The controversial Medical Commission Bill is one of those anti-people legislations, pushed through by Modi government in parliament on the back of its brute majority and without giving opportunity for adequae debate and deliberations.
For all its possible failings, the Medical Commission of India has been overseeing education, service and employment domains of the medical sector of the country for over the last six decades, and that body is now being replaced by the new Medical Commission. Organizations lincluding the doctors' forum, Indian Medical Association (IMA) are in a nation-wide strike against the impracticable and unscientific structure of the bill. But the central health minister has been hailing it as one of the major reforms by the Modi government. Although the bill had been moved in 2017, it was referred to the parliamentary standing committee on health affairs, for detailed review and suggestions. The Opposition is absolutely right in its view that it is more or less the same original bill that was re-introduced after two years, discarding most of the suggested amendments. Not only that, beyond addressing merely the educational and employment aspects of medical sector, there are also some clear political agenda injected into the bill. For that very reason, there are several hazardous dimensions to the bill much more than what health workers and medical organizations have raised.
It is undeniable that what led to the framing of a new bill are the unequalled corruption that prevailed in Medical Council of India. The fact is that the corruption that had gripped our ruling class has rotten this authority too. Naturally, the people had expeted a scientific and systematic mechanism that would form a strong defence against such corruption. What happened however is just its opposite. This bill is bound to throw out of gear the health education sector to a great extent and authorise medical quackery entering rural India. The concept of NEXT (National Exit Test) that makes MBBS Final exam also the entrance test for post-graduation, is per se impractical. To implement this proposal, the final MBBS examination will have to be turned into an 'objective type' test. The existing final examination in fact puts to test several things including the 'treatment skills' of the student who has to work among the people the following year. When that system is fully abolished and replaced by a mere entrance test, it will render it incapable of gauging the level of the student. For this very rreason, the strikers' demand that PG admissions should continue to be based on the current separate entrance test (NEET) instead of NEXT, is rational.
Another contentious part of the bill is its 32nd section which gives limited authorization to those without medical degree to do medical practise. In rural India, where adequate number of doctors are not available, the bill gives conditional permission to appoint community health providers (middle-level practitioners) to meet medical emergencies. The argument against it is that this will make things easy for quacks. True, if middle-level practitioners allowed to function for definite terms under conditions cross their limits, matters may turn risky. Not only that, it is a lopsided view that these 'second grade' hands will suffice to maintain the health of the rural sector. However, in our country which is six lakh doctors short of requirement, in most villages quacks do operate already. In this situation, definitely the middle-level practitioners equipped with some training will be better than such illiterate quacks. This is not to justify the provision entirely, but when one is seized of the current reality of rural India, the concept of middle-levell practitioners is not to be entirely shunned at least for a certain period. But the permanent solution to this health emergency lies in accomplishing a comprehensive expansion of this sector. As of now, only one percent of the country's GDP is set apart for health sector. Only if this is increased three times can even a small improvement be achieved.
As in the case of other laws being fast-baked in the ongoing parliamentary session, the Medical Commission Bill also has its reaking and complexion of fascism. As seen in several other government moves including GST, here again we see the propensity to do away with federalism and to bring everything under central control. This intention is clear in very provision in the bill that the members to the Commission are to be nominated by a search committee appointed by the Centre. And the Centre is also empowered to remove the chairman at any time of its choice. Although the Commission will have a secretariat, the secretary will be decided by the Centre. In other words, the body which will henceforth control matters of our health sector will be a panel with no autonomy in effect, and destined to work completely under the Modi government. Such a state of affairs is sure to lead to a health emergency. The agenda of the current strike should be widened to encompass such aspects too. Only then will it become a struggle of the health community against neo-fasacism. Otherwise, it will end up as a mere 'labour' agitation.