A new report by the Parliamentary Standing Committee on Health and Family Welfare makes an in-depth analysis of the Medical Council of India; examining issues with its governance and functioning and the context of the health system in India today. Looking at these challenges, and the problems facing medical education in the country, it makes strong recommendations for a complete overhaul of the present system.
The Committee held hearings and study visits in 2015 and has done considerable in-depth research to come up with this document, which was tabled in the Rajya Sabha on March
“The Committee is constrained to observe that the existing system of the graduate medical education in the country has failed us and unless total revamping of the undergraduate education system is undertaken, the present system will not be able to generate the medical manpower required to deliver the ambitious programme of Universal Health Coverage. The Committee also observes that the medical education in India is increasingly depersonalized and has failed to instill humane values of care, concern, courtesy and compassion. …. The Committee, therefore, recommends that soft skills (including ethics) should be made one of the cornerstones of the syllabus of medical education.”
“The Committee recommends that the Government of India in coordination with State Governments should establish robust PG Programmes in Family Medicine and facilitate introducing Family Medicine discipline in all medical colleges. This will not only minimize the need for frequent referrals to specialist and decrease the load on tertiary care, but also provide continuous health care for the individuals and families.”
The report looks squarely at corruption within the MCI
12.11 The Committee is shocked to find that compromised individuals have been able to make it to the MCI, but the Ministry is not empowered to remove or sanction a Member of the Council even if he has been proved corrupt. In a day and age when the need for sturdy systems and enhanced transparency based regimes are being increasingly emphasized, such state of affairs indicate that the MCI has not evolved with the times.
It concludes –
13.5 Game changer reforms of transformational nature are therefore the need of the hour and they need to be carried out urgently and immediately. Because, if revamping of the regulatory structure is delayed any further on any grounds including political expediency, it will be too late …with the result that our medical education system will fall into a bottomless pit and the country will have to suffer great social, political and financial costs.
13.6 Keeping all these facts in mind, the Committee is convinced that the much needed reforms will have to be led by the Central Government. The MCI can no longer be entrusted with that responsibility in view of its massive failures.
The Committee is, however, aware that any attempt at overhauling the regulatory framework will face huge challenges from the deeply entrenched vested interests who will try to stall and derail the entire exercise. But if the medical education system has to be saved from total collapse, the Government can no longer look the other way and has to exercise its constitutional authority and take decisive and exemplary action to restructure and revamp India’s regulatory system of medical education and practice. The Committee, therefore, exhorts the Ministry of Health and Family Welfare to implement the recommendations made by it in this report immediately and bring a new Comprehensive Bill in Parliament for this purpose at the earliest.
The report also mentions the SATHI Publication and JSA-AIDAN-IJME-MFC statement:
9.12 The Committee’s attention has also been drawn to a Report titled “Voices of Conscience from the Medical Profession” which was released by Support for Advocacy and Training to Health Initiatives (SATHI), an NGO on the 28th February, 2015 at the All India Institute of Medical Sciences. The Report contains interviews of 78 doctors by the whistle-blowing doctor from Maharashtra, Dr. Arun Gadre and exposes the realities of the private sector such as irrational drug prescriptions, bribes for referrals and unnecessary diagnostics and surgeries, the distorting influence of corporate and multi-specialty hospitals on ethics of the medical profession and the growing grip of pharmaceutical companies on private medical practice.
9.15 Following the February, 2014 decision of the MCI, several doctors, health activitists and organisations of health advocacy groups, including Smt. Brinda Karat, ex-MP (Rajya Sabha) Jan Swasthya Abhiyan, Indian Journal of Medical Ethics, All India Drug Action Network and Medico Friends had written to the Ministry of Health and Family Welfare, stating that “We cannot conceive how an action that is ethically impermissible for an individual doctor can become permissible if a group of doctors carry out the same action in the form of an association.”