936 Rajya Sabha
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RAJYA SABHA _______ SUPPLEMENT TO SYNOPSIS OF DEBATE _______ (Proceedings other than Questions and Answers) _______ Thursday, August 1, 2019 / Shravana 10, 1941 (Saka) _______ GOVERNMENT BILL THE NATIONAL MEDICAL COMMISSION BILL, 2019-Contd. THE LEADER OF THE OPPOSITION (SHRI GHULAM NABI AZAD): The Government was making some tall claims about their past five year period. They said that the number of under- graduate doctors, that means M.B.B.S. doctors, had increased by 28,000 in these five years and the number of post-graduates had increased by 18,000. But, according to me, the number of doctors, under-graduate doctors, by now should have been 40,000 in five years. And, the number of post-graduate doctors, in five years, should have been 25,000. So, it has come down. It was in the previous Government wherein I had the opportunity to be the Health Minister, we brought sweeping changes in the Medical Council Act. And, large number of administrative decisions, to increase the infrastructure and to increase the human resource, were taken. I took a policy decision that all those medical colleges in Government sector whose seats had not been increased for the past 20 consecutive years, their seats would be doubled by the Ministry of Health. As a result of that decision 4,000 seats were increased. Then, another decision was taken, which was again an Executive decision, in consultation with the Medical ___________________________________________________ This Synopsis is not an authoritative record of the proceedings of the Rajya Sabha. 936 Council. So, we made a change that if a private or a Government medical college had surplus infrastructure and surplus human resources, the cap was increased from 150 to 250. As a result of that decision a few thousand seats were increased. We changed the student-teacher ratio to 1:2 and 1:3. As a result of that decision, 100 per cent post-graduate seats were increased in all the streams, and in some streams, 300 per cent seats were increased. In addition to that, there were two other decisions. All those boys and girls, who were doing PG in the United States of America and other countries, their degrees were not recognised. We took a decision to recognise the degrees of five English-speaking countries. There was another decision to increase the number of PG seats both in Government and private colleges. It was for the new colleges. Earlier the situation was that they could take the PG seats only after the first batch had completed the MBBS. But, we said that colleges need not wait for that because the PG teachers are different from under-graduate teachers. So, keeping all these decisions in mind, in five years, this number should not have been 18000, but, it should have been 30000 by now. It is being said that this is the first Government which has introduced NEET. Actually, it is being implemented since the year 2013. It has been claimed that the competence-based curriculum has been worked out by this Government. I would like to request that this curriculum was created by the reconstituted Medical Council of India, in the year 2014. It is also being said that this Government has introduced the registration of doctors by the State Medical Council. The State Medical Councils and State Medical Registers are defined in the year 1956 in the Indian Medical Council Act. The representatives of the States are only six, due to which, the States will get their turn after 12 years. The representation of the Medical Council from the States is five, due to which, the State Medical Council will get their turn after 14 years. So, my submission is that the representation of the States in the NMC should be increased from six to ten, and the representation of the State Medical Council should be increased from five to nine, so that, maybe after four years they can get their turns. Our aim is to produce efficient doctors. But many earlier provisions which were essential for maintaining quality in medical profession have been done away with. Take the Exit Test if a person does not come in the merit list for PG, or he fails the Exit exam, whether he fails for the PG or he fails for MBBS degree also or his licence also goes. I would 937 request Hon. Minister to clarify this most important issue. Next issue is about termination of permanent employees, the Bill speaks about compensation not exceeding three months salary. Their termination is violative of article 21 of the Constitution. By compromising these provisions you are playing with the lives of 70 percent population of the country. The persons like assistant or a clerk with some basic knowledge who are only helping doctors will be given a bridge course and they would become a doctor. This is like risking the lives of the people. There was this course Bachelor of Science (Community Health) approved by the Cabinet in the meeting held on 13th November, 2013. The duration was three and half years. The course was proposed to be introduced to create mid-level health professionals who would posses necessary public health and ambulatory care competencies to serve rural people. It was accredited by NBE and approved by Medical Council of India. It is now being replaced by this. Now somebody doing basic help to a doctor will be given six month training and he would become a doctor. I have strong objection to this. SHRI KANAKAMEDALA RAVINDRA KUMAR: The Bill provides an elaborate set-up for complete Central Government control over this area. Representatives from States and Nominated members will get their subsequent tenure only after twelve years. The same is fourteen years for medical professionals. But Nominees of the Central Government are permanent. It provides a Medical Advisory Council which has only advisory role and four autonomous Boards. President of the Boards will be the members of National Medical Commission automatically and Commission itself is the appellate body. Now the President of respective Boards as members of NMC will become appellate court for orders passed by themselves. It is against the law. National Medical Commission would determine fee of fifty percent seats and conducting three exams. This would harm the students. The Bill will bring monopoly of the Central Government. All State Governments should have representation in National Medical Council. SHRI JOSE K. MANI: Clause 32 of NMC Bill provides for licensing of 3.5 lakh unqualified non-medical persons to practise modern medicine. The term community health providers has been vaguely defined. This law encourages quackery and puts the lives of 938 ordinary people in danger. The Bill says final MBBS exam would be common for all. Nowhere it provides the scheme of the exam. This bill will create half-trained medical graduates. Another apprehension is about role of medical universities, they will become mere rubber stamps under NMC. This Bill makes medicine a bureaucratic institution as all 25 members are nominated by Central Government. In the Bill only five states will be represented in the NMC at a time. This is against the federal structure of our Constitution. DR. D.P. VATS: The Bill is student-friendly. They do not have to appear in many exams. Through one exam they will qualify for many institutes as per their merit. By taking a single test you qualify for license to practice medicine, you qualify as a medical graduate also. If you come in merit you qualify for PG also. There is also provision for improvement in merit. The same common exam would be taken by foreign students. Only 20 to 30 percent of foreign students would qualify. There is no lowering of standard. Final MBBS exam will include practical, clinical and theoretical aspects. All modalities will be finalized by involving all the stakeholders. It is only a transition from MCI to NMC. MCI is not working well as pointed out twice by Supreme Court and High Court called it den of corruption. MCI inspects and all of a sudden cancels the recognition leaving the students in the lurch. Despite having good infrastructure medical college had to be closed. Now still States are involved. It is not anti-federal. I still say Boards are there, they will formalize the modalities for its conduct. SHRI BINOY VISWAM: Medical Council was full of corruption. They are bringing National Medical Commission to replace it. It will bring more corruption. A large number of Medical colleges have mushroomed all over the country. They are factories that produce doctors. Now in NMC Bill 50 percent of the seats are for those factories which produce quacks. So this Government believes in quackery, not nationalism. This Bill brings a too much centralized form of governance. Everything at every level will be decided by the Central Government alone. What will happen to the staff of Medical Council who have been working there for 15 to 20 years. Their future has to be guaranteed. 939 SHRIMATI ROOPA GANGULY: Medical Council of India is full of corruption. The relatives of Ministers are occupying important posts in the Medical Organisations. They issue fake medical certificates. In remote rural places no MBBS goes, only quacks go and provide treatment in odd hours. Then what is wrong in giving them certification. The Commission would issue certificates after looking into their capabilities. I request Hon'ble Minister to make arrangements for issue of these certificates in regional languages also. This certification will help in detecting the disease early and provide primary and urgent healthcare. Some members concerned about State power.