July 29, 2019
Dr Kakoli Ghosh Dastidar speaks on The National Medical Commission Bill, 2019
Thank you, Honourable Sir. I stand here to oppose the National Medical Commission Bill, 2019 in its present form. It is totally unacceptable. It is an attempt to take total control of the medical system of the country by the Central Government, which is against the federal structure of this country.
It is unfortunate that health is neglected so much in our country that less than 2 per cent of the Union Budget is devoted to it. Today doctors throughout the country are protesting against this Bill and they are also burning copies of the Bill because at every stage, the Bill totally ignores the States’ concern and the concern of doctors across the country. The doctors actually start their work from the age of 17 or 18, when they begin studying for 12 to 14 hours a day to become doctors, and even after passing, they are always working for patients. I support the Honourable Member who said that he worked on a labour case for a fee of just Rs 40 because doctors are devoted to patients.
This Bill tries to demolish the mentality of doctors, and their attitude towards patients and towards learning because it says that an exit exam has to be given. Now this means that if a would-be doctor doesn’t pass the exit examination, he becomes a 12th standard student. He fails at becoming a doctor.
So what was the board dong and what were the examiners doing when the examinations were being taken by the student during the course of study? A student passes examinations on subjects like anatomy, physiology, pathology, biochemistry, gynaecology and surgery to pass the full course and then does one year of internship to be able to practise as a doctor. If you say that despite passing through these phases, you have to sit for another examination, an exit examination, that means you are trying to derecognise all the previous examinations that the child has passed through. You just cannot do this. This is an attack on the federalism of our country.
The mood of the nation today is that we have to protect federalism. The notion is to nurture and also to preserve the federal fabric formulated by our founding forefathers, which is not there today. The total control would be going to the Central Government. But, as per Dillon’s Rule, the Central Government and the State Government both are supreme in their own jurisdictions and as per Schedule 7, Health is a State subject.
Here there is a total disregard of the State’s involvement in the formation of this Bill, involvement of the State doctors. Previously they used to be elected through the State medical council. No doubt there has been mafia control. No doubt there has been criminality. No doubt there has been corruption. People sitting inside jails were controlling the medical education. We agree to it and steps have been taken and we agree that fee structures used to be controlled. The State Governments were held on short leash. They wanted perks like staying in five5-star hotels and other perks that I don’t want to mention in this august House. Officers of MCI have done it in the past but that doesn’t mean that we have to trample upon the federal structure of the country; this is totally against our country.
The federal structure which we are trying to trample upon Article 12, Part 3 which clearly states that the state includes the government and Parliament of India and the government and legislature of each State; but here we have absolutely no involvement of the State Government. We are neglecting them.
Today in the country we have about one million doctors practicing modern medicine, to treat 1.3 billion people. The doctors are overworked. We need more colleges, teachers and funds. Instead of talking about that we are just trying to increase the number of healthcare professionals through the route of community healthcare providers who are nothing but quacks. Fifty-seven per cent of them don’t have medical qualifications and one- third of them have not even passed the twelve standard. They know that if there is pain you can give ibuprofen but the reaction of anaphylaxis may be followed by ibuprofen that might happen in some patients, and despite issues like these we are having quacks, we are letting loose these killers in society in the name of community practitioners.
If a six-month course was enough for the practice of modern medicine then why have a four-and-a-half course at all? Do away with the course. After the twelfth standard, let students give a six-months course and let them practice and kill people, and reduce the population. So this is absolutely unwarranted in the country. Today it is shameful and unfortunate that this country has to go through this. This cannot be accepted.
Funds have to be allotted for more seats, more teachers, more equipment and cutting-edge infrastructure. I agree completely with Honorable Minister here when he says the Government is trying to encourage medical professionals to adopt the latest medical research in the world and to contribute to research.
Cutting-edge research has to be done because we have to keep up with the latest developments in the world. Modern medicine can nearly bring back a dead man through timely intervention in the golden hour. I have done it several times, once in an aeroplane, once on a busy road. A person who has a blockage of heart can be brought alive just by pumping. Modern medicine should be taught to the students of the country so that the last man in the last village of my India can get that kind of care, but not through a quack. This cannot be accepted. Enough funds have to be given. I agree there is nepotism as far as research is concerned, the tendency being ‘I scratch your back, you scratch mine’.
People who are doing integral research are not given due recognition. I have worked for twenty-five years with cutting-edge technology. I was the first person in the country to start it in 1985-86 and after publishing 28 papers in peer-reviewed international journals and have not got any recognition from anybody in the country. So many scientists commit suicide but I am too strong for this.
So research is one thing very important particularly in medicine. Just knowing that a Crocin can bring down your fever does not make you a doctor. We have to respect our doctors and doctors have to be given proper care and proper training, particularly in the grey areas. Students have to be encouraged to take an active interest in research right from the first year of college curriculum. They have to be encouraged to write short papers so that they get to know how to do research. Research is required today.
Now about the rest of the formation of the Medical Commission. I must say that total supervision of the Central Government without any election is very undemocratic, this has to be done away with. The Honourable Member rightly elaborated that you have to have members at every stage where they are elected like was done previously. At every step we cannot have the chairman to be nominated, the cabinet secretary here becoming the chairman, the three experts to be nominated by the Central Government, one member in every State and in the common body.
I also agree to the aspect of National Eligibility-cum-Entrance Test spoken about this in this august House. Our country is one of pluralities, of multiple languages, and there are State boards under which students study in their mother tongues. This has been going on for ages. So if you have one exam for the whole of the country then you first prepare a uniform curriculum for the entrance examination for the country first. That might take three to four years. Then start the national eligibility exam.
The regional languages are learned by students. They are preparing as per their own curriculum. And then they are asked to sit for the CBSE examination. A brilliant girl committed suicide in Tamil Nadu. Many of our students in West Bengal did not get the chance because they had studied in Bengali, their mother tongue; even the syllabus is different. So make a uniform syllabus, implement the uniform syllabus. And after three to four years of that curriculum, let them sit for the entrance examination. But for those three to four years, let the boards have their own joint entrances, like we have in our State. So neither do we approve of the National Eligibility Test nor of the exit exam. These are not compatible with enhancement of knowledge in medical science.
And as far as the boards are concerned, the different boards have being formed. The States are major stakeholders in the administration of their medical education systems but there is no effective representation granted to them under the Bill. The MCI has direct representation of one representative from each State, which now goes away. And also about those four bodies, the appellate authority, the NMC will act as an appellate authority with respect to the decisions of those four boards but it is not clear whether the state will have any authority to appeal against any decision of the board. That is also not clear here.
And the Medical Advisory Council has representation from the state but their function is entirely advisory. Also that in both places, in the commission and in the advisory body, there is a single person, like you are saying, the tehsildar and the collector becomes the same. That is also erroneous here.
No rationale has been given for determining the fee. It is only for a maximum of 40 per cent of the seats in private medical Institutions. It is not clear why the balance 60 per cent of the seats has been left open. Is it for more corruption to take place through the 60 per cent, which is not in keeping with the Honorable Supreme Court verdict. So as it stands today, this bill cannot be accepted. It should be send back for reconsideration. We oppose this Bill. Thank you, Sir.