Spotlight
New Delhi, 17 March, 2017
Medical
Education
TIME TO
REFORM, BILL VITAL
By Dr
Oishee Mukherjee
India is ailing, when it comes
to its health sector. On a very conservative estimate the country is short of 35
lakh-odd doctors across the country. Thus, while it is aspiring to gain status
as a developed nation, it is imperative that health should be accorded top
priority. The big question then is whether the National Medical Commission Bill
2016, which proposes to revamp the Medical Council of India (MCI), will finally
be brought this Parliament session.
Recall that last year, the Supreme
Court curbed the powers of private medical colleges in admission matters to
MBBS and BDS exams. It stated that the admission process would be in a
centralised manner conducted by the State governments concerned even as the
Association of Private Medical & Dental Colleges (APDMC) had opposed the
move. The apex court’s direction is well meaning to ensure that educational
institutions cannot manipulate the selection process, thereby curbing money
power transactions. As per available data, there are 11 lakh students chasing
55,000 seats in medical colleges.
The five-bench Constitution had
passed the order on a petition filed by the Madhya Pradesh government seeking
contempt proceedings against private colleges which, it said, were defying the
SC order by holding their own counselling for admission in MBBS and BDS
courses. Earlier, the apex court ruled that that single national eligibility
entrances test would be conducted for admission to all medical colleges in the
country.
The orders of the court, though
belated, would go a long way in ensuring that only the meritorious students get
admission and the people good medical help. As is well-known the private
medical institutions in the country are notorious for demanding lakhs for
rupees to see the names of students in the merit list of exams conducted by
them. One estimate is that these colleges would ask for anything between Rs 60
and 80 lakhs for admission. The huge sum demanded obviously made it possible
for only the rich to ensure admission for their wards.
A big lobby was instrumental in this
admission game. There have been reports that political parties patronised these
private medical institutions. In a few government colleges also, huge sums of
money and influence at the top levels, helped a few get admissions, obviously
through the back door.
Though the Central and State
governments remained a silent spectator, possibly having vested interests, the
situation is likely to see a drastic change once the National Medical
Commission Bill 2016, becomes a reality. The Bill proposes to revamp the
Medical Council of India by replacing the Indian Medical Council Act 1956.
Based on the recommendations of Niti Aayog and an expert committee
appointed by the Prime Minister last year, the bill proposes to establish
National Medical Commission in place of MCI as the premier regulator of medical
education.
This action is critical and
much-needed as it no secret that medical education was mismanaged by the MCI,
having allowed an admission system based on illegal capitation fees, apart from
creating shortage of doctors and devalued merit and ethics. In this connection,
the proposed bill is expected to revamp the admission process and take care of
related problems.
Fortunately, a beginning has been
made. The Government has already introduced the National
Eligibility-cum-Entrance Test for both under graduate and post graduate medical
and dental admissions. The draft bill proposes to regulate under graduate
courses, post graduate, accreditation, and assessment board and a board for
registration of medical colleges and monitoring ethics in the profession.
It is expected that the regulators
would monitor how well the college performs in student learning. It is
understood that a considerable number of seats would be on full scholarship for
poor and meritorious students. What is more important is that freeing the
curriculum will allow the best colleges to offer innovative courses. Regarding
monitoring ethics, it needs to be pointed out that there are reports from
across the country that, at the behest of nursing homes run for purely profit
motive, the doctors fall a prey to high salaries and are thus forced to carry
out unethical work.
Can the tendency be changed by
focussing on the new generation of doctors? Perhaps, and it is sufficient
reason for both Government and private medical colleges to be encouraged for
common entrance test not just for MBBS and BDS but for MD and MDS courses too.
Note should be made that the number of PG seats are very low – in the ratio of
1:30 or even more – and, in an age of specialisation, urgent steps need to be
taken to increase these by at least a thousand in the coming years.
However, an influential section of
doctors who virtually mint money do not want the number of post graduate seats
to increase and keep the demand at high ebb. As specialists are needed across
the country, the monopoly of this section must be stopped. At the same time,
there are reasons to believe that passing the draft bill may not be
easy.
Undoubtedly, the acute shortage of
doctors is bound to remain future. However, some measures need to be taken
where para-medical staff – trained through short-term medical course -- could be
trained for working in the villages. There was some debate to start some course
in this direction but fierce opposition forced the Government not to formulate
any concrete plans.
Though the draft bill doesn’t delve
into this aspect, it should come under serious consideration. Sociologists and
developmental experts believe that para-medics strength is vital in rural --
and even semi-urban areas – as the increase in seats for doctors alone would
not match the requirement, more so keeping in view the growth in population.
The incidence of diseases have
increased at a fast rate in the rural areas, not just due to lack of medical
infrastructure but also due to lack of doctors. On the one hand, the poor and
the economically weaker sections are deprived of medical care, and on the
other, the middle class has to pay through their nose for treatment in private
hospitals and nursing homes. For the rich, it doesn’t matter. This anomaly
cannot continue for long.
Both the Centre and State
Governments need to give top priority to health education, thereby providing
health facilities in the remotest areas. As a first step, perhaps it should be
made mandatory for all gram panchayats or at least the panchayat samitis to
appoint one or two doctors, from the next financial year? A proper action
plan to develop medical education would obviously ensure better health
facilities in the country. Law makers must note--a stitch in time saves nine.
---INFA
(Copyright,
India News and Feature Alliance)
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