NMC Bill Persists With Old Tendency Of Centralisation

On August 1, the Rajya Sabha passed the National Medical Commission Bill which seeks to replace the Medical Council of India Act, 1956. This Bill seeks to replace the selection process of the governors of the MCI — currently, by and large, medical practitioners elected by state-level peers — with governors who will mostly be medical practitioners nominated by the Central Government. In its opposition to this bill, the Indian Medical Association has said that “the autonomy of the medical profession and the watch-dog role it should play. will be lost. It will only lead to autocracy in these institutions.” Many doctors have also risen up in protest against this Bill because a clause allows work by health professionals. But that is misguided opposition borne of the sense that doctors do special work and, therefore, should regulate themselves autonomously.

This physician self-regulation harms Indians. Starting with training, being a doctor in the US involved me having to stay up all night ensuring that everything relevant was done for the patient and documenting those activities. The reason was a system of accountability — I could easily get sued for not providing the best care. And crucially, this also ensured that my providing good care was the responsibility of other people. Medical errors are estimated to kill 250,000 people every year in the US, the third largest cause of death in the country.

While there is no comparable data in India, it is likely that many more people die here because of the absence of accountability. When errors happen in the US, patients are empowered to seek redress from doctors. But in India, medical services are not under the Consumer Protection Act. This ensures that the patient and their kin can’t have their say and the incentive to hold someone accountable dies away. As a result, while nearly 5,000 US doctors have a disciplinary procedure in different state boards every year, in India the centralised MCI reports that only 96 have been blacklisted in the last 60 years (none since 2014). This system of unaccountability has ensured that while there are some extremely good, dedicated doctors in India, most of those I come across act in a manner more accountable to their own pockets than to the well-being of their patients. – The Indian Express

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