Saturday, October 06, 2018

How long does it take the High and Mighty to fall? Medical council of India

To speak of reforming the system and ensuring ethical practices is hypocritical when the apex regulatory body does not generate either trust or respect of the medical community

News

Indian medical council should be scrapped, says parliamentary committee

BMJ 2016; 352 doi: https://doi-org.ezp-prod1.hul.harvard.edu/10.1136/bmj.i1610 (Published 21 March 2016)Cite this as: BMJ 2016;352:i1610

Ganapati Mudur

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An Indian parliamentary panel has urged the government to dismantle the Medical Council of India, saying that the organisation had consistently failed to regulate medical education and practice.

In a report, the parliamentary standing committee on health said that the regulatory body could no longer be entrusted with its responsibilities in view of its “massive failures.”1

The committee said that the council had failed to tackle gaps in medical education that left many doctors poorly equipped to manage even common illnesses. The panel also said that the council had not checked corruption during approvals of medical colleges, stopped the sale of undergraduate and postgraduate seats through “capitation fee” payments, or curbed unethical practices in healthcare.

“The situation has gone far beyond the point where incremental tweaking of the existing system or a piecemeal approach could give contemplated dividends . . . the (council) cannot be remedied,” the panel said, urging the government to introduce “game changer reforms” to restructure the regulatory system.

The council is made up of 102 members all of whom are doctors—67 elected by sections of the medical community nationwide and 35 members nominated by the central government.

The parliamentary committee said that the council was neither accountable nor transparent. The report said that the current composition of the council was “biased against” public health goals and public interest, with more than half of the council’s members from corporate hospitals or private practice.

The committee revealed that during its hearings the council’s president had “admitted there was corruption.” Health ministry officials said that the existing rules did not empower the government to remove even corrupt council members.

The committee recommended that a new regulatory agency—appointed by the government through a rigorous, independent, and transparent selection process—be established.

Hebri Subhakrishna Ballal, a senior radiologist and the pro chancellor at Manipal University, and a member of the council’s academic panel, told The BMJ, “The reputation of the council has been tarnished in the past, but things have become better now. It is always people who matter, elections represent a democratic process, can we be certain that a council appointed by the government will be perfect?”

Long standing critics of the council have welcomed the parliamentary panel’s report. Kunchala Michael Shyamprasad, a cardiothoratic surgeon and former member of a health ministry task force on medical education, told The BMJ, “It is heartening that our legislators have recognised the implications of the council’s functioning on the state of education and medical practice in the country.”

However, doctors have questioned whether the government will take action. Amar Jesani, a physician and editor of the Indian Journal of Medical Ethics told The BMJ, “We’ll just have to wait and watch—it is up to the government to take action on this report. Inaction will mean the existing crisis in our healthcare system will only get worse.”