IMA STRONGLY OPPOSES NCHRH BILL 2011

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Background…….• MCI formed by an Act of Parliament – IMC

Act, 1956• Dissolved in April 2010• Function of 130 members taken over by 7

handpicked Board of Governors (BoG)• Extension of BoG sought after 1 year; No. of BoG

brought down to 6• Third year NCHRH Bill 2011 was introduced• Opposed by Professionals, Parliamentarians &

CMs• Extension of BoG sought again in the 3rd year

NCHRHWhat next ?

MCI – Role and Functioning

• Statutory Body to Regulate Medical Education& Practice

• Representatives of Medical Professionals all over India• Nominees – Governments – Central & State• Elected Members• Indian Medical Register (IMR)• Standardize Medical Schools – UG & PG education• Ensure good Medical Practice

MCI must be independent of Government control but be accountable to the Parliament

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Why MCI was Dissolved?

MCI dissolved in April 2010 upon alleged corruption charges

Many heads of statutory bodies of India facing corruption charges

However, the Institutions are not dissolved and are still functioning

Why should MCI singularly be dissolved? MoHFW repeatedly trying to usurp the autonomy of

MCI Supreme Court Committee in 2002 testified the need

for autonomy of MCINCHRH

Indian Medical Council Amendment Bill, 2005

In 2005, the then Union Health minister, Dr.Anbumani Ramadoss, tried unsuccessfully to bring in a legislation to dissolve the MCI and set up another council under the control of the Health Ministry.

The Parliamentary Committee rejected it

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Powers of MoHFW on MCI

Powers to form Rules & notify them.Prior approval of Govt. is needed to notify regulationsRight to constitute Enquiry Committee37 Nominated membersTo start new Medical colleges / Courses, MCI is only a

Recommending AuthorityDirect Control of PG education rests with Medical

Education Committe, 6 of whom are nominated by the Government out of a total of 9

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IMA strongly opposes NCHRH Bill 2011. Why?• The framework of the Bill seriously falls short

of any evidence affirming at an honest attempt to achieve its listed objectives.

• This Bill does not assure of any improvement in quality of Health Care and accessibility

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NCHRH BILL 2011

Vision of NCHRH Bill

• To consolidate the laws in certain disciplines of Health sector.

• To promote Human Resources in the health sector

• To provide for mechanism for the determination, maintenance, coordination and regulation of standards of health education throughout the country.

• To ensure adequate availability of human resources in all the states.

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IMA’s Objections - NCHRH Bill

• The purported object of the Bill to provide healthcare for all, is hidden from the perspective of the individual regulatory bodies and is untenable to be considered enough reason to bring in this Bill with sweeping powers.

• Classical example of colorable exercise of power and abuse of legislative process.

• The case for abolishing the existing institutions is unconvincing and by taking away the powers of these autonomous councils, the Govt. loses credibility in the eyes of people of India.

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NCHRH Bill 2011Political & Conceptual Objections:• Lack of Representative Character• Non conducive to the Federal Nature• Loss of Autonomy of the only elected bodies,

National councils.• Lack of Democratic structure and loss of Federal character

in the Commission, Board and Committee• Elected National Councils have been stripped of the power

& meant for Registration & disciplinary procedures only

Replacing Democratic Body with Autocratic Nominated Body is nothing but betrayal of

Democratic norms and FederalismNCHRH

NCHRH Bill 2011Technical Objections:• The word “Medical” as “Modern Medical”• The word “Medical Practitioner” as “Modern Medical

Practitioner”• The Bill has failed in defining Dentistry, AYUSH, Nursing,

Pharmacy, Pharmacists and Paramedical Personnel.• Does not take cognizance of:

– Rehabilitation Council of India Act 1991,– Delhi council for Physiotherapy & Occupational Therapy Act

1971,– Maharashtra State Council for Occupational Therapy &

Physiotherapy Act 2002,– Gujarat State Council for occupation Therapy & Physiotherapy

Act 2011– Tamil Nadu State Council for Physiotherapy

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NCHRH Bill 2011

Technical Objections (Contd.):• State Council Registration entailing practice in that State

only• Engagement of Medical Professional in any other Business

is termed as Misconduct – is unconstitutional• Governmental control enabling removal of

Chairperson/member of Commission is dictatorship• Funds & Assets of councils to be transferred to NCHRH –

cannot be transferred to a common pool• Decisions of Commission cannot be questioned in court of

Law – Against natural justice• Non Medical persons govern Medical Profession – Only

medical professionals to decide on medical related issuesNCHRH

Technical Objections (Contd.):National Board of Health Education:

• Medical Education will be handled by 7 members of National Board of Health Education – State representative not included

• Cross disciplinary progress will promote Quackery  

National Evaluation & Assesment Committee:• 6 members with a Quorum of 2 will decide on nearly 20,000

Health Institutions in all disciplines – inadequate Quorum• Using external evaluation agency will increase discrepancy

and inefficiency

NCHRH Bill 2011

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NCHRH Bill 2011 Summary ……….

Indian Medical Association does not acceptNCHRH Bill 2011, for the undermentioned reasons:

• Democracy is lost to Autocracy:– Representative character of the Democratic Institution is lost.

Only appointed members with uncertain tenure

Can the Indian Parliament become an Appointed Body?• Federal Fabric of Indian Constitution is lost.

– Right of States being usurped by the Central Government. • Fundamental Right of Citizen is eroded.

– No legal remedy for Disputes– Doctors engaging in other Profession is misconduct.– Registration with State Council is valid only for that state

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NCHRH Bill 2011 Summary ……….

Indian Medical Association does not acceptNCHRH Bill 2011, for the undermentioned reasons:

• NCHRH Bill will pave way for corruption.– External Evaluation Agency is a standing example.

• National Board of Health Education with 6 members will not be able to control the vast number of institutions & courses .

• Funds of Democratic Councils cannot be transferred to an Autocratic Body.

• Decentralization is the way to better organization and achievements but NCHRH Bill will lead to Centralization of powers leading to poor performance of the custodian of Medical Education which will jeopardize tomorrows Health Care and Health science education of India

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What is the way forward?

IMA’s Health Vision for India

• To retain the Autonomous Representative character of Medical & Allied Councils functioning in a Transparent manner.

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Solutions…..• Restore the Medical Council of India &

Allied National Councils by conducting elections democratically immediately

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• Increase the number of elected members from the Indian Medical Register (IMR) pro-rata, Professional Bodies & Health care professionals.

• Let the councils be observed keenly by the MoHFW using the powers vested with them in a structured manner and adequate checks & balances.

Time tested….

1. The existing institutions have stood the test of time and have served the nation well.

2. They have a democratic structure and a representative character.

3. The plurality of the voices represented reflect the Federal nature of our Union.

4. The nominated / appointed NCHRH can never have either the legitimacy nor the wisdom of the present institutions.

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AUTONOMOUS TRANSPARENT MEDICAL COUNCIL OF INDIA

&ALLIED NATIONAL COUNCILS

IS THE ONLY KEY

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IMATHANK YOU