National Medical Commission Bill, 2019: Here's all you need to know about legislation that will replace IMC Act

The National Medical Commission (NMC) Bill, 2019 was passed by the Rajya Sabha on Thursday. The proposed law has faced widespread protests by doctors. It repeals the Indian Medical Council Act, 1956 that led to the formation of the Medical Council of India (MCI). Follow LIVE updates from Parliament here Health Minister Harsh Vardhan has called it “one of the greatest reforms ushered in by the Narendra Modi government”, whereas the Opposition has questioned its motive saying that the provisions of the bill will dilute the doctors’ authority and give more powers to the central government with the replacement of the autonomous MCI. Nearly 70 percent of the 100-plus-strong MCI comprised elected members, while the 25-member NMC will have a majority of them nominated, mostly by the Centre. A ‘Search Committee’, which will have seven members, will recommend names to the Centre for the post of chairperson, and the part-time members of the NMC. All the seven members of the search committee, including the five experts, will be nominated by the Centre. Meanwhile, out of the eight ex-officio members of the commission, four will 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. [caption id=“attachment_4333695” align=“alignleft” width=“380”]  Representational image. Reuters[/caption] Since, the appointments will majorly be directed by the central government, citing this clause, the Opposition has protested against it claiming that will lead to “favouritism and bureaucratic interference” in the selection process. Moreover, the NMC chairperson and other members nominated by the Centre can’t be renominated. Also, in the MCI, 15 of 100-plus members were enough to make a meeting and its decisions valid, but the NMC will need 13 of 25 members to agree on the same. The MCI’s tenure was of five years, while the NMC’s is four years except for part-time members — whose tenure is two years. The council was to meet at least once a year while the commission has to meet every quarter. The broad role of the NMC will include: — Regulation of the fees for 50 percent seats at both MBBS and postgraduate level in all private and deemed universities. — Introducing new schemes and reforms to tackle the skewed distribution of medical seats across various medical institutes in the country Provisions for NMC members Unlike MCI members, NMC members will have to declare their assets and liabilities at the time of entering and demitting office. They will also have to give a conflict of interest declaration of professional and commercial engagements or involvements and these are to be displayed on the commission’s website. Moreover, they will also have a two-year cooling-off period after their tenure during which they cannot be employed in any capacity, including as consultant or expert in any private medical institution whose matter they might have dealt with directly or indirectly. This cooling-off period, however, can be waived by the Centre. Though, MCI had to be dissolved through ordinances and any action against the MCI president could be taken only if directed by a court, through the new bill, the Centre will have the power to remove the chairperson or any member of the NMC for several reasons including if their continuation in office is “prejudicial to public interest” or the person has abused the position or has acquired financial or other interest likely to affect functioning. The bill states that: “The ethics board of the commission will “exercise appellate jurisdiction with respect to actions taken by state medical councils” on issues of compliance with the ethical code.” Uproar over NEXT The NMC Bill proposes a common final-year MBBS examination, known as National Exit Test (NEXT), for admission to post-graduate medical courses and for obtaining a license to practice medicine — which will also serve as a screening test for foreign medical graduates. Currently, foreign students with MBBS degrees are automatically entitled to practice in India. Therefore, going forward, the National Eligibility-cum-Entrance Test (NEET) common counselling and NEXT would be applicable to for admission to institutes such as All India Institute of Medical Sciences (AIIMS). That is, admissions to all AIIMS, JIMPER Pondicherry or PGI Chandigarh will now have to be through NEET. This has been done to ensure uniformity throughout the medical entrance procedure including examinations to grab seats in premier institutes. The bill also introduces a Medical Assessment and Rating Board (MARB) which will conduct an assessment of the medical colleges and develop a system of ranking the institutes. MARB will grant permission for new medical colleges, starting PG course and increase of seats based on the standards set by the UG and PG boards. Further, the NMC will have the authority to grant a limited licence to certain mid-level practitioners connected with the modern medical profession to practice medicine. Doctors protest However, the medical fraternity has been opposed to this draft legislation as they argue that under Section 32 of the bill, nearly 3.5 lakh community health providers — mostly ‘quacks’ (health frauds) — would become legalised to prescribe drugs. “Section 32 of the NMC Bill provides for licensing of 3.5 lakhs unqualified non-medical persons to practise modern medicine. The term Community Health Provider has been vaguely defined to allow anyone connected with modern medicine to get registered in NMC and be licensed to practise modern medicine. This means persons without a medical background will become eligible to practise modern medicine and prescribe independently. This law legalises quackery," the Indian Medical Association (IMA) stating its concerns. Several doctors have also termed the bill as ‘anti-poor and anti-public’ since making NEXT mandatory before NEET can reduce the chances of people from economically weaker section entering the medical sector. Many have opposed the idea of an exit test altogether. With inputs from agencies