The National Medical Commission Bill, 2019 was passed recently by the parliament. The bill sets up the National Medical Commission (NMC) which will act as an umbrella regulatory body in the medical education system. The NMC will subsume the MCI and will regulate medical education and practice in India. Apart from this, it also provides for the reforms in the medical education system.

Body:

Key highlights of the bill:

• The bill provides for the constitution of four autonomous boards entrusted with conducting undergraduate and postgraduate education, assessment and accreditation of medical institutions and registration of practitioners under the National Medical Commission.
• Composition of National Medical Commission: It will have government nominated chairman and members, and the board members will be selected by a search committee under the Cabinet Secretary. There will be five elected and 12 ex-officio members in the commission.
• As per the Bill, the government, under the National Medical Commission (NMC), can dictate guidelines for fees up to 40% of seats in private medical colleges.
• The bill also has a provision for a common entrance exam and licentiate (exit) exam that medical graduates have to pass before practising or pursuing PG courses. For MBBS, students have to clear NEET, and before they step into practice, they must pass the exit exam.
• Recognised medical institutions don’t need the regulator’s permission to add more seats or start PG course. This mechanism is to reduce the discretionary powers of the regulator.
• Earlier, medical colleges required the MCI’s approval for establishment, recognition, renewal of the yearly permission or recognition of degrees, and even increase the number of students they admitted. Under the new bill, the powers of the regulator are reduced to establishment and recognition. This means less red tape, but also less scrutiny of medical colleges.

Significance and the need:

• The Bill seeks to regulate medical education and practice in India.
• The Bill attempts to tackle two main things on quality and quantity: Corruption in medical education and shortage of medical professionals.
• The Bill aims to overhaul the corrupt and inefficient Medical Council of India, which regulates medical education and practice and replace with National medical commission.
• Over the years, Medical Council of India has been marred by several issues regarding its regulatory role, composition, allegations of corruption, and lack of accountability.
• In 2009, the Yashpal Committee and the National Knowledge Commission recommended separating the regulation of medical education and medical practice.

Potentials of the bill:

• According to the Bill, the Commission may grant limited licence to practice medicine at mid-level as Community Health Provider to such person connected with modern scientific medical profession who qualifies such criteria as may be specified by the regulations.
• The NMC has the potential to link the disease burden and the specialties being produced.
• In the UK, for example, it is the government that lays down how many specialists of which discipline need to be produced, which the British Medical Council then adheres to.
• In India, the MCI has so far been operating independently. This gap can be bridged by the NMC.
• By introducing qualifying exams like NEET and NEXT, NMC can instil uniformity in the standard of competence and skills.
• It can reduce the burden of taking multiple exams, ensure a minimum level of knowledge in science, and reduce corruption by restricting student admission to those qualifying these exams.
• The State Medical Council will act as a grievance redressal body for any complaints relating to professional or ethical misconduct against a registered medical practitioner.
• This will protect the interest of the patients and checks the corrosive impact of the process of commercialisation of medical services.
• The differential pricing of medical education can benefit the economically weaker sections of society.
• NMC will have a final say in the determination of fees for up to 50% of the seats in private medical institutions and deemed universities.
• NMC can encourage and incentivise innovation and promote research by laying down rules that make research a prerequisite in medical colleges.

Conclusion:

India has suffered from the problem of inappropriately trained doctors of varying quality since a very long time. Decades back, the Mud liar Committee Report (1959) pointed out that doctors had neither the skills nor the knowledge to handle primary care and infectious diseases that were a high priority concern at the time. In recent times, the excessive reliance on a battery of diagnostic tests is reflective of commercial considerations and weak knowledge.