paradigm shift from MCI to NMC
- 1. PARADIGM SHIFT FROM MCI TO NMC AYSHATHUL FEMITHA 9897
- 2. MEDICAL COUNCIL OF INDIA The Indian Medical Council was first established in 1934 under the Indian Medical Council Act, 1933 and then reconstituted under MCI Act 1956. MCI an elected body of medical doctors which regulates medical education and practices in India - for a period of two years. The Council grants recognition of medical qualifications, gives accreditation to medical schools, grants registration to medical practitioners, and monitors medical practice in India
- 3. HISTORY In November 2000, Delhi High Court concluded high corruption of MCI S P Jhingon was appointed as administrator of MCI In November 2002, Jhingon was relieved and 3 member watch dog committee was appointed October 2003 CBI filed case against Dr. Desai which was only look into in October 2005 2007 Desai was back as a member in MCI and president in2009
- 4. National Council for Human Resource in Health bill (NCHRH) 2009 In 2009 a declaration to establish an overreaching regulatory body to entire health sector was introduced but the bill had not been cleared by the cabinet. 2011 In 2011, NCHRH bill was introduced in Lok Sabha and sent to the Standing Committee which rejected the bill
- 5. DISSOLVING MCI • The MCI was taken over first in 2010, following the arrest of its president Ketan Desai by the Central Bureau of Investigation (CBI) for allegedly accepting a bribe of Rs 2 crore to grant recognition to a medical college in Punjab • In may 15, 2010 an ordinance come up to constitute a Board of Governors to regulate MCI for a year
- 6. This was initially meant for a period of one year but the arrangement continued until 2013. 2013 The government's failure to follow appropriate legal processes in 2013 led to the revival and reconstitution of the MCI in its old form, which continued till 2018. 2018
- 7. March 8, 2016 Standing Committee’s 92nd report called the complete restructuring of MCI said it had failed as a regulator of Medical education and the profession Corruption and lack of accountability threaten medical education – said the committee May 2016, oversight committee was constituted with 3members to supervise the functioning of MCI July 13 2016, OC complained that MCI not cooperating with its direction, led to formation of second OC September 2018 the second OC resigned with same reason
- 8. • November 6 2016 the Indian Medical Association(IMA) organized pan India strike of doctors and medical students to protest against NMC Bill. Protest continued till March 2017
- 9. • September 27, 2018 MCI (Amendment)Ordinance again dissolved the MCI with new BoG with 7 members • The new board includes NITI Aayog member – VK Paul AIIMS Director – Randeep Gularia PGI Chandigarh Director - Jagat Ram NIMHANS Bangalore chief – BN Gangadhar AIIMS Professor – Nikhil Tandon Director General Health Services –S Venkatesh Secretary Health Research- Balram Bhargava
- 10. • By the time, the Minister of Health and Family Welfare JP Nadda had introduced the NMC Bill of 2017 in the Lok Sabha • This Bill too ran into trouble for several reasons. lack of representational character of the NMC powers relating to fee structures of private medical colleges proposing a "bridge course" for the practitioners to also let them practice and prescribe allopathic medicines • January 2 2018, the NMC bill was sent to standing committee • March 2018, standing committee reported on NMC bill with changes made removal of bridge course
- 11. 31 Dec. 2018 Lok Sabha passed the IMC Amendment Bill 29 July 2019 NMC Bill approved by Lok Sabha 1 Aug. 2019 NMC bill approved in Rajya Sabha 8 Aug. 2019 the NMC bill was signed to law by the president
- 12. NATIONAL MEDICAL COMMISSION (NMC) • The bill attempts to set up a regulatory body called the National Medical Commission in place of the tainted Medical Council of India (MCI). • According to the government, the NMC bill will provide for a medical education system that improves access to quality and affordable medical education, and guarantee availability of adequate and high quality medical professionals in all parts of the country.
- 13. • The National Medical Commission Bill of 2019 proposes to have four autonomous boards to take care of its different functions: Under-Graduate Medical Education Board Post-Graduate Medical Education Board Medical Assessment and Rating Board Ethics and Medical Registration Board
- 14. FUNCTIONING OF NMC Framing policies for regulating medical institutions and medical professionals. 01 Assessing the requirements of healthcare-related to human resources and infrastructure. 02 Framing guidelines for determination of fees for up to 50 percent of the seats in the private medical institutions and deemed universities which are regulated as per the Bill. 03
- 15. FEATURES OF NMC The CHPs are a new class of medical practitioners to be given licenses to practice modern medicine at mid-level to those "connected with modern scientific medical profession“ National Exit Test (NEXT) for granting "license" to practice and admission to postgraduate "broad- speciality courses". frame guidelines for determination of fee and other charges" for 50% of seats in private medical institutions and deemed to be universities. Other powers of the NMC include permission to establish new medical colleges, start post-graduate courses, increase the number of seats, recognition of medical qualifications in and outside India etc.
