NEW DELHI: NRI doctors are a step closer to be able to practice or teach medicine in India.
The Cabinet on Tuesday cleared the National Council of Human Resources in Health ( NCHRH ) Bill that allows doctors who hold the Overseas Citizens of India (OCI) status to work in India. They can also join medical college as faculty.
The move has been initiated primarily to reduce the country’s acute doctor shortage. India has one doctor for 1,953 people, or a density of 0.5 doctors per 1,000. The Planning Commission says the country is short of six lakh doctors, 10 lakh nurses and two lakh dental surgeons.
Union health secretary P K Pradhan said, “We expect the Bill to come up in Parliament next week since it got cleared by the Cabinet on Tuesday. It will then go to the standing committee.”
The Bill also brings in penal provisions against authorities running private medical colleges who fudge figures like bed strength, number of faculty members or infrastructure to get registration. At present, the only punishment they face is the institute’s de-recognition.
However, the Bill stipulates that errant authorities will face three years of imprisonment and a fine of Rs 25 lakh.
“False patients and faculty members are brought in hordes in buses on the morning of the inspection by event managers for those who run the colleges to show the inspection team that they have the required faculty, manpower and infrastructure to run a medical college,” an official said.
According to the Bill, an overarching body will have under it the Medical Council of India (MCI), Pharmacy Council of India (PCI), Nursing Council of India (NCI), Dental Council of India (DCI) and the proposed Central Councils for Paramedical and Allied Medical Sciences Education.
“Currently, all councils are working separately and are over burdened with evaluation, assessment of institutions, monitoring academic standards and regulating the profession. The 21-member body will bring synergy to all these councils. It will have under it a National Board for Health Education that will put in place academic standards, a National Evaluation Committee and a professional Council,” an official said.
The Bill makes it mandatory for state councils to maintain live registers of the available strength of nurses and doctors. This will help correct regional imbalance of human resources.
The government on Wednesday tabled the Higher Education and Research Bill, 2011 in the Rajya Sabha that seeks to establish the National Commission on Higher Education and Research (NCHER), an overarching regulatory body for university education including vocational, technical, professional and medical education.
The existing regulatory bodies including the University Grants Commission and the All India Council for Technical Education would subsequently be scrapped. While there is no provision for protecting the chairperson or members of the UGC once the Bill is enacted, the services of officers and employees of the existing regulators would be saved. The Ministry of Human Resource Development has already started the process of selection of UGC chairperson but now there appears to be uncertainty over it now as there would not be many takers for the post.
The Bill seeks to promote autonomy of higher education and innovation and to provide for comprehensive and integrated growth of higher education and research keeping in view the global standards of educational and research practices, for which it will establish the National Commission for Higher Education and Research.
The NCHER will facilitate determination, coordination, maintenance and continued enhancement of standards of higher education and research other than agricultural education and matters pertaining to minimum standard of medical education as are the subject of proposed National Commission on Human Resources in Health (NCHRH).
The NCHRH Bill, 2011 piloted by the Ministry of Health and Family Welfare was tabled in the Rajya Sabha last week. The Commission will consist of a chairperson and six members, one of whom will be the chairperson of the National Commission for Human Resources for Health, who will be appointed by the President on the recommendations of a search-cum-selection committee headed by the Prime Minister with the Lok Sabha Speaker, the Leader of Opposition in the Lok Sabha and the Ministers in charge of medical education and higher education.
The Commission will have powers to take all measures necessary to spearhead the transformative changes in higher education. It will frame regulations and promote autonomy for institutional accountability, promote joint and cross-disciplinary programmes between and among institutions of higher education, to promote development of a curriculum framework with specific reference to new or emerging or inter-disciplinary fields of knowledge and to promote synergy of research in universities and higher educational institutions and with other research agencies.
The legislative proposal provides for the establishment of a General Council, which is proposed to be a representative body with advisory and recommendatory functions, in addition to the powers to approve the regulations framed by the Commission. The Council will have, in addition to chairperson and members of the Commission, the heads of professional bodies, research councils and experts in all sectoral areas of higher education.
Participation of States is being ensured through representation in the General Council. The existing regulators had no representation from the States and the NCHER draft was revised to accommodate States in the General Council. States have also been exempted from seeking prior approval of the NCHER before establishing new universities.
The Board for Research promotion and Innovation will formulate research and innovation policy for sustained global competitiveness, promote transformative and multi-disciplinary research in higher educational institutions, and facilitate the modernisation of research infrastructure in higher educational institutions. The powers and functions of the Board have been synergised with functions of the proposed NCHRH by including two members nominated by the NCHRH in the Board.
The proposed law also has provisions for the establishment of a Higher Education Financial Services Corporation that will disburse grants to universities and higher educational institutions.
The Prime Minister’s Office (PMO) has asked the Ministries of Human Resource Development and Health and Family Welfare to identify linkages between the two proposed regulatory bodies — National Commission for Higher Education and Research (NCHER) and the National Commission on Human Resource for Health (NCHRH) — being promoted by them respectively to speed up the process of setting up the two authorities.
