MCI in dire straitsDecember 13, 2018
Nearly two months after the Union Government promulgated an ordinance replacing the existing Executive Committee of the Medical Council of India (MCI) with a nominated board of governors, nobody is sure what is going to happen next. The Sept 26 notification, titled Indian Medical Council (Amendment) Ordinance 2018, has effectively placed the MCI in suspended animation and blocked the process of election or nomination of its executive members until further notice.
“Whereas Parliament is not in session and the President is satisfied that circumstances exist which render it necessary for him to take immediate action…” the text of the ordinance says by way of introduction. In addition, the ordinance mentions that the Board of Governors would be assisted by a Secretary General who may be deputed from among the government’s own cadres or appointed from outside on a one-year contract.
While the ordinance does not spell out the ‘circumstances’ which impelled President Ramnath Kovind to take this decision, independent reports in the media suggest that an Oversight Committee appointed by the Supreme Court to look after the affairs of the MCI was being ignored by those in charge. The Supreme Court committee had been formed after repeated allegations of corruption against some members of the MCI Executive Committee.
In the past few years, the MCI had come under stringent criticism from the Supreme Court as well as the Parliamentary Standing Committee for Health and Family Welfare. In its 92nd report, the Standing Committee wrote in September 2015: “The situation has gone far beyond the point where incremental tweaking of the existing system or a piecemeal approach can give the contemplated dividends. That is why the committee is convinced that the MCI cannot be remedied according to the existing provisions of the Indian Medical Council Act, 1956 which is certainly outdated.”
The latest ordinance has to be ratified through suitable legislation within six months from the date of promulgation, or by the end of March 2019. Meanwhile it has evoked strong criticism from the Indian Medical Association (IMA) and other professional bodies.
“My main point of opposition is that the Board of Governors is a nominated body which has replaced a democratically elected body; that is, the MCI Executive Committee,” says Dr K K Agrawal, IMA’s immediate past president and the president-elect of the Confederation of Medical Associations of Asia and Oceania as well as the president of the Heart Care Foundation of India. “Hence, by its very nature, the government action is undemocratic.”
Besides, Dr Agrawal adds, the Board comprises entirely of doctors belonging to the government cadres, while private doctors are nowhere in the picture. “Who will deal with the problems of the private doctors?” he asks rhetorically. Also, there are no representatives from any of the universities, nor anybody to represent state-level issues.
A larger issue which could render the latest ordinance unnecessary and obsolete is that of the National Medical Commission (NMC). The draft NMC bill has been pending since 2016, after undergoing several modifications during these two years, and is likely to come up for discussion in the winter session of Parliament which is scheduled to begin in late November or early December. It will most probably be the last opportunity for a discussion on the Bill in the current Lok Sabha, whose term ends in June 2019.
Under the NMC Bill, which was cleared by the Union Cabinet as far back as August-September 2016, the Medical Council will be replaced by the NMC. The new body would comprise four subordinate bodies: the Undergraduate Medical Education Board, Postgraduate Medical Education Board, the Medical College Assessment and Ratings Board and the Board of Medical Registration. Thus the NMC would take over all the important functions of the MCI.
Senior medical teachers also point out that the NMC Bill could transform the state of medical education in the country, perhaps for the better. One of its proposals is to introduce a common final MBBS examination for all the medical colleges in the entire country. This would surely be an unprecedented innovation for medical education. The problem of varying standards of medical training imparted in various parts of the country would thus become a thing of the past.
The IMA has been conducting a fierce campaign against the NMC Bill ever since it was made public two years ago on the grounds that the new body would almost entirely be composed of bureaucrats and government doctors, with no elected representatives.
In addition, the IMA website describes the NMC Bill as anti-poor and anti-people, while alleging that “all the state health universities have been marginalized into an advisory role.” Also, the Parliamentary Standing Committee, to which the Bill had been sent for consideration, had recommended as many as 24 amendments. Of these, the government has accepted just one in full, and three in part, IMA sources said.