- 16. • Moreover, the Medical Assessment and Rating Board (MARB) under the NMC will rate institutions on quality of education/training imparted. These ratings, coupled with the transparency accorded by the NEXT, will ensure that fees are regulated through market forces. • Responding to the demands from States to increase their representation in the NMC, the nominees of States and UTs in the NMC have been increased from 3 to 6. The NMC will comprise of 25 members of which at least 21 will be doctors.
- 17. NMC (pros and cons) PROS: • As per the Bill, the government, under the National Medical Commission (NMC), can dictate guidelines for fees up to 50% of seats in private medical colleges. • Recognized medical institutions don’t need the regulator’s permission to add more seats or start PG course. This mechanism is to reduce the discretionary powers of the regulator. • the role of Community Health Providers (CHP) in providing primary and preventive treatment in rural areas which remain unserved by MBBS graduates. • National Exit Test (NEXT) for granting ‘license’ to practice and admission to postgraduate broad-specialty courses, prevent suboptimal doctors getting the registration to practice and hopefully improve the quality of MBBS doctors..
- 18. cons • By getting the power to set guidelines for setting fees in private colleges and recognition of medical institutes there is more chances for corruption • It's not yet clear as to what kind of professionals could be certified as CHPs and up to what limit they should provide care and treatment to the patients. • The new exit examination is expected to be implemented within three years of the bill becoming a law. • the crucial practical part of the present qualifying MBBS exam in the final year would lose its importance. • Section 45 (2) says that “the decision of the Central Government whether a question is one of policy or not shall be final. The Act under the same clause restricts the Commission and the autonomous boards to express their views without giving an opportunity.
- 19. cons • Govt failed to answer how NEXT Exam will work to calibrate the standard of medical education uniformly among all medical institutions across the country to enable candidates to take up such competitive nationalised tests. • Also the one who couldn’t appear for NEXT will not be able to enter in the national registry, to practice or to do post graduate studies • With the institution of NMC, the role of the state government will be reduced drastically—from being in the governance to a merely advisory one. • At present, 70% of representatives in MCI are elected members. But when it comes to NMC, only 20% of the members would be the elected representatives
- 20. SIMILIARITIES AND DIFFERENCES (NMC vs MCI) Members- While MCI had 100+ members, NMC will only have 25 members in the committee. Re-nomination- MCI members could be re- nominated or re-elected. But NMC members nominated by the central government Cannot be renominated. Decision- In MCI fifteen of 100+ members were enough to make a meeting and its decisions valid while for NMC, it will be 13 out of 25.
- 21. Tenure- The MCI tenure was five years, while the NMC tenure will be four years. MCI had to meet at least once a year while the commission has to meet every quarter. Appointment- Nearly 70% of the 100-plus member MCI were elected members were elected. But a majority of the representatives of the NMC would be nominated by the central government. Assets- Unlike MCI, the members of NMC will have to declare their assets at the time of assuming office and when they leave. They will also have to submit a conflict of interest declaration. No jurisdiction over AIIMS- Like MCI, NMC also will have no jurisdiction over the various AIIMS, JIMPER or PGI in almost all matters.
- 22. conclusion • There is no denying that medical education needs continuous reforms to ensure improvements in health care. There cannot be just one solution. The success of any legislation depends upon how it is implemented and interpreted. The future of the medical education and treatment of our country is unclear till the new NMC system prove its efficiency .
- 23. REFERENCES : • The Hindu. "Court extends judicial custody of Ketan Desai by 14 days". 14 May 2010. Retrieved 17 May 2010 • My medical mantra:“NMC Bill defies the principles of democracy,” states IMA President-elect By Dr Avinash Bhondwe on August 8, 2019 • The Economic Times health world:How to make the new NMC Bill more effective and acceptable: Vimal Wakhlu, August 28, 2019 • India Today : Indian Medical Council (Amendment )bill 2019: continuation of ad hoc approach to regulatory functions. July 6, 2019 • The Hindu business line: unfair criticism of NMC bill, Uravshi Prasad on September 04, 2019. • Moneycontrol news.com: here’s how the NMC’s functioning differs from MCI , July 25, 2019 • The tribune : govt dissolves MCI, new body led by doctors takes over, September 27, 2018
- 24. THANK YOU