The Big Picture - National Medical Commission Bill

Resident doctors at government hospitals, including AIIMS and Ram Manohar Lohia Hospital in Delhi, went on an "indefinite" strike from 8 am to protest the National Medical Commission Bill, 2019. Among the problems raised by the medical fraternity is Section 45 of the bill, which allows the government to override any suggestion of the National Medical Commission. The Post Graduate Institute of Medical Education & Research in Chandigarh and Medical students and doctors in Kerala also joined the strike. The proposed legislation was passed by the Lok Sabha on Monday by voice vote. The bill looks to replace the existing Indian Medical Council Act, 1956 and reform the medical sector, in the wake of corruption allegations against the Medical Council of India. It also looks to regulate admission to medical colleges. The health minister defended the bill, describing it as "historic". On this edition of The Big Picture we will analyse the National Medical Commission Bill, 2019. Joining me on the program today are:
Anchor: Frank Rausan Pereira
Show- Big Picture

Guest Name:-
R K Srivastava, Former Director General, Health Services, GOI

Aditi Tandon, Special Correspondent, The Tribune

Chakshu Roy, Head of Outreach, PRS Legislative Research

Dr. Gagan MS Malhotra, Senior Physician // Visiting Consultant BLK Hospital

[docreyaz]

NMC bill will be a game changer. Love you Modi ji for bringing the change in medical education, Stopping corruption, and making medical education accessible to middle class families. NaMo NaMo 🙏🙏🙏🙏🙏🎉🎉🎉🎉👍👍👍

Love you Modi ji ❤️❤️😍❤️

[kamleshbharti]

One thing that RSTV lacks in is it doesn't discuss controversial or to say things which are anti establishment. I strongly suggest RSTV to add some flavour in discussion by inviting some critical analyzer of topics. RTI, UAPA, NIA, Hate crime etc must have discussed so as we also get other side of story. Otherwise we will be kept in dark by just showing only positive sides of topics. NMC is just a start!

[ashwin]

Aditi Tandon mam always has very good points.

[adityabajpai]

I m pharmacist I have no job. But I have good knowlage in modern medicine n I also taken training in ICU. But I m not perform practice even village area n I'm fully dedicated to this work but here not such provisions to work like that. So I jobless. So support this bill. Bharat mata ki jai. Jai hind

[govindvishwakarma]

Thanks to all guests n frank sir missed u for a couple of episodes.

[kislaymahaseth]

Don’t make medical course so diluted to meet the same fate of engineering...89% are unemployable as per the govt report.

[scorhigh]

National Medical Commission Bill

Features:
National Medical Council will be established and underneath it will be 4 boards- regulate undergraduate admissions, curriculum, infrastructure and facilities required, similar thing for postgraduates, Board for ethics and registration of doctors
A cap of 50% on the fees that can be charged.
Complaint mechanism
Representation of state bodies on to the NMC

Significance:
Bill is a betterment to that in 2014
Improved version.
The 4 sub-boards duly controlled by a governing or advisory body is the right diversification from the Medical Council of India.
Costing of medical education - has a share of the private sector around 50-60%. This point has been addressed squarely. 50% of seats for public health use with fees duly controlled by the govt in all the institutions which have a separate stream of entrance clubbed together under NEET.
50% of left-outs are a large number of private medical colleges as well as some percentage of public sector medical colleges. There will be a cap on the fees which will not be entirely decided by the government so that there is a commercial component. Achieves parity across all players.
Mid-level service provider - At present govt is reaching 5000 population through Health and wellness centres and these are being managed by mid-level service providers. Government step to reach a larger population with the help of qualified doctors. Mid-level service provider will have to undergo some course approved by IGNOU. More scientific and standardised manner.
Mainstreaming more professionals
NEXT exam- it is a compilation of 3 systems. It is a licentiate exam too. It provides an entrance for the PG.
Uniforming the exams of different college in the form of NEXT exam is trying to create a Single measuring tool for the doctor to enter the internship training.
Aberration has been done away with the NEXT exam and it eases the total system of regulation.
In this draft, the governing body will be a little more representative. Out of 25 people, 21 will be from the medical background. Fair representation from state medical colleges and the state govts.
Separating medical education and medical profession.
Mid-level health cadre is being proposed.

