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The counting of votes for General Election 2019, which concluded on Sunday, will begin tomorrow, i.e., 23rd May at 8 AM. The election was conducted in 7 phases for 543 constituencies of Lok Sabha. The Election Commission of India (ECI) uses Electronic Voting Machines (EVM) to conduct elections. Since 2000, ECI has conducted 113 assembly elections and three general elections using EVMs.[1] Voter Verified Paper Audit Trail (VVPAT) system was added to EVMs in 2013 to increase transparency and improve voter confidence in the system. The VVPAT system generates a printed paper slip bearing the name and election symbol of the candidate. On April 8, 2019, Supreme Court instructed the ECI that printed VVPAT slips from randomly selected five polling stations in each assembly segment of a parliamentary constituency should be matched with EVMs.[2] In this blog, we explain the election counting process in India.
Who is responsible for counting the votes?
The Returning Officer (RO) is responsible for conducting elections in a constituency, which also includes counting of votes.[3] The RO is an officer of the government or a local authority nominated by the ECI for each constituency in consultation with the state government.[4]
Where does the counting take place?
The RO decides the place where the votes will be counted for the parliamentary constituency. The date and time of counting is fixed by the ECI. Ideally counting of votes for a constituency should be done at one place, preferably at the Headquarter of the RO in that constituency. It should be performed under the direct supervision of the RO. However, each Parliamentary Constituency has multiple assembly segments. In this situation, counting can take place at different locations for various assembly segments under the direct supervision of an Assistant Returning Officer (ARO).
Layout of the Counting Hall
Page 431, Handbook for Returning Officer Document 23 Edition 1, Election Commission of India
Counting of votes for each assembly segment of a parliamentary constituency is performed in a single hall. In each round of counting, votes from 14 EVMs are counted. In case of simultaneous parliamentary and assembly elections, such as Odisha, the first seven tables are used for counting votes for assembly elections, and the rest for parliamentary elections.
In constituencies with a large number of candidates, it may not be possible to count votes for all candidates in a single hall without overcrowding it. In such a situation, the number of counting halls or tables can be increased with the prior permission of the ECI. A hall can also be used for counting votes of another assembly segment after the results of the first segment are declared. However, counting may be done for only one assembly segment in a hall at any point of time.
What is the counting process?
Counting is performed by counting supervisors appointed by the RO. Counting staff is appointed through a three stage randomisation process to ensure impartiality. Candidates along with their counting agents and election agents are also present in the counting hall.
Counting of votes begins with Electronically Transmitted Postal Ballots (ETPB) and Postal Ballots (PB). These votes are counted under the direct supervision of the RO. Counting of EVMs can start 30 minutes after the commencement of PB counting, even if all PBs have not been counted. At the end of each round of counting, the results from 14 EVMs are declared.
What is the process for counting VVPAT slips?
The ECI prescribes the process for randomly selecting one EVM for each assembly segment of a parliamentary constituency for VVPAT matching. The verification of VVPAT paper slips is conducted inside a secured VVPAT Counting Booth in the counting hall with access to authorised personnel only. Any counting table in the hall can be converted into VVPAT Counting Booth after completing EVM vote counting. Parliamentary constituencies generally have between five and ten assembly segments.
The Supreme Court has decided that VVPAT slips of five randomly selected polling stations for each assembly segment shall be matched with the result shown in the respective EVMs. This implies that VVPAT paper slips need to be matched for about 25-50 machines for each parliamentary constituency. This process requires personal supervision of RO/ARO. The ECI has decided that the counting of five VVPATs will be done sequentially.[5] The RO can declare the final result for the constituency after the VVPAT matching process has been completed.
What happens if there is a discrepancy between the VVPAT count and the EVM results?
In such a case, the printed paper slips count is taken as final. The ECI has not clarified whether there would be any further action (such as counting of all VVPATs in a constituency or assembly segment) if there is a discrepancy in the counts of one of the five VVPATs.
[1] https://www.eci.gov.in/files/file/8756-status-paper-on-evm-edition-3/.
[2] N Chandrababu Naidu and Ors. v. Union of India and Anr WP(C). 273/2019 decided on April 8, 2019.
[3] https://www.eci.gov.in/files/file/9400-hand-book-for-returning-officer-february-2019/.
[4] https://www.eci.gov.in/faqs/elections/election-machinery/faqs-election-machinery-r1/.
[5] https://www.eci.gov.in/files/file/10197-mandatory-verification-of-vvpat-paper-slips-regarding/.
The National Medical Commission (NMC) Bill, 2017 was introduced in Lok Sabha in December, 2017. It was examined by the Standing Committee on Health, which submitted its report during Budget Session 2018. The Bill seeks to regulate medical education and practice in India. In this post, we analyse the Bill in its current form.
How is medical education and practice regulated currently?
The Medical Council of India (MCI) is responsible for regulating medical education and practice. Over the years, there have been several issues with the functioning of the MCI with respect to its regulatory role, composition, allegations of corruption, and lack of accountability. For example, MCI is an elected body where its members are elected by medical practitioners themselves, i.e. the regulator is elected by the regulated. In light of such issues, experts recommended nomination based constitution of the MCI instead of election, and separating the regulation of medical education and medical practice. They suggested that legislative changes should be brought in to overhaul the functioning of the MCI.
