As a statutory body regulating medical colleges, their affiliation, new colleges, and doctors’ registration, the Medical Council of India (MCI) is the guardian of ethical practices in the medical profession. It is mandated with maintaining the highest standards of integrity and answerability to consumers and the nation. Its very own code of ethical conduct for the medical profession prevents the realisation of any personal benefit in cash or kind from entities that may benefit from recommendations and practices of the profession. But Ketan Parekh, its own president, stands accused of accepting bribes from a medical college. Personal propriety aside, there are a host of accusations against the MCI of not carrying out its responsibilities in a manner desired. Consequently, quality of many colleges is suspect; protection against poor practices of doctors is more or less absent; and the list of registered practising doctors has errors of omission and commission. The MCI is a professional body consisting of membership from within the profession. But interest groups and lobbies have taken it over and that has impacted transparency, un-biasedness and professionalism. It is quite apparent that the MCI needs to be reformed if India is to meet its health goals in the near future.
Who will regulate this regulator? The ability of the Ministry of Health and Family Welfare is itself suspect, otherwise things would not have come to this pass. Creating a new public health entity that oversees the whole sector is not necessarily the solution; for the same regulatory takeover by established interest groups and lobbies is possible there as well. While we grapple with practical solutions to this problem, there are a range of actions that can reduce its scale and scope. Each of these lies in the realm of greater transparency. First, the list of registered doctors needs to be made up-to-date. Other professional regulatory bodies, such as the Dental Council of India, are already conducting such an exercise. Second, such a list needs to be made easily accessible via the Internet, where details of every single registered practitioner are available to the public. Third, up-to-date status of every single medical college — where it has met the norms, where it has not, where improvements are required, the quality of its output etcetera — is put in the public domain. Fourth, the status of complaints against registered practitioners and the action taken on past complaints also needs to be made transparent. Last, within the profession itself, there are many voices calling for better functioning of the MCI, and these voices need to be provided a public forum.
Greater transparency cannot solve all the problems of the MCI, and ultimately it would require the profession and the government to work hand in hand. They will need to identify and implement the right set of checks and balances within the structure of professional self-regulation as has been outlined in India’s Constitution. Greater transparency, a higher degree of professionalism and commitment to professional values on the part of doctors and health care institutions would help and by themselves promote reform.