The National Medical Commission Act, 2019 is a significant reform brought in the field of medical education, and the Act received its assent from the President on 8th August 2019 and it came into force on 25th September 2020. The main purpose of the Act was to bring in positive changes in the field of medical sciences as well as in the medical education system in order to enhance the quality of medical studies and make it affordable to more students.
The legislation regulating before NMC Act 2019 was the Medical Council of India which was repealed and replaced by the NMC Act as per the recommendations and suggestions made by the NITI Aayog. There were many points lacking in the Indian Medical Act and even with the operation of the body of the Medical Council of India. There were increasing complaints against the regulating body alleging corruption charges and the functioning of the body was not completely transparent and seemed fishy to many. The quality of medical studies, infrastructure, institutions, and research was also deteriorating. The Medical Council of India was composed of only doctors and other members like health experts, social scientists, and health economists. Aim of the National Medical Commission Act, 2019
The Union Health Minister, Harsh Vardhan stated that NMC Act was an advanced Act that was enacted to fulfill the following purposes for the enhancement of medical education.
Constitution of National Medical Commission
- It was reducing the pressure and burden of studies of medical students
- The Act would be trying to make medical education more affordable and improve the standard of medical studies
- The act also aims for a better quality of medical professionals all around the country
- The Act encourages the adoption of a recent and updated version of medical research
- Provide better medical infrastructure and healthcare facilities
- Make regular assessments of the medical institutions and promote enforcement of ethical standards by all medical professionals
Under section 3 of the Act, it is mentioned that Central Government will be setting up the Commission to perform the functions and powers as granted by the Act and the Commission will be a legal body which will be having perpetual succession and a common seal and the head office is at New Delhi. As stated NMC will be a statutory body and regulatory body with 33 members. Section 4 of the Act states the composition of the body which will be appointed by the Central Government which is as follows-
- The Chairperson of NMC should be from the medical profession
- 10 ex officio members
- The rest of the 22 members will be representing States and Union Territories (19- States and 2- Union Territories) and will work as part-time members
NMC shall not comprise of doctors and health practitioners only, but it shall also include non-medical administrators and bureaucrats. Functions of NMC
Section 10 of the NMC Act 2019, mentions the functions of the Commission to be carried out in order to achieve the objective of the Act. The functions of NMC are-
Autonomous Boards constituted under the NMC Act, 2019
- The commission needs to frame the policy for maintaining the standard and quality of the medical field and make further necessary regulations with regard to the policies framed
- The commission also needs to frame policies for the regulation of Medical institutions, researches, and professionals
- The Commission is also responsible for providing the basic healthcare requirements as well as human resources and other resources and even propose a way to achieve all of this
- The commission is responsible for framing necessary guidelines and policies for the proper working of the Commission as well as other bodies framed under the Act and even promote and coordinate these bodies.
- The commission has to guarantee coordination among the Autonomous Boards and also act as an Appellate body with respect to decisions taken by the Autonomous Boards.
- The commission should also frame a Code of ethics for the medical profession and promote ethical conduct by the medical practitioners.
- The commission has to frame guidelines for the fee structure of the 50% of the private medical institutions and deemed to be universities as per the provisions of the Act.
Under Section 16 of the NMC Act, 2019 four autonomous boards are constituted to carry out the work as assigned to them
Medical Advisory Council and its functions
- Under-Graduate Medical Education Board and Post-Graduate Medical Education Board- These boards are given the responsibility of formulating the curriculum, guidelines, standards of medical education and even grant the medical recognition to the medical qualifications at the under-graduate and post-graduate level accordingly.
- Medical Assessment and Rating Board- This board shall perform the function of evaluating and rating of medical institutions throughout the country and cane levy penalties on the institutions where they fail to maintain the prescribed standards as mentioned by the Under-graduate and Post-graduate Medical Education Board. The board has the responsibility to grant permission for establishing a new medical college for under-graduation or post-graduation course or even if the existing institutions want to increase the number of seats in their institutes.
- Ethics and Medical Registration Board- this Board has the function of regulating the professional conduct by the Medical faculty while they are providing medical services. The board has to even maintain a National register of all the medical practitioners. Only those medical practitioners can practice medicine who is mentioned in the register and for Community Health Providers there is a separate National Register maintained.
The NMC Act 2019 has proposed to establish a Medical Advisory Council for advising the Commission on certain policy matters regarding medical education, research, and institutions. The Advisory Council will be set up under Section 11 of the Act and section also mentions that who will be the members of the Council. The Council will be presenting the perspective and concerns of States and Union Territories before the Commission and shape the overall agenda, policy, and action relating to medical education and training. Along with these functions, the Advisory Council shall also recommend NMC on the measures to determine and maintain and even coordinate with minimum standards of all matters relating to medical education, training, and research and the measures for advancing equitable access to medical education. Why the NMC Act 2019 is being opposed by some Doctors and Medical Students?
The main reason for bringing in total new legislation for improving medical education was to enhance the standard of medical facilities and studies provided by the country like India is facing an acute shortage of doctors and other medical staff in relation to its population due to which many patients are suffering and with this Act, the Parliament has made a provision under NMC Act to give license to non-medical practitioners also i.e. Homeopathic, Ayurveda, etc. to practice modern and scientific medicine. The bridge course which was compulsory for the AYUSH practitioners to practice modern medicine was also removed by the Act which caused intense opposition towards the Act by the Allopathic doctors. The government has also introduced a concept of Community Health Providers (CHP) in the Act to deal with the disease burden in remote areas. These community health providers are mid-level health practitioners and they are not experts in modern medicine. The Act has given the CHPs the authority to prescribe certain medicines independently in primary and preventive healthcare. However, in other cases, the CHP can prescribe medicine under the supervision of medical practitioners who are qualified and connected with the modern medical profession and registered under Section 32(1) of the NMC Act. People were against this provision also, as it might put the lives of the people in danger by permitting CHPs to prescribe medicines and the medicines can be prescribed for wrong purposes too. The Indian Medical Association was against the fixation of fees of private colleges for up to 50% of the seats as it will lead to complete deregulation of the private seats regarding the fee subject to non-binding guidelines. Thus, medical education will get even more expensive increasing the socio-economic gap among the people and would affect the backward groups adversely. The students from the medical fraternity are vigorously opposing the conduct of the NEXT exam for taking admission in post-graduation and obtaining licenses. As per the students, the merit of the student should decide the admission for post-graduate courses and thus the ongoing pattern of NEET-PG should not be scrapped. The major reason for the Act’s opposition by the Medical Association is that it will increase the threat to the normal working of the medical professionals and it can be possible that the medical professionals would be made accountable to the non-elected administrative and bureaucrat members of the Commission. Thus, these were some of the listed reasons why doctors, medical students, and the Medical Association were opposing the enactment of the NMC Act, 2019.