To meet this objective, the Bill repeals the Indian Medical Council Act, 1956 and dissolves the current Medical Council of India (MCI) which regulates medical education and practice.
Who will be a part of the NMC?
The NMC will consist of 25 members, of which at least 17 (68%) will be medical practitioners. The Standing Committee has noted that the current MCI is non-diverse and consists mostly of doctors who look out for their own self-interest over larger public interest. In order to reduce the monopoly of doctors, it recommended that the MCI should include diverse stakeholders such as public health experts, social scientists, and health economists. In other countries, such as the United Kingdom, the General Medical Council (GMC) responsible for regulating medical education and practice consists of 12 medical practitioners and 12 lay members (such as community health members, and administrators from the local government).
How will the issues of medical misconduct be addressed?
The State Medical Council will receive complaints relating to professional or ethical misconduct against a registered doctor. If the doctor is aggrieved by the decision of the State Medical Council, he may appeal to the Ethics and Medical Registration Board, and further before the NMC. Appeals against the decision of the NMC will lie before the central government. It is unclear why the central government is an appellate authority with regard to such matters.
It may be argued that disputes related to ethics and misconduct in medical practice may require judicial expertise. For example, in the UK, the GMC receives complaints with regard to ethical misconduct and is required to do an initial documentary investigation. It then forwards the complaint to a Tribunal, which is a judicial body independent of the GMC. The adjudication and final disciplinary action is decided by the Tribunal.
What will the NMC’s role be in fee regulation of private medical colleges?
In India, the Supreme Court has held that private providers of education have to operate as charitable and not for profit institutions. Despite this, many private education institutions continue to charge exorbitant fees which makes medical education unaffordable and inaccessible to meritorious students. Currently, for private unaided medical colleges, the fee structure is decided by a committee set up by state governments under the chairmanship of a retired High Court judge. The Bill allows the NMC to frame guidelines for determination of fees for up to 40% of seats in private medical colleges and deemed universities. The question is whether the NMC as a regulator should regulate fees charged by private medical colleges.
A NITI Aayog Committee (2016) was of the opinion that a fee cap would discourage the entry of private colleges, therefore, limiting the expansion of medical education. It also observed that it is difficult to enforce such a fee cap and could lead medical colleges to continue charging high fees under other pretexts.
Note that the Parliamentary Standing Committee (2018) which examined the Bill has recommended continuing the current system of fee structures being decided by the Committee under the chairmanship of a retired High Court judge. However, for those private medical colleges and deemed universities, unregulated under the existing mechanism, fee must be regulated for at least 50% of the seats. The Union Cabinet has approved an Amendment to increase the regulation of fees to 50% of seats.
How will doctors become eligible to practice?
The Bill introduces a National Licentiate Examination for students graduating from medical institutions in order to obtain a licence to practice as a medical professional.
However, the NMC may permit a medical practitioner to perform surgery or practice medicine without qualifying the National Licentiate Examination, in such circumstances and for such period as may be specified by regulations. The Ministry of Health and Family Welfare has clarified that this exemption is not meant to allow doctors failing the National Licentiate Examination to practice but is intended to allow medical professionals like nurse practitioners and dentists to practice. It is unclear from the Bill that the term ‘medical practitioner’ includes medical professionals (like nurses) other than MBBS doctors.
Further, the Bill does not specify the validity period of this licence to practice. In other countries such as the United Kingdom and Australia, a licence to practice needs to be periodically renewed. For example, in the UK the licence has to be renewed every five years, and in Australia it has to renewed annually.
What are the issues around the bridge course for AYUSH practitioners to prescribe modern medicine?
The debate around AYUSH practitioners prescribing modern medicine
There is a provision in the Bill which states that there may be a bridge course which AYUSH practitioners (practicing Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) can undertake in order to prescribe certain kinds of modern medicine. There are differing views on whether AYUSH practitioners should prescribe modern medicines.
Over the years, various committees have recommended a functional integration among various systems of medicine i.e. Ayurveda, modern medicine, and others. On the other hand, experts state that the bridge course may promote the positioning of AYUSH practitioners as stand-ins for allopathic doctors owing to the shortage of doctors across the country. This in turn may affect the development of AYUSH systems of medicine as independent systems of medicine.
Moreover, AYUSH doctors do not have to go through any licentiate examination to be registered by the NMC, unlike the other doctors. Recently, the Union Cabinet has approved an Amendment to remove the provision of the bridge course.
Status of other kinds of medical personnel
As of January 2018, the doctor to population ratio in India was 1:1655 compared to the World Health Organisation standard of 1:1000. The Ministry of Health and Family Welfare stated that the introduction of the bridge course for AYUSH practitioners under the Bill will help fill in the gaps of availability of medical professionals.
If the purpose of the bridge course is to address shortage of medical professionals, it is unclear why the option to take the bridge course does not apply to other cadres of allopathic medical professionals such as nurses, and dentists. There are other countries where medical professionals other than doctors are allowed to prescribe allopathic medicine. For example, Nurse Practitioners in the USA provide a full range of primary, acute, and specialty health care services, including ordering and performing diagnostic tests, and prescribing medications. For this purpose, Nurse Practitioners must complete a master’s or doctoral degree program, advanced clinical training, and obtain a national certification.
