Census 2011 or the 15th National Census, a gigantic exercise to capture the socio-economic and cultural profile of India’s population, began on April 1, 2010. India undertakes this exercise every 10 years through the Office of the Registrar General and Census Commissioner in the Ministry of Home Affairs. The census documents details of a billion plus population on diverse subjects such as demography, literacy, fertility and mortality and provides primary data at village, town and ward level. The first census ever to take place in India was in 1872 and the last one was held in 2001. The Census of India Act, 1948 lays down the rules and regulations pertaining to conduct of a census. The Act makes it obligatory for the public to answer all the questions faithfully while guaranteeing the confidentiality of the information. The last census was held in 2001, which revealed that India’s population was about 1.03 billion. Statistical data related to literacy rate, sex-ratio, urban-rural distribution, religious composition, SC/ST population and so on were captured by Census 2001. Features of Census 2011 Census process: India uses the canvasser method for collecting census data. Under this method, the canvasser approaches every household and records the answer on the schedules himself after ascertaining the particulars from the head of the household or other knowledgeable persons in the household. The full detail of the methodology is available here. National Population Register (NPR): It would be a register or database of residents of the country. The government states that such a database would facilitate better targeting of the benefits and services under government schemes and programmes; improve planning and help strengthen the security of the country. The register is being created under the provisions of the Citizenship Act and Rules. NPR process: Basic details such as name, date of birth and sex shall be gathered by visiting each household of a resident of the country. A database shall be created with addition of biometric information such as photograph, 10 fingerprints and probably Iris information for all persons aged 15 years and above. The list shall be sent to the Unique Identity Authority of India (UIDAI) for de-duplication and issue of UID Numbers. The cleaned database along with the UID Number would form the National Population Register. There was a controversy over whether Census 2011 should capture caste data. Since India last collected caste data in 1931, proponents argued that up-to-date, reliable caste data was essential to target welfare schemes towards various backward castes. Opponents however contended that this would perpetuate the caste system. The government finally decided not to include caste as one of the parameters in the 2011 census. Table 1: Schedule of Census 2011
| Schedule | State/UT |
| April 1 | New Delhi (NDMC area), West Bengal, Assam, Andaman & Nicobar Islands, Goa, Meghalaya, Bihar, Jharkhand |
| April 7 | Kerala, Lakshadweep, Orissa, Himachal Pradesh, Sikkim |
| April 15 | Karnataka, Arunachal Pradesh, Chandigarh |
| April 21 | Gujarat, Dadra & Nagar Haveli, Daman & Diu |
| April 26 | Tripura, Andhra Pradesh |
| May 1 | Haryana, Chhattisgarh, Delhi, Punjab, Uttaranchal, Maharashtra |
| May 7 | Madhya Pradesh |
| May 15 | J & K, Manipur, Mizoram, Rajasthan, Uttar Pradesh |
| June 1 | Tamil Nadu, Puducherry, Nagaland |
The National Medical Commission Bill, 2017 was introduced in Lok Sabha recently and is listed for consideration and passage today.[1] The Bill seeks to regulate medical education and practice in India. To meet this objective, the Bill repeals the Indian Medical Council Act, 1956 and dissolves the current Medical Council of India (MCI). The MCI was established under the 1956 Act, to establish uniform standards of higher education qualifications in medicine and regulating its practice.[2]
A Committee was set up in 2016, under the NITI Aayog with Dr. Arvind Panagariya as its chair, to review the 1956 Act and recommend changes to improve medical education and the quality of doctors in India.[3] The Committee proposed that the Act be replaced by a new law, and also proposed a draft Bill in August 2016.
This post looks at the key provisions of the National Medical Commission Bill, 2017 introduced in Lok Sabha recently, and some issues which have been raised over the years regarding the regulation of medical education and practice in the country.
What are the key issues regarding the regulation of medical education and practice?
Several experts have examined the functioning of the MCI and suggested a different structure and governance system for its regulatory powers.3,[4] Some of the issues raised by them include:
Separation of regulatory powers
Over the years, the MCI has been criticised for its slow and unwieldy functioning owing to the concentration and centralisation of all regulatory functions in one single body. This is because the Council regulates medical education as well as medical practice. In this context, there have been recommendations that all professional councils like the MCI, should be divested of their academic functions, which should be subsumed under an apex body for higher education to be called the National Commission for Higher Education and Research.[5] This way there would be a separation between the regulation of medical education from regulation of medical practice.
