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Medical Council of India

Medical Council of India

- Lalita Panicker

The Narendra Modi government came to power on the magic mantra of development. So far, the one thing holding India back from realising Modi’s vision has been all pervasive corruption.

As a result all efforts to put development onto to centre-stage have been Sisyphean. Among the most prominent areas in this miasma of corruption are health services and medical education. And the most glaring evidence has been the profusion of capitation fees for entry into medical colleges. Not only do vast sums change hands, the quality of doctors coming out of these institutions is dodgy to say the least.  They have little aptitude or dedication, their principal aim being to recover the money they paid to get their degrees. And it is against this background of questionable aptitude, personal favour and profit that the debate about how to improve access to medicine and new insurance models for India’s people is set.

MCI compromised in fighting corruption

Some of the nation’s top health experts have appealed to the prime minister to stem the rot that has set into the health sector, calling for urgent attention to both health education and primary health care. The role the Medical Council of India (MCI) has played in the current shameful state of public health services cannot be glossed over and this explains why the courts have dissolved the organisation as it is constituted now. They include former health and biotechnology department secretaries as well as former MCI members and prominent doctors. They have alleged that successive governments have been unable to handle ‘compromised individuals’ in the MCI, an organization whose mission is to promote excellence and uphold standards in the medical profession and medical education.

Letter demands action

They have published a letter, signed by such distinguished experts as Javid Choudhury, Sujata Rao, Keshav Desiraju, Gautam Sen, Sita Naik and Samiran Nundy, calling on the prime minister for ‘revamp of the curricula for graduate and postgraduate education, separate the three functions of regulation, education and accreditation with eminent individuals known for their professional and personal integrity and the institution of a national entrance and exit examination so as to ensure better quality of the doctors being produced.’

They have asked that he give particular attention to the functions of regulation, education and accreditation within the body. This, they say, is essential to ensure that owners of hospital chains and private medical colleges do not make inroads into regulatory processes and subvert them for their private gain.

An open secret

The former Union Health Minister, Dr. Harsh Vardhan, said that it was an open secret that the MCI, for years, had looked the other way when medical colleges flouted regulations in a cavalier manner. Vardhan had previously castigated the MCI for ‘punishing’ MBBS aspirants instead of the medical colleges for not complying with the rules. Thanks to the machinations of private medical colleges, the number of seats were reduced though there were many eligible aspirants.   He said that in 2014 though 2,750 new MBBS seats were approved, applications for renewal of 3,920 seats were rejected by the MCI, citing the failure of colleges to meets its requirements. This adversarial position of the MCI led the Supreme Court to step in and dismiss the Ministry’s appeal for seeking a modification of the time schedule for granting approval for new colleges and renewal of permission to increase seats in existing old colleges.

Fundamental restructuring required

A recently formed parliamentary panel also recommended that a  fundamental restructuring of MCI as it was before the courts dissolved it was needed, stating that its composition is ‘biased’ against the larger public health goals and is in effect, an ‘exclusive club’ of medical doctors from corporate hospitals and private practice.

MCI no stranger to controversy

The MCI, ‘a statutory body, was constituted for establishing uniform and high standards of medical education in the country, that grants recognition to medical colleges, gives accreditation to medical schools and grants registration to medical practitioners, and monitors medical practice in the country,’  is no stranger to controversy, with long standing issues relating to corruption.

Corrupt officials arrested

In 2010, the MCI was dissolved following the arrest of its chief, Dr Ketan Desai, by the CBI on April 22 that year. Desai, along with an alleged middleman JP Singh, and Sukhwinder Singh and Kanwaljit Singh, both doctors, was booked under the Prevention of Corruption Act after the recovery of 1.5 kg of gold and 80 kg of silver from his premises. Following this gold worth Rs 35 lakh was recovered from Desai’s bank lockers.

More doctors, better access to healthcare

The present Government, soon after it was elected to office, started work on a major overhaul of the MCI in an effort to create more medical colleges and deliver larger numbers of qualified doctors to meet India’s growing healthcare needs. Towards this objective it had set up a three-member panel to prepare a blueprint for the overhaul of the medical education regulator, that included the Niti Ayog vice-chairman, Arvind Panagariya, PK Mishra, additional principal secretary, and the Niti Ayog chief executive, Amitabh Kant. They identified the MCI as the major barrier to expanding higher education in medicine. The meeting also identified a pressing need for more doctors in the states of Jharkhand, Bihar, Uttar Pradesh, Chhattisgarh and Odisha as these states have been lagging behind the rest of the sub continent, as far as medical facilities are concerned.

Time to act is now

With the giant international drug companies increasing their influence in the field of health care in India and the burgeoning of super-specialty hospitals across urban and even the rural landscape, the promise of high earnings will continue to fuel corrupt practises unless there is immediate and effective action. Failure to act will not only hold Indian health care back at the moment in time when accessible, high quality medical services are needed more than ever before, but will consign millions to poverty as they continue to struggle to meet prohibitive healthcare costs and ever rising health insurance premiums. Modi’s government must act and act decisively, or India will face a major crisis on the health front.

Lalita Panicker

Lalita Panicker is senior associate editor in charge of the Comments Page of the Hindustan Times, India’s second largest English daily. She writes on social development issues and politics with a focus on the marginalised and disempowered.

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