Criticism:
Lack of infrastructure at the PHC level so doctors
Mixing basic systems of different medicines will be diluting the medicine system.
Foreign medical graduates can sit for NEXT exam and start practising. This is will be differentiating for Indian students.

Medical council of India elected body.
In 1995 the govt decided that it does not have enough investment and capacity to expand medical education and the private sector has to be invited for it. Then the entire scenario changed.
From the time the constituent of MCI started changing.
Medical council of India was declared corrupt.

Way forward
A robust mechanism for training guided by university standards.
Proper infrastructure at PHC level.
1:1000 proportion should be reached.
Mid-level can reach to the last mile person in the health facility.
Medicine is an essential service.

[upenderk]

frank could have given more time to aditi madam, u have to move forward in the interest of the nation fabulous

[shivangiseth]

Thank u frank sir Big picture is a great platform of discussion, very useful for answer writing🙌🙌🙌🙌🙌🙌🙌🙌🙌🙌👏👏👏👏

[ashishupadhyay]

thanks frank sir for your valuable support

[sanjana]

Therefore; after analysing and listening to discussion of experience panelist. All the doubts are erased. And therefore I support the bill in its revived format.

[countryfirst]

Desh mein ek crore Doctor ki Kami hai Hospital nahin hai medical College nahin janatha maar rahi hai government so rahi hai

[vijayvr]

Nurse practitioner is a well established system of health care in different parts of world. It has been in existence in USA since last 60 years and has got the credentials among people. The same has been practiced in different countries both in developed and developing countries. As we are in the era of evidence based practice, if you search literature in any data base likewise Medline, web of science, Cochrane, embase, CINAHL, Pubmed, Scopus, it is very clear that nurse practitioner is much cost effective than the primary physician in rendering primary care. If evidences are supporting and we have success stories from many other countries then why it is so delaying to start nurse practitioner in India. As of now we were totally dependending on physician centered health care delivery model, still our all health care indices are much below when you compared with other developing countries. Where as the countries which follow decentralized health care system they could achieve low MMR, NMR, high life expectancy, low rate of infections, high quality life etc. Hence this is the time for democracy in health care system, where it should not be physician centered. The much awaited nurse practitioner system should be implemented in India with needed modification in a democratic way.
It's the high time for democratic and decentralized health care system.

[arundhool]

The episode would've been a total lets-watch-it-later, if it weren't for Aditi Tandon's inputs

[stalinabraham]

Well said by special correspondent Aditi Tandon.

[HistoryGypsy]

*The NMC bill provides for setting up of a National Medical Commission in place of the MCI for development and regulation of all aspects of medical education, profession and institutions.
Doctors are demanding certain amendments in the bill. According to them, if not amended, the bill will lead to deterioration of medical education and degradation of healthcare services.The fraternity was opposing section 32(1), (2) and (3) of the bill, saying it will encourage quackery by providing licence to practice modern medicine as community health providers for persons other than those possessing MBBS degrees.The doctors said there was no clarity over the introduction of NEXT and scrapping the NEET-PG.They are also opposing decreasing the percentage of seats under controlled fees structure in private medical colleges and deemed universities from 85 to 50 per cent, reducing the representation of elected members from 75 per cent in MCI to 20 per cent in the National Medical Commission and autonomous boards constituted there-under*

[bharathdk]

Excellent. Superb quality of debate. The best kind of news citizens need.

[AmalAmal-bwbw]

Please include caption for all videos🙏

[AakashSingh-juzq]

If we have people like Dr. Gagan Malhotra who are open and receptive to ideas and consultation process, we can certainly iron out the creases. He presented a really mature picture.

[Mechaniccarservices]

Pharmacist nd nurses log bhi ilaj kar sakte they know