GS-II: Health care is ailing.

Context

The National Medical Commission Bill passed by Rajya Sabha addresses these concerns.

Why medical education needs these regulations?

• To ensure that doctors are appropriately trained and skilled to address the prevailing disease burden
• To ensure that medical graduates reflect a uniform standard of competence and skills
• To ensure that only those with basic knowledge of science and aptitude for the profession get in
• To ensure ethical practice in the interest of the patients
• To create an environment that enables innovation and research
• To check the corrosive impact of the process of commercialization on values and corrupt practices
• The problem of inappropriately trained doctors of varying quality has been known for decades. The report of the Mudaliar Committee set up in 1959 pointed out how doctors had neither the skills nor the knowledge to handle primary care and infectious diseases that were a high priority concern then as now
• Standards vary greatly with competence levels dependent upon the college of instruction.

Importance of the Bill

• In setting curricula, teaching content, adding new courses and providing the much-needed multi-sectoral perspectives.
• It has the potential to link the disease burden and the specialities being produced. In the UK, it is the government that lays down how many specialists of which discipline needs to be produced, which the British Medical Council then adheres to. In India, the MCI has so far been operating independently.
• It can encourage and incentivise innovation and promote research by laying down rules that make research a prerequisite in medical colleges.

Limitations

1. Bill has proposed mandating the NEET and NEXT. NEET was mooted for three reasons:

• To reduce the pain of students taking almost 25 examinations to gain admission in a college.
• Given the abysmal level of high school education, to ensure a minimum level of knowledge in science.
• To reduce corruption by restricting student admission to those qualifying the NEET.
• NEXT is an idea borrowed from the UK that has been struggling to introduce it. In all such countries, the licensing exams are stretched into modules, not a multiple choice questions type of exam. Bill has virtually given up inspections for assuring the quality of education.

2. Relying only on the NEXT as the principal substitute is to abdicate governance. Undoubtedly, there are grey areas giving scope for corrupt practices and the production of substandard doctors.
3. The reduced oversight allowing extensive discretionary powers to the government makes it virtually an advisory body
4. Permitting a registered medical practitioner to prescribe medicines.
5. While there is a need to decentralize, to give to non-medical personnel some powers and authority it needs tight regulation and supervision.

Conclusion

Government has under this Bill, arrogated to itself an unprecedented power to appoint people in the various arms of the proposed structure. The quality and integrity of these people will then define the future of the health system in India.