The Lok Sabha on Monday passed a Bill that seeks to create National Medical Commission in place of Medical Council of India (MCI) with Health Minister Harsh Vardhan terming it as an "anti-vested interests Bill" which will be remembered as one of the greatest reforms brought by the Modi government.
The National Medical Commission Bill, 2019, was passed following a division even as the minister had appealed for its unanimous passage.
The Bill was passed with 260 members voting in its favour and 48 against it. The amendments moved by the Opposition were negatived.
Congress members staged a walkout before the passage of the Bill.
In his reply to points raised by Opposition members, Vardhan termed the Bill as "pro-public" and said it will help "move away from inspector raj". He said the Bill will help improve standards of medical education in the country and bring down costs.
The minister referred to his own experience as a medical practitioner.
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"After 45 years, this is probably the happiest moment for me because this is going to improve the status of medical education in the country in a big way. I can assure every medical student, every doctor and every aspiring doctor that the Bill is a visionary move of Prime Minister Narendra Modi and will go down in history as one of the greatest reforms the government has undertaken. This is a major, major reform for medical education," he said.
The Bill provides that the common final year MBBS exam be known as National Exit Test (NEXT) which would serve as a licentiate exam for entrance to post-graduate medical courses and as a screening test for foreign medical graduates.
It also provides that the national entrance test, i.e. NEET, common counselling and NEXT shall also be applicable to Institutes of National Importance (INIs) like AIIMS to have common standards in the country.
The Bill provides that the Medical Assessment and Rating Board (MARB) will conduct an assessment of medical colleges and develop a system of ranking them which would enable students to choose medical colleges wisely. It provides for the repeal of the Indian Medical Council Act 1956.
Harsh Vardhan said that NEXT will provide students with MBBS degree, get them registered to start practice and also be the basis for admission in post-graduate courses.
"I don't think there can be a greater boon for medical students than this exit examination," he said.
He said NEXT will have to be implemented in three years and details will be clear once the rules are framed after the passage of the Bill.
"Once NMC Bill becomes law, there will be a period, say, up to nine months, during which time various sections and provisions of the Act will be implemented. Considering the global standards of examination in the medical field, all those methods of examination will be taken care of by the NMC," he said.
He said fees for 50 per cent seats in private medical colleges will be "done by the central government".
Vardhan said there are about 80,000 MBBS seats in the country of which almost 40,000 seats are in the government sector. "So 40,000 seats are already regulated with minimal fees. Another 50 per cent of the private colleges is being regulated by the Central government. That makes it regulation in over 75 per cent of the total seats available at the Central government level," he said.
Referring to 50 per cent seats in the private sector, he said the state governments will have full right to make any amendments and enter into any MoUs with the private medical colleges.
Rejecting allegations of Opposition parties that the Bill is anti-federal, he said no medical college will be set up without the state government's Essentiality Certificate, the registration of doctors will continue to be done by the state governments and enforcement of medical ethics will continue to be with the State Medical Councils.
Also, the central government will have no role in the day-to-day administration of medical education, he said.
"The National Medical Commission shall be lean and effective," Harsh Vardhan said, adding that the Modi government has already increased 28,000 MBBS seats and 17,000 post-graduate seats in the last five years.
The Minister said that the Under-Graduate Medical Education Board (UGMEB) will define the standards for Under-Graduate education in great detail, including what is required for curriculum, what is required for infrastructure and Post-Graduate Medical Education Board (PGMEB) will have similar functions.
The Medical Assessment and Rating Board (MARB) will issue ratings to medical colleges according to their performance.
"The NMC is to look at global best practices like distributed hospitals, possible ways of reducing costs like using colleges in double shifts, adjunct faculty, equated designations and larger class sizes," he said.
He said the Bill will not only help regulate fee but all other charges of private and deemed to be universities and there will be stronger punishment to quacks.
Referring to questions about community health providers, he said NMC, which will have 21 doctors out of 25 members, will decide if they want mid-level health workers of the modern scientific system of medicine are trained for a few months or a few years.
"We have an ambitious plan of putting 1.5 lakh health and wellness centres all over the country. If you do not have a doctor at the sub-centre, the health services will suffer," he said.
He said NMC members will be persons with unquestionable integrity and will be required to declare their assets before and after they leave the commission.
The minister did not answer members who were not present in the House.