The Medical Council of India (MCI) has seen a few major controversies over the past decade. In the latest incident, MCI President, Dr. Ketan Desai was arrested by the CBI on charges of accepting a bribe for granting recognition to Gyan Sagar Medical College in Punjab. Following this incident, the central government promulgated an ordinance dissolving the MCI and replacing it with a centrally nominated seven member board. The ordinance requires MCI to be re-constituted within one year of its dissolution in accordance with the provisions of the original Act. Background The Medical Council of India was first established in 1934 under the Indian Medical Council Act, 1933. This Act was repealed and replaced with a new Act in 1956. Under the 1956 Act, the objectives of MCI include:
Over the years, several committees, the most recent being the National Knowledge Commission (NKC) and the Yashpal Committee, have commented on the need for reforms in medical regulation in the country. The Ministry of Health and Family Welfare (MoH&FW) has recently released a draft of the National Council for Human Resources in Health (NCHRH) Bill for public feedback. (See http://mohfw.nic.in/nchrc-health.htm) Key issues in Medical Regulation Oversight Currently, separate regulatory bodies oversee the different healthcare disciplines. These include the Medical Council of India, the Indian Nursing Council, the Dental Council of India, the Rehabilitation Council of India and the Pharmacy Council of India. Each Council regulates both education and professional practice within its domain. The draft NCHRH Bill proposes to create an overarching body to subsume these councils into a single structure. This new body, christened the National Council for Human Resources in Health (NCHRH) is expected to encourage cross connectivity across these different health-care disciplines. Role of Councils Both the NKC and the Yashpal Committee make a case for separating regulation of medical education from that of profession. It is recommended that the current councils be divested of their education responsibilities and that these work solely towards regulation of professionals – prescribing a code of ethics, ensuring compliance, and facilitating continued medical education. In addition, it has been recommended that a national exit level examination be conducted. This exit examination should then serve the purpose of ‘occupational licensing’, unlike the prevalent registration system that automatically grants practice rights to graduating professionals. In effect, it is envisaged that the system be reconfigured on the lines of the Institute of Chartered Accountants, wherein the council restricts itself to regulating the profession, but has an indirect say in education through its requirements on the exit examination. A common national examination is also expected to ensure uniformity in quality across the country. Both committees also recommend enlisting independent accrediting agencies for periodically evaluating medical colleges on pre-defined criteria and making this information available to the public (including students). This is expected to bring more transparency into the system. Supervision of education – HRD vs. H&FW The Ministry of Human Resources and Development (MHRD) is proposing a National Council for Higher Education and Research (NCHER) to regulate all university education. However, MoH&FW is of the opinion that Medical Education is a specialized field and needs focused attention, and hence should be regulated separately. However, it is worth noting that both the NKC and the Yashpal Committee recommend transferring education overseeing responsibilities to the NCHER. Internationally, different models exist across countries. In the US, the Higher Education Act, 1965 had transferred all education responsibilities to the Department of Education. In the UK, both medical education and profession continue to be regulated by the General Medical Council (the MCI counterpart), which is different from the regulator for Higher Education. Composition of Councils In 2007-08, MCI, when fully constituted, was a 129 member body. The Ministry in its draft NCHRH Bill makes a case for reducing this size. The argument advanced is that such a large size makes the council unwieldy in character and hence constrains reform. In 2007-08, 71% of the members in the committee were elected. These represented universities and doctors registered across the country. However, the Standing Committee on H&FW report (2006) points out that delays in conducting elections usually leads to several vacancies in this category, thereby reducing the actual percentage of elected members. MCI’s 2007-08 annual report mentions that at the time of publishing the report, 29 seats (32% of elected category) were vacant due to ‘various reasons like expiry of term, non-election of a member, non-existence of medical faculty of certain Universities’. In November 2001, the Delhi High Court set aside the election of Dr. Ketan Desai as President of the MCI, stating that he had been elected under a ‘flawed constitution’. The central government had failed to ensure timely conduct of elections to the MCI. As a result, a number of seats were lying vacant. The Court ordered that the MCI be reconstituted at the earliest and appointed an administrator to oversee the functioning of the MCI until this was done. Several countries like the UK are amending their laws to make council membership more broad-based by including ‘lay-members’/ non-doctors. The General Medical Council in the UK was recently reconstituted and it now comprises of 24 members - 12 ‘lay’ and 12 medical members. (See http://www.gmc-uk.org/about/council.asp) Way ahead According to latest news reports, the MoH&FW is currently revising the draft Bill. Let's wait and see how the actual legislation shapes up. Watch this space for further updates!