An Expert Committee led by Prof. Ranjit Roy Chaudhury (2015), recommended structurally reconfiguring the MCI’s functions and suggested the formation of a National Medical Commission through a new Act.3 Here, the National Medical Commission would be an umbrella body for supervision of medical education and oversight of medial practice. It will have four segregated verticals under it to look at: (i) under-graduate medical education, (ii) post-graduate medical education, (iii) accreditation of medical institutions, and (iv) the registration of doctors. The 2017 Bill also creates four separate autonomous bodies for similar functions.
Composition of MCI
With most members of the MCI being elected, the NITI Aayog Committee (2016) noted the conflict of interest where the regulated elect the regulators, preventing the entry of skilled professionals for the job. The Committee recommended that a framework must be set up under which regulators are appointed through an independent selection process instead.
Fee Regulation
The NITI Aayog Committee (2016) recommended that a medical regulatory authority, such as the MCI, should not engage in fee regulation of private colleges. Such regulation of fee by regulatory authorities may encourage an underground economy for medical education seats with capitation fees (any payment in excess of the regular fee), in regulated private colleges. Further, the Committee stated that having a fee cap may discourage the entry of private colleges limiting the expansion of medical education in the country.
Professional conduct
The Standing Committee on Health (2016) observed that the present focus of the MCI is only on licensing of medical colleges.4 There is no emphasis given to the enforcement of medical ethics in education and on instances of corruption noted within the MCI. In light of this, the Committee recommended that the areas of medical education and medical practice should be separated in terms of enforcement of the appropriate ethics for each of these stages.
What does the National Medical Commission, 2017 Bill seek do to?
The 2017 Bill sets up the National Medical Commission (NMC) as an umbrella regulatory body with certain other bodies under it. The NMC will subsume the MCI and will regulate the medical education and practice in India. Under the Bill, states will establish their respective State Medical Councils within three years. These Councils will have a role similar to the NMC, at the state level.
Functions of the NMC include: (i) laying down policies for regulating medical institutions and medical professionals, (ii) assessing the requirements of human resources and infrastructure in healthcare, (iii) ensuring compliance by the State Medical Councils with the regulations made under the Bill, and (iv) framing guidelines for determination of fee for up to 40% of the seats in the private medical institutions and deemed universities which are governed by the Bill.
Who will be a part of the NMC?
The NMC will consist of 25 members, appointed by the central government. It will include representatives from Indian Council of Medical Research, and Directorate General of Health Services. A search committee will recommend names to the central government for the post of Chairperson, and the part-time members. These posts will have a maximum term of four years, and will not be eligible for extension or reappointment.
What are the regulatory bodies being set up under the NMC?
The Bill sets up four autonomous boards under the supervision of the NMC, as recommended by various experts. Each autonomous board will consist of a President and two members, appointed by the central government (on the recommendation of the search committee). These bodies are:
What does the Bill say regarding the conduct of medical entrance examinations?
There will be a uniform National Eligibility-cum-Entrance Test (NEET) for admission to under-graduate medical education in all medical institutions governed by the Bill. The NMC will specify the manner of conducting common counselling for admission in all such medical institutions.
Further, there will be a National Licentiate Examination for the students graduating from medical institutions to obtain the license for practice. This Examination will also serve as the basis for admission into post-graduate courses at medical institutions.
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[1] The National Medical Commission Bill, 2017, http://www.prsindia.org/uploads/media/medical%20commission/National%20Medical%20Commission%20Bill,%202017.pdf.
[2] Indian Medical Council Act, 1933.
[3] A Preliminary Report of the Committee on the Reform of the Indian Medical Council Act, 1956, NITI Aayog, August 7, 2016, http://niti.gov.in/writereaddata/files/document_publication/MCI%20Report%20.pdf.
[4] “Report no. 92: Functioning of the Medical Council of India”, Standing Committee on Health and Family Welfare, March 8, 2016, http://164.100.47.5/newcommittee/reports/EnglishCommittees/Committee%20on%20Health%20and%20Family%20Welfare/92.pdf
[5] “Report of the Committee to Advise on Renovation and Rejuvenation of Higher Education”, Ministry of Human Resource Development, 2009, http://mhrd.gov.in/sites/upload_files/mhrd/files/document-reports/YPC-Report.pdf.
