Daily Current Affairs – 31st August, 2016DEVENDRA VISHWAKARMA
Managing the medical professionals in India
Medical care in India
- India still spends only around 4.2% of its national GDP towards healthcare goods and services (compared to 18% by the US).
- Government spends only about 30% of the country’s total healthcare budget for primary healthcare.
- Many reports commissioned by Government of India highlights one fact of lack of accessibility and affordability of medical care by large number of Indians.
- Thus, the system of health-care delivery and medical education in India are poorly regulated, expensive, opaque and corrupt.
- Double blow: India has to deal with burden of infectious and chronic diseases on one hand and concentration of medical professionals in urban areas on other hand.
Draft National Medical Commission Bill, 2016 (Prepared by NITI Aayog)
The recommendations are:
- Medical Council of India (MCI) to be replaced by National Medical Commission (NMC).
- ‘For-profit’ organizations be permitted to establish medical colleges.
- Creation of a Medical Advisory Council (MAC) by the central government to articulate the national agenda for medical education.
- Creating a statutory basis for common entrance examinations (NEET) for admission to undergraduate and postgraduate courses in medical colleges.
- It was discussed to insert an additional enabling provision of voluntary recertification/renewal of licence exam once every 10 year. However, it was concluded that it was not an appropriate time for such radical step in India.
Two recommendations that have attracted debate are:
- Replace MCI
- It has become inflexible and opaque
- It has failed to provide leadership role in educating a cadre of medical professionals that is trained and willing to deal with the medical problems of the people of India.
- Large scale corruption has plagued MCI while granting approvals for establishing medical colleges.
- A new National Medical Commission to replace MCI to serve as the policy-making body for medical education.
- To improve the standard of medical education in the country
- The regulators who were elected to be replaced with broad-based search-cum-selection committee. However, there should be a mix of nominated and elected members which will encourage a healthy tension between various points of view rather than only nominated members who would want to please the government of the day.
- NMC provides for four autonomous boards for Under Graduate Medical Education, Post Graduate Medical Education, Medical Assessment and Rating and Registration and Ethics.
Hence, a new institution is expected to utilise the opportunity to correct the inaccuracies and create a visionary framework to train medical professionals and equip them to deal with needs of people.
- Allow ‘For profit’ entities to establish medical colleges
- Micromanagement encouraged rent-seeking behaviour in the process of approval of new medical colleges by the MCI.
- Rent seeking: increase one’s share of existing wealth without creating new wealth which results in poor economic efficiency.
- A cap on fees in private colleges discouraged their entry which runs contrary to the objective of a rapid expansion of medical education.
- Enforcing regulation on fees was difficult.
- Thus, government was not able to enforce rule of law.
- It will severely damage the objective of providing cadre of medical professionals who are able and willing to work in small towns and villages.
- The sale of medical seats in private colleges for capitation fees going up to Rs.50 lakh.
- The medical professionals will want to recover the cost spent on medical education and thus encourage them to work in urban areas and private clinics only.
Conclusion- India’s healthcare needs:
Primary care doctors:
- There is a need for primary care physicians, equally in cities, towns and villages.
- On ground, most lives are saved and pain is alleviated by the primary care physician.
- Throughout the developed world, there is a great emphasis on primary care doctors but in India the role model of aspiring medical students is the emergency care physician and surgeons performing highly complex surgeries.
- Thus, the career as a primary care physician has to be made attractive for the aspiring medical professionals.
- The medical aspirants have to be made aware of India’s primary healthcare professional needs and it needs to be ensured that only those with an outlook in tune with the requirements of medical professionals enter medical colleges.
Cadre of medical teachers
- There is a shortage of suitable qualified teachers, especially, specialities like forensic science, community medicine, tuberculosis and radio diagnosis which are facing severe teacher crisis.
- In such scenario, opening new medical colleges will not serve the purpose as the faculty will be eventually called from government colleges.
- MCI for years failed to address this problem by taking adequate steps nor provided leadership and guidance on faculty shortage.
- Thus, there is a need to train enough teachers and it will take considerate time.
- Medical education is not the sole tool for dealing with India’s health challenges.
- Inducting non-medical professionals of integrity and community health experts to regulatory bodies would help advance public interest.