Narendra Modi's dissolution of Medical Council of India was necesary to usher in radical changes in healthcare
Narendra Modi's plan to dissolve the Medical Council of India (MCI) was so confidential that people in the council did not even see it coming
Narendra Modi's plan to dissolve the Medical Council of India (MCI) was so confidential that people in the council did not even see it coming. The Cabinet meeting was to be held on Wednesday — it was known to all, but it even took ministers present in the Cabinet by surprise when such a sudden decision was taken. The prime minister inaugurated the Jan Arogya Yojana on 23 September to provide healthcare to all. But forming a new board of governors after disintegrating the MCI is one of the key precedents in the series of daring decisions by Modi.
The prime minister categorically put the necessity of the Ordinance before his Cabinet colleagues and after getting the Cabinet nod, it was immediately sent to the president for its promulgation. At the Cabinet meeting, Modi spoke about the reason for the dissolution of the MCI and how it would bring about a change in healthcare services. The prime minister expressed the need to open one-and-a-half lakh primary healthcare centres, so that the healthcare-for-all scheme could come to fruition. The prime minister emphasised on the effective steps to be taken to fulfil the shortage of doctors and medical professionals, to successfully deliver a healthy India.
Further, Modi also expressed his concerns about the corruption in medical education and stressed on the need to disintegrate the MCI to rein in the mafia in the council.
In fact, the last Monsoon Session of Parliament was abuzz with the passing of the National Medical Council Bill and because of the non-passage of this bill, the government started facing various charges. It was alleged that the Gujarat lobby directly or indirectly had its clout in the MCI. And this was the reason the government did not pass the bill to support the council. Doctors were divided on the issue of the bill. But the promulgation of the Ordinance by the president with such alacrity meant that all the rumours about the government were swiftly deflated.
Presently, the MCI stands disintegrated and it will function with the help of a board of governors. According to the press release, seven names on the board of governors are globally recognised in their respective work areas. These are:
1) Dr VK Paul, who is a member of NITI Aayog and will be taking over as the chairman of the council.
2) Dr Randeep Guleria, who is at present the director of AIIMS.
3) Dr Jagat Ram, who is the director of PGIMER, Chandigarh.
4) Dr BN Gangadhar, who is the director of NIMHANS, Bengaluru.
5) Dr Nikhil Tandon, who is a professor in endocrinology and metabolism.
6) S Venkatesh, who holds the position of director-general, health.
7) Dr Balram Bhargav, who is director-general of the Indian Council of Medical Research.
By choosing such experts, the government seems to be seeking to give a fitting response to the rumours doing the rounds against the National Medical Council Bill. It was alleged that the institution of doctors was to be replaced by the bureaucrats.
The background behind the disintegration of the MCI
Due to out-of-pocket expenditure on healthcare, 66 lakh people have been pushed below the poverty line. This is a big challenge to the government. To cope with this, the government is preparing to open one-and-a-half lakh primary healthcare and wellness centres. And the target to achieve it has been fixed for the year 2022. Thirty-one states have already agreed to be part of the Ayushman Bharat Yojana. Meanwhile, 26 states have already started the process of its implementation.
According to government data, 2,300 healthcare and wellness centres are operational and by the end of this year, the target has been fixed at 15,000 new centres in total. The scarcity of capable healthcare professionals has let to difficulties in achieving the targets of universal healthcare coverage, sustainable development goals and the national health policy. And the main reason for this failure seems to unchanged medical education and massive corruption in the field.
The government wants and improvement in the quality of tertiary healthcare. In order to achieve this goal, there are plans to open 14 AIIMS in various parts of the country. After the opening of all these, the total number of AIIMS in the country will be 22. There are plans to open super specialty blocks in 54 medical colleges for which a sum of Rs 9,000 crore has been earmarked.
Further, at an expense of Rs 16,000 crore, there is a plan to open 82 medical colleges in backward areas, under the sponsorship of the Centre. Therefore, without the reformation in medical education, implementation of such a vast project was very difficult. It is obvious that the need of doctors and health professionals for such a large project is a major challenge. That is why the government believes that the need of the hour is a change in medical education.
The government had to take this step because the National Medical Council Bill was prepared on the basis of a report by the parliamentary committee in 2016 under the chairmanship of late Ranjit Roy Chaudhary and it was tabled in the Lok Sabha on 29 December, 2017. The bill stressed on the need to increase the numbers of undergraduates and postgraduates, and a reform in medical education was also proposed in the bill. The draft spoke of the formation of four boards which must ensure the best integrity and professionalism of its members. The draft was again sent to the parliamentary committee for advice. This bill was passed by the Cabinet on 28 March this year and was tabled in the Lok Sabha for its passage, but is still pending.
A second oversight committee was formed at the end of 2017. But on 6 July, 2018, the oversight committee complained about its lack of authority through a letter to the Ministry of Health and all members handed in their resignations.
The government believes that when the order of the Supreme Court was surpassed and the MCI began taking decisions without taking the oversight committee into confidence, it was then imperative to replace the MCI. The National Medical Council Bill is pending in the House and for better medical education and to provide better health services, the government has made its intentions clear by taking effective steps.
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