[Answered] “National medical bill although has many advantages but it may lead to other consequences.” Comment.

Demand of the question
Introduction. Contextual Introduction.
Body. Positive and negatives of the NMC bill.
Conclusion. Way forward.

Over the years, there have been several issues with the functioning of the MCI with respect to its regulatory role, composition, allegations of corruption, and lack of accountability. The National Medical Bill, 2019 seeks to remove such issues ensuring transparency and better medical standards.

Positive Outcomes of the NMC Bill:

  1. It will help commission to regulate medical education.
  2. It will lead to better medical research and policies by medical professionals.
  3. It will ensure accountability of medical institutions through their periodic assessment.
  4. It provides for an effective grievance redressal mechanism.
  5. It will help in addressing the issue of corruption as was seen in medical council of India.
  6. It will help in reducing shortage of medical professionals by giving license to community health providers.
  7. It will ensure ethical standards in the medical practice through Ethics board.

Adverse consequences of the Bill:

  1. Monopoly of doctors: The NMC composition lack diverse stakeholders such as public health experts, social scientists, health economists, and health related non-government organisation leading to monopoly of doctors.
  2. Lack of expertise: Disputes related to ethics and misconduct in medical practice require judicial expertise. 
  3. Rise in cost of medical education: With the proposed cap on fees, the costs for the remaining seats are likely to escalate, thereby putting medical education out of the reach of vast, especially underprivileged sections of the society. Meritorious students would then enrol themselves in institutions where the quality of education is low.
  4. Favour corruption: There is no provision of election for all the chief posts of these multiple bodies. This would lead to corruption and favouritism.
  5. Centralisation of powers: States have been reduced to mere advisory roles from being in governance mode leading to centralisation of power.
  6. Delayed decision making: Advisory council will comprise more than 100 members, including 24 members of the commission. Thus it would be difficult to reach a consensus on any issue with such an overwhelmingly large body. This will hit the decision making at the top.
  7. Shortage of doctors: The Bill mentions that National Exit Test, which is to gain a licence to practise after MBBS, can also serve as an entrance examination to post-graduate level. It has left a lot of room for confusion. It seems that those who don’t clear the exam will not be allowed to practise at all, which is huge. It will lead to acute shortage of doctors in our country.
  8. Crony capitalism: Now inspection is entrusted upon Medical Assessment and Rating Board. Not only members of the board can inspect, but it may hire and authorise any other third party agency or persons for carrying out inspections. This will only increase the corruption of and crony capitalism.
  9. Incompetence: The Bill introduces a National Exit Test for students graduating from medical institutions to obtain the licence to practice as a medical professional. But Bill does not specify the validity period of this licence to practice. It may promote gross incompetence.
  10. Legalises Quackery: According to the Bill, the Community Health Provider may prescribe specified medicine independently. This legalises quackery. A six-month course will not be enough to train them.

A strong evaluation framework with a strong regulatory governance is extremely important to prevent corruption in medical field and related governing bodies. Thus, NMC bill may end up in complicating issues more than resolving it.

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