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After more than five hours of discussion, the Rajya Sabha passed the National Medical Commission Bill on August 1, 2019, overriding the concerns and protests of a large number of medical experts and doctors.
The National Medical Commission (NMC) would now replace the Medical Council of India.
Members of all parties, except the Bharatiya Janata Party, vehemently opposed the bill on three broad accounts.
First, they said, the way states had been given representation in the NMC on rotational basis, a state would get representation only in 12-14 years.
Moreover, according to the Bill, since the Centre had over-arching power over all the four boards — UG Medical Education Board, PG Medical Education Board, Medical Assessment and Rating Board and Ethics and Medical Registration Board — and even the NMC, the Centre would rule over them.
Second, the members raised a huge hue and cry over the form and structure of the National Exit Examination (NEXT).
Union Minister of Health and Family Welfare Harsh Vardhan replied that this exam would be for three things — the final year exam of MBBS students, the licence to practice medicine and the entry into post graduate courses.
This meant if a student failed to pass NEXT, s/he would be not able to practise as a doctor. Members said this would further hit the number of doctors as the country was already acutely short of them.
NEXT would be multiple choice questions (MCQ)-based, a provision that was criticised by many members, who said an MCQ-type examination could assess only the theoretical acumen of a person and not the practical, as a normal final year exam does at the moment.
Vardhan failed to address concerns as to whether there would be a chance to improve oneself if one failed NEXT.
Many members said it was unclear as to who would award the degree as in the normal course, the university which conducts exams for five years does it. But, in the case of NEXT, the Centre would be conducting the exam.
About who would issue the degree, Vardhan said the NMC, once it came into existence, would give modalities of the exam. The aspect again remained unclear.
Many members, including Congress leader Jairam Ramesh, who was a member of the Parliamentary Standing Committee before which the Bill had been brought in 2018, raised the issue of fee determination of only 50 per cent seats in all private medical colleges being under the ambit of the Bill.
A Biju Janata Dal member from Odisha Sasmit Patra said state governments were already regulating fees for 85 per cent of seats.
Harsh Vardhan responded that state governments would be free to decide on the remaining 50 per cent of seats when the NMC was formed.
He, however, accepted the opposition’s contention and said that NMC would not merely “frame guidelines for fee determination”, as the bill envisages in the current form, but would rather put an upper limit to fees of the 50 per cent seats.
Vardhan also defended the provision of community health providers, which the Indian Medical Association had said would ‘legalise quackery’.
He said a precedent for the same already existed in Britain, the United States and few other developed countries.
Yielding to members’ complaints about poor representations of state governments (as they would be on a rotational basis), Vardhan moved an amendment to increase the representation from each state to a certain number.
However, the opposition, including Ramesh, said it would not serve the purpose in actuality as only the elected nominees’ number had been increased and not the representatives’ of states per se.