 ex-officio members and 22 part-time members appointed by the government.
To ensure transparency, the members will have to declare their assets at the time of joining and demitting office, along with declaring their professional and commercial engagement or involvement. Further, the chairperson/member ceasing to hold office will not accept any employment for two years in a private medical institution whose matter has been dealt with either directly or indirectly.
The purpose of the NMC Act, 2019, is to provide for a medical education system that improves access to quality and affordable medical education in various medical Colleges and Universities. It also ensures the availability of adequate and high-quality medical professionals in all parts of the country. It helps in promoting equitable and universal healthcare that encourages community health perspective and makes the services of medical professionals access to all citizens. Further, it promotes national health goals; encourages medical professionals to adopt latest medical research in their work and to contributes to research; has an objective, periodic and transparent assessment of medical Colleges, Universities and facilitates maintenance of a medical register for India. It also enforces high ethical standards in all aspects of medical services; is flexible to adapt to changing needs and has an effective grievance redressal mechanism.
Main Functions of the NMC include:
It has to lay down policies for regulating medical institutions and medical professionals.
It has to assess the requirements of human resources and infrastructure in healthcare.
It has to ensure compliance by the State Medical Councils with the regulations that were made under the Bill.
It has to frame various guidelines for the determination of fees in the institutions for up to 50% of the seats in the private medical institutions.
The NMC will make guidelines for a new cadre of non-MBBS mid-level health service providers such as nurse practitioners and pharmacists with limited rights to prescribe Medicines.
The NMC will have to frame policies and co-ordinate the activities of four autonomous boards. Each autonomous board will consist of a president and four other members. These are appointed by the central government. These boards are—Under-Graduate Medical Education Board (UGMEB), Post-Graduate Medical Education Board (PGMEB), Medical Assessment and Rating Board (MARB) and the Ethics and Medical Registration Board (EMRB).
a) a Chairperson (medical professionals only)
b) 10 ex officio Members:
The President of the Under-Graduate Medical Education Board.
The President of the Post-Graduate Medical Education Board.
The President of the Rating Board and Medical Assessment.
The President of the Medical and Ethics Registration Board.
The Director-General of Health Services, Directorate General of Health Services, New Delhi.
The Director-General, Indian Council of Medical Research.
Director of any of the All India Institutes of Medical Sciences.
Two persons from amongst the Directors of Postgraduate Institute of Medical Education and Research, Jawaharlal Institute of Postgraduate Medical Education and Research, Tata Memorial Hospital, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, and All India Institute of Hygiene and Public Health.
One person to represent the Ministry of Health and Family Welfare.
c) 22 Part-time Members:
Three Members appointed from amongst persons who are having special knowledge and professional experience in such areas including management, law, medical ethics, health research, consumer or patient rights advocacy, science and technology, and economics.
Ten members appointed on a rotational basis from amongst the nominees of the states/union territories in the Medical Advisory Council.
Nine members had been appointed from amongst the nominees of the States and Union territories in the Medical Advisory Council.
Of these, at least 60% of the members must be medical practitioners.
The opposition to the Bill is centered around three major factors.
Section 32 of the Bill is empowering the commission to “grant limited license to practice medicine at mid-level as Community Health Provider”.
Critics argued that the term ‘Community Health Provider’ has been vaguely defined, and this will simply allow the people without sufficient medical background to practice medicine.
The second bone of the contention is the National Exit Test (NEXT) which is proposed by the Bill. Currently, admissions to postgraduate medical courses are done through NEET-PG (National Eligibility cum Entrance Test for Postgraduate). However, NEXT has been conceptualized and considered as a single test, which will be acting as a common final-year undergraduate medical exam. It can also be used for granting medical license as well as admission to the postgraduate courses.
Medical practitioners are currently required or needed to register with a state medical council to practice, but they are not required to give any test for obtaining a license.
It has also been argued by the doctors that a single exam has been given too much weightage, and it can have an adverse impact on the career and of medical aspirants. It can also lead to stressed conditions for medical aspirants.
Thirdly, the Bill allows the commission to “frame guidelines for determination of fees and all other charges in respect of fifty percent of seats in private medical institutions and deemed to be universities”. This will increase the number of seats for which private institutes will have the discretion to determine fees. At present, in such institutes, state governments decide fees for almost 85 percent of the seats.
There have also been suggestions to put a cap on the fees charged by unaided medical institutes.
Some of the provisions of the Bill, however, may prove to be helpful in fighting corruption, which has affected the Medical Council of India.
Unlike the Medical Council of India, the members of the National Medical Commission will have to declare their assets at the time of assuming office and when they leave. They are required to submit a conflict of interest declaration.
The members will have to serve a two-year cooling-off period after their tenure, which, however, could be waived by the government if required.
Also, the World Health Organization has prescribed a doctor to patient ratio of 1:1,000, but as reports indicate, India is far from achieving that target. Allowing ‘Community Health Providers’ for practising medicine is likely to plug this shortfall to some extent which will not be good for our Nation.