Recently, the Parliament passed a law that addresses the issue of sexual harassment in the work place. The Bill, introduced in the Lok Sabha on December 7, 2010, drew on the 1997 judgment of the Supreme Court (known as the Vishaka judgment) to codify measures that employers need to take to address sexual harassment at the work place. (See PRS analysis of the Bill here). The Bill was first passed in the Lok Sabha on September 3, 2011. It incorporated many of the amendments recommended by the Standing Committee on Human Resource Development that examined the Bill. The Rajya Sabha passed it on February 27, 2013 without any new amendments (see Bill as passed by Parliament). We compare the key provisions of the Bill, the Standing Committee recommendations and the Bill that was passed by Parliament (for a detailed comparison, see here).
| Bill as introduced | Standing Committee recommendations | Bill as passed by Parliament |
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Clause 2: Status of domestic workers |
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| Excludes domestic workers from the protection of the Bill. | The definition should include (i) domestic workers; and (ii) situations involving ‘victimization’; | Includes domestic worker. Does not include victimisation. |
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Clause 4: Constitution of Internal Complaints Committee (ICC) |
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| The committee shall include 4 members: a senior woman employee, two or more employees and one member from an NGO committed to the cause of women. | The strength of ICC should be increased from 4 to at least 5 (or an odd number) to facilitate decisions in cases where the bench is divided. | Disqualifies a member if (a) he has been convicted of an offence or an inquiry is pending against him or (b) he is found guilty in disciplinary proceedings or a disciplinary proceeding is pending against him. |
| Members may not engage in any paid employment outside the office. | Barring paid employment outside the office goes against NGO members who may be employed elsewhere. This clause must be edited. | Deletes the provision that disallows NGO members to engage in paid employment outside. NGO members to be paid fees or allowances. |
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Clause 6: Constitution and jurisdiction of Local Complaints Committee (LCC) |
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| An LCC is required to be constituted in every district and additional LLCs at block level. At the block level the additional LCC will address complaints where the complainant does not have recourse to an ICC or where the complaint is against the employer. | The functions of the district level and the block level LCCs are not delineated clearly. It is also unclear whether the block level LCCs are temporary committees constituted for dealing with specific cases. Instead of creating additional LCCs at the block level, the District level LCC may be allowed to handle cases. A local member from the block may be co-opted as a member to aid the LCC in its task. | Accepted. |
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Clause 10: Conciliation |
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| The ICC/ LCC shall provide for conciliation if requested by the complainant. Otherwise, it shall initiate an inquiry. | Distinction should be made between minor and major offences. Conciliation should be allowed only for minor offences. | Adds a proviso that monetary settlement shall not be the basis on which conciliation is made. |
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Clause 11: Inquiry into Complaint |
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| ICC/LCC shall proceed to make inquiry into a complaint in such manner as may be prescribed. | No suggestion. | Inquiries will be conducted in accordance with service rules or in such manner as may be prescribed.For domestic workers, the LCC shall forward the complaint to the police within seven days if a prima facie case exists. The case shall be registered under section 509 of Indian Penal Code (word, gesture or act intended to insult the modesty of a woman). |
| Sources: The Protection of Women Against Sexual Harassment at Work Place Bill, 2010; the Standing Committee on HRD Report on the Bill; the Sexual Harassment at Work Place (Prevention, Prohibition and Redressal) Bill, 2012; PRS. | ||
