Explained: What is National Medical Commission Bill 2019 and why are doctors opposing it?

New Delhi, July 30: The National Medical Commission (NMC) Bill, which seeks to replace the 63-year-old Medical Council of India (MCI) to reform the medical sector in India, was introduced in Lok Sabha on Monday.

The Bill, introduced by Health Minister Harsh Vardhan, also seeks to repeal the Indian Medical Council Act 1956, stating that the Council set up under it was corrupt. It has been alleged that the process by which the MCI regulated medical colleges was flawed. Opposition members objected to provisions like exit exam and replacing elected members with nominated members in the proposed commission. They alleged that the legislation was against the spirit of federalism.

Here is what National Medical Commission (NMC) Bill is all about:

The NMC bill seeks to replace the Medical Council of India with National Medical Commission as top regulator of medical education in India.

The bill also seeks to put in place a common entrance exam and licentiate exam, which all medical graduates will have to clear to get practicing licences.

The bill also has a provision for making national standards in medical education uniform by proposing that the final year MBBS exam be treated as an entrance test for PG and a screening test for students who graduate in medicine from foreign countries.

It would also put in place a four-tier structure for the regulation of medical education. The 20 members National Medical Commission will be at the top of this structure.

NMC will be a 20 member body comprising a Chairperson, a member secretary, eight ex-officio members and 10 part-time members. Out of the eight ex-officio members, four shall be presidents of the boards constituted under the act and remaining four shall be nominees from three ministries viz. Health, Pharmaceuticals, HRD and one from Director General of Health Services.

The bill 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.

The NMC can permit a medical professional to perform surgery or practise medicine without qualifying the National Licentiate Examination, in circumstances that may be specified in regulations. According to the NMC Bill, the Ethics and Medical Registration Board can maintain a separate national register that would have the names of licensed AYUSH practitioners.

The names of graduates of Bachelor of Ayurvedic Medicine and Surgery and Bachelor of Homeopathic Medicine and Surgery are already registered with their respective councils and on taking the bridge course they would be incorporated in a separate register maintained by the NMC, resulting in dual registration with two councils, which is neither open nor permissible.

The government, under the National Medical Commission (NMC), can dictate guidelines for fees up to 40 per cent of seats in private medical colleges. This is aimed at giving students relief from the exorbitant fees charged by these colleges and is a standout feature of the bill.

So far, all admissions are through the NEET and no licensing is required for practice but a medical practitioner has to register with a state medical council for this.

Why is Medical Council of India being replaced?

A Parliamentary panel which had looked into the matter had recommended restructuring and revamping of the regulatory system of medical education and practice. "When MCI was tested on the given parameters (of producing competent doctors, ensure adherence to quality standards etc) has repeatedly been found short of fulfilling its mandated responsibilities. In our country quality of medical education is not good; the current model of medical education is not producing the right type of health professionals that meet the basic health needs of the country."

What are the changes in the 2019 Bill?

There are two crucial changes, following the recommendations of the Parliamentary Standing Committee on Health and Family Welfare (109th report in 2018). One, it has dropped a separate exit examination. Two, it has dropped the provision that allowed practitioners of homoeopathy and Indian systems of medicine to prescribe allopathy medicines after a bridge course.

What are the major concerns?

The Indian Medical Association (IMA) - the apex body representing the medical fraternity in India has been opposing the NMC Bill that seeks to replace the Medical Council of India (MCI), saying it is "anti-poor and anti-students" and the current version has only undergone cosmetic changes as the core concerns raised by the medical fraternity still remain unaddressed.

Since its introduction in Parliament, the medical fraternity has voiced protest against the Bill with thousands of its copies being burnt at various organisations across the nation.

The IMA is also opposing other provisions in the bill, including the decision to couple NEXT and NEET and regulation of fees by the NMC for 50 per cent seats in private medical colleges and deemed universities.