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 This Act was repealed and replaced with a new Act in 1956.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!
In 2010, the Legislative Assistants to Members of Parliament (LAMP) Fellowship was conceptualised by PRS Legislative Research, creating a unique platform for young Indians to engage with policy making at the national level. The Fellowship, a first of its kind in India, provides an opportunity for youth passionate about public policy to work with a Member of Parliament. Launched in collaboration with the Constitution Club of India, the Fellowship began with 12 Fellows and has now grown to include more than 40 young men and women from across India working with MPs from across political parties.
The Work
The bulk of the Fellow’s work focuses on Parliament. On average, Parliament passes 60 Bills a year. These Bills, covering a wide range of issues from food security to criminal laws, represent the government’s policy choices. Informed debates on legislation are therefore critical. Parliamentarians also use the floor of the House to discuss and debate urgent matters of public interest. The LAMP Fellowship provides young Indians with the opportunity to do legislative work through a 11-month professional engagement with an MP. Fellows are exposed to critical issues in public policy through which they will acquire knowledge about policy, parliament and governance structures, develop analytical abilities and hone leadership skills.
The Fellow typically supports an MP by providing research inputs for: policy and legislative debates, parliamentary Questions, standing committee meetings, and framing private members’ Bills. Beyond Parliament, MPs have to focus on their constituency; LAMP fellows may work on issues at the constituency level. Many Fellows in the current cohort have also had a chance to visit the parliamentary constituencies, often travelling with the MP to meet district officials and engage with constituents. Visits usually include a trip to the site of a centrally-sponsored scheme, engaging with public health officials, or attending panchayat meetings. Some Fellows also assist their MPs with media-related work like drafting press releases and preparing research for public appearances.
Policy Exposure
The LAMP Fellowship is enriched by various workshops, seminars and discussions providing greater exposure to public policy. The current cohort have already engaged with experts like former Director General, CAG Amitabh Mukhopadhyay; social activists Reetika Khera and Harsh Mander; policy practitioners Nitin Pai of The Takshashila Institution, Laveesh Bhandari of Indicus Analytics and former Chairman of TRAI Nripendra Misra; and leading JNU academic, Niraja Gopal Jayal.
"At LAMP, there is no 'typical' day at work. Each day comes with new tasks, new challenges. My work for my MP has forced me out of my comfort zone to explore and understand an array of subjects." - Kavya Iyengar, LAMP Fellow 2012-13
Fellows also get the opportunity to interact with organisations from various sectors like Google India, UNHCR and BCG. For instance, this year’s Fellows participated in the iPolicy workshop for young leaders, organised by the Centre for Civil Society. Last year, the Indian School of Business (ISB) Hyderabad hosted LAMP Fellows for a 3-day residential leadership development workshop, led by professors and guest speakers, including former RBI Governor, Dr. YV Reddy.
The LAMP Fellowship provides policy exposure but also guarantees a truly distinctive year: no two LAMP Fellows have the same experience. Every MP will have different research demands; LAMP Fellows have to be flexible, self-motivated and hungry to learn. Work can be challenging but also hugely rewarding. Previous Fellows have used the Fellowship as a launch pad, pursuing further studies at top Universities like Yale, John Hopkins, and Oxford and embarking on careers in political consulting, public relations and think tanks. Some Fellows have even continued to support the work of parliamentarians, pursuing their area of interest like media, policy and constituency development projects.
India’s vibrant democracy is constantly confronted by complex, urgent and important challenges. The Fellowship provides a once in a lifetime opportunity to understand these challenges and, perhaps, even help overcome them. Be a part of the solution, be a LAMP Fellow.