Both the Ministries have been given time up to Friday next to resolve issues and work to form common grounds for coexistence. The PMO is keen on the resolution as the Medical Council of India (Amendment) Act, 2010 ends on May 15 and it is important that a mechanism is in place before that.
The Prime Minister is said to have already expressed his ‘agreement’ with the NCHER.
The two Ministries have been fighting a turf war for more than a year now with the task force, set up by the HRD Ministry, bringing all higher education, including medical education and legal education under the purview of an overarching regulatory body — the NCHER — while the Ministry of Health and Family Welfare has been opposing it tooth and nail saying that medical education was closely linked with health infrastructure and should come under the ambit of the NCHRH.
While both the Ministries claim that the draft bills for NCHER and NCHRH are ready to be placed before the Cabinet, neither have been able to do so because of possibility of overlapping and lack of clarity.
With several attempts made earlier to make the two Ministries come to a consensus having failed, the PMO on Friday convened a meeting of the HRD task force members and experts from the Health and Family Welfare Ministry (since the task force that drafted the NCHRH Bill has been disbanded) to thrash out the issues in the presence of T.K.A. Nair, the Principal Secretary to the Prime Minister.
After both the sides placed their version, Mr. Nair asked them to find a common ground for the existence of both the Commissions. One possible way could be cross representation, the second could be bringing the medical colleges and research under the purview of the NCHER while the related health infrastructure and services, accreditation, ethics and maintenance of medical registers could remain with the NCHRH. There was also a suggestion that bodies such as the National Board of Examinations that are outside the university system could be central to NCHRH.
The Joint Forum of Medical Technologists of India (JFMTI) has expressed disappointment over the National Commission for Human Resources in Health (NCHRH) Bill-2011 introduced in Parliament recently.
In a statement issued here, Kaptan Singh Sehrawat, general secretary of the Forum said that while the proposed Commission-to be established as regulatory body under the Act – is supposed to adopt all existing councils with same identity and name without any deliberation on the numbers of professionals to be regulated under it, all other unregulated allied health professionals who have significant numbers in health care will have to do with single common Paramedical Council to be set up for them as per the proposed Bill.
“Practically it is impossible to manage more than 15 unregulated categories of allied health professionals/paramedical staff under the single Paramedical Council under NCHRH while on the other side very few health professional will enjoy the status of an independent council like pharmacists, dentists. Either there should be a common Health Professional Council of India (HPCI) with different departments under it or it requires separate councils for different categories to be constituted under NCHRH,’’ he said.
The JFMTI is a national organisation representing the common voice for its more than 30 associations of Allied health professionals from various streams like Medical Laboratory Technology, Radiology Technology, Radiation Therapy Technology, Operation Theatre Technology, Cardiology and Neurology Technology from Central government, State government autonomous bodies and private health establishments in India.
Mr Sehrawat said the world has moved away from an archaic term like ‘paramedical’ and switched over to ‘allied health professional’ recognizing the reality of different characteristics and importance of each of the streams by establishing independent council for them while in India it is to be clubbed under one Council as per NCHRH.
This, he said, was a retrograde action as the medical science had, over the years, primarily evolved due to revolutionary changes in allied health sciences and diagnostics has acquired as much importance as treatment itself. I
n Indian health system the word ‘Paramedics’ is indistinguishable therefore ‘medical technologists or allied health professionals’ were accepted by the Parliamentary Standing Committee during Paramedical Bill but “we do not know why the concerned Ministry has again presented these disputed version of Bill.’’ He sought to know.
It may be recalled that the government had planned to bring Paramedical Councils Bill in 2007 where it was recommended by Department related Parliamentary Standing Committee in its report that separate council were required for different streams. The exercise to bring forward NCHRH was supposed to provide an overarching Act to cover all sectors of the health professionals. The Forum says, it expected that such an Act would not only streamline the education facilities in all streams of paramedical/allied health sector but also accord recognition to the different streams of allied health professionals in the country but present draft has completely ignored the recommendation made by Parliamentary Standing Committee on Paramedical and Physiotherapy Central Council Bill in 2007.
“Besides, we on behalf of all allied health professionals under JFMTI had also submitted a comprehensive memorandum on preliminary NCHRH draft bill which was made available on public domain by ministry of health, seeking necessary suggestions on this national health issue but concerned Ministry has, without deliberating upon these suggestions seriously, presented a vague draft bill again which is very sad for us,’’ said Mr. Sehrawat.
We welcome the move of setting single regulatory mechanism under one Act but it requires separate councils under it. The proposed single council for paramedical staff under NCHRH will be overburdened with plethora of issues of several categories with no expertise to handle all. Though the idea of providing a comprehensive and coordinated regulatory framework is good but it should not be too much centralized and impractical to implement it, therefore the Government should make serious initiatives if they are keen to improve current regulatory framework says JFMTI statement.
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