National Coalition for Restructuring of Medical Regulation in India
Networks of ethical doctors and health activists resolve to form National coalition for restructuring of medical regulation in India. The national consultation on ‘Reform and Restructure Medical Council of India’ was held on 4th May 2016 at YMCA, New Delhi.
Several networks of rational, ethical doctors and civil society groups working in the field of health including Indian Doctors for Ethical Practice (IDEP), Jan Swasthya Abhiyan (JSA), Indian Doctors for Peace and Development (IDPD), Medico Friend Circle (MFC), Forum for Medical Ethics Society (FMES) and SATHI, Pune collaboratively organised a National Consultation on ‘Reform and Restructure of Medical Council of India’ on 4th May 2016 at YMCA, New Delhi.
Over 75 rational, ethical doctors, health activists, academicians and senior retired officials from different parts of the country along with three Members of Parliament participated in this consultation, which was held given the following background:
The recent report of the Parliamentary Standing Committee (PSC) on the Functioning of Medical Council of India (MCI) released in March 2016 has scathingly criticised MCI for its widespread failures, opaqueness, corruption and non-responsiveness. This is accompanied by a comprehensive range of recommendations by the PSC for thorough overhaul and basic restructuring of MCI, to transform the scenario regarding regulation of medical education and protection of medical ethics in India.
The recent Supreme Court order (2nd May 2016) dealing with medical admissions has also clearly indicted the MCI for its complete inability to regulate admission processes and fee structure in medical colleges, and has appointed a three-member oversight committee.
The High level Committee led by Dr. Ranjit Roy Chaudhury (Sep. 2014) has also emphasised the need for major changes in the ethos of MCI as a regulatory body, requiring major structural reconfiguration of its functions. This expert committee has suggested the formation of a National Medical Commission (NMC) through a new Act.
Participating doctors and activists strongly expressed the need to substantially restructure, reorient, make transparent and democratise the Medical Council of India and State medical councils, in view of the recommendations of the recent report of the Parliamentary Committee related to MCI and the recent Supreme Court judgement related to MCI. This includes mechanisms for Medical councils to deal with patient's complaints regarding unethical conduct and malpractices by a section of doctors and hospitals.
The consultation was preceded by the press conference and book release ceremony of the book ‘Dissenting Diagnosis’. Reporters from major newspapers, magazines covered this press conference. Dr K. V. Babu from Kerala who is known for courageously taking on mighty Indian Medical Association for its unethical endorsements of commercial products and who himself is a victim of vested interest in MCI made opening remarks in the press conference. Dr G. S. Grewal (President- Punjab Medical Council) exposed corruption and ghost faculties in medical colleges. He took on both MCI and Health Minster of Punjab State for providing protection to these kind of blatantly unethical practices. He described how gold is preferred instead of cash by the medical college inspectors! He welcomed the Parliamentary Standing Committee Report. Dr Samiran Nundy (Senior Surgeon) demanded adoption of General Medical Council model of UK in place of existing MCI and open up membership of medical council to non-medico persons of repute like public health experts, health activists, representatives of patient advocacy groups, legal experts etc. Jashodhara Dasgupta talked about unethical conduct of medical practitioners and failure of MCI in redressing patient’s complaints.
She emphasised that restructuring of MCI must be done. Dr Abhay Shukla demanded that the entire current MCI leadership should resign on moral grounds in the backdrop of two strongly critical reports from nation’s topmost institutions of governance i.e. the Parliament and the Supreme Court. He demanded scrapping of the current Indian Medical Council Act and bringing a new law in its place to curb corruption in medical education and to promote ethics in the medical profession. A broad based, participatory process should be adopted to draft such a new statute. Dr Arun Gadre declared that new coalition of ethical doctors and health activists will undertake nationwide campaign for restructuring of MCI. Speakers in press conference expressed their worry about the silence of the Health Ministry on the Parliamentary committee report and Supreme Court judgement. Dr Grewal while answering questions from journalists said that this new coalition of doctors and health activists will meet PMO, NITI AYOG, Health Minister, leaders of all political parties and urge them to take appropriate actions and stands on the demands raised in this press conference. Dr Abhay Shukla told that if government does not make efforts to bring in new law then this coalition will take draft a model bill and will do advocacy for adoption of that bill.
During the press conference, the book 'Dissenting Diagnosis: Voices of conscience from the medical profession' (Authors- Dr Arun Gadre and Dr Abhay Shukla; Published by Penguin Random House) was released, which is a hard-hitting expose of the sickness in India's healthcare and a call to arms to re-establish ethical medical practices. This book was released at the hands of Dr Samiran Nundy (Senior Surgeon, Gangaram Hospital), with Dr G. S. Grewal (President- Punjab Medical Council) as the Chief Guest. Ms Dipti from Penguin Random House gave brief introduction about this book, followed by thought sharing by one of the author Dr Arun Gadre.
In the first session, senior medical professionals and health activists from across the country, who have been demanding reform of medical education and protection of medical ethics spoke in the consultation. These include Dr K.V. Babu (Kerala, Health Activist), Dr Sanjib Mukhopadhyay (Kolkata, Indian Doctors for Ethical Practice), Dr Sanjay Nagral (Mumbai, Forum for Medical Ethics Society), Dr Amit Sengupta from Delhi (Jan Swasthya Abhiyan), Dr Shakeel Ur Rahman from Bihar (Indian Doctors for Peace and Development). Dr Arun Mitra from Punjab Medical Council moderated this session.
Participant in this session welcomed the Parliamentary Standing Committee Report but expressed caution about what kind of structure will take place of the MCI. It was emerged through the panel discussion that we need to be more alert and keep watch on moves happening in PMO and NITI AYOG. Some of them expressed their disapproval about recommendation by PSC about scrapping election process in MCI and appointing new members by selection considering bad record of political nominations over many such bodies. Some panellist stressed that reforms in MCI should be looked in larger public health system perspective. Conversion of district hospitals into medical colleges managed by private institutions was heatedly discussed. Participants discussed recent experience of Andhra Pradesh where 13 district hospitals are proposed to be taken over by private corporate medical colleges. Some participants raised fear that dissolution of MCI may accelerate this process by removing last barrier.
In second session, Dr Amar Jesani emphasised the need to make medical education affordable while minimising the costs to students, and to definitively eliminate gross commercialisation of medical education. It is also being expressed that the system of regulation of medical education and ethics must help to bring down costs of health care for ordinary people. Further, there needs to be effective regulation of corporate hospitals to prevent growing commercialisation of health care.
Shri K.C. Tyagi (MP- Janata Dal United) criticised privatisation of education in general and privatisation of medical education in specific. He supported the demand to restructure MCI and assured his help in raising this issue in Parliament. Shri Husain Dalwai (MP, INC) also expressed his support to the new coalition of doctors and activists in raising this issue in much bigger way in Monsoon Session. Shri A V Swamy (MP from Orissa) shared memories about Medico Friend Circle in 1980s. He promised all support for this advocacy. Shri Keshav Desiraju (Former Secretary, MoHFW) welcomed this courageous step by networks of doctors and health activists.
He stated that reforms in mere MCI is not sufficient and doctors, health activists should also demand reforms in state medical councils. He informed that about 88 Members of parliament have direct interest in medical colleges. Thus reforming MCI is very tough task considering entrenched vested interests but recent PSC report and Supreme Court judgement definitely provided an opportunity which must be used. Dr Samiran Nundy and Dr G S Grewal gave some concrete practical suggestions to carry forward the functioning of this new coalition for restructuring the MCI. Dr Abhay Shukla and Jashodhara Dasgupta facilitated this session.
Overall, it was fairly successful programme.