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 This Act was repealed and replaced with a new Act in 1956.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:

  • Maintenance of standards in medical education through curriculum guidelines, inspections and permissions to start colleges, courses or increasing number of seats
  • Recognition of medical qualifications
  • Registration of doctors and maintenance of the All India Medical Register
  • Regulation of the medical profession by prescribing a code of conduct and taking action against erring doctors

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!

The Chemical Weapons Convention (Amendment) Bill, 2010 (the Bill) was recently passed by the Lok Sabha without any amendment.  The Chemical Weapons Convention Act, 2000 (the Act) was enacted to give effect to the United Nations Convention on the Prohibition of the Development, Production, Stockpiling and Use of Chemical Weapons and on their Destruction (the CWC).  The CWC aims to eliminate chemical weapons by prohibiting their development, acquisition, stockpiling, transfer or use by State Parties. The 188 State Parties of the CWC are required to take the steps necessary to prohibit these activities within their jurisdiction. India signed the Convention on January 14, 1993. The Bill was introduced in the Rajya Sabha on April 16, 2010 by the Minister of State in the Ministry of Chemicals and Fertilizers, Mr. Srikant Kumar Jena.  The Standing Committee submitted its report on August 3, 2010. This Bill was passed by the Rajya Sabha on May 3, 2012 with some amendments based on the recommendations of the Standing Committee.  The recommendations of the standing committee and the subsequent amendments made by the Rajya Sabha are as follows:

  • The Act disallows any person from transferring or receiving specified toxic chemicals from a citizen of a non-State Party.  The Bill changes this position by prohibiting transfer or receipt of the specified toxic chemicals from a non-State Party to the Convention.  The Committee recommended that the provision should clearly prohibit transfer or receipt from both non-State Parties and citizens of non-State Parties.  The Rajya Sabha has made the corresponding amendment to the Bill.
  • The Act mandates the registration of persons engaged in the production, transfer, or use of any toxic chemical.  The Bill makes registration mandatory, subject to certain threshold limits that are prescribed, for manufacturers of specified chemicals.  The Committee observed that this would make registration mandatory only for those manufacturers who cross the specified limit.  Thus, the Committee asked the government to consider a two-step process of compulsory registration of all manufacturers, followed by a declaration of those crossing the threshold limits.  This recommendation has not been accepted by the Rajya Sabha.  Hence, only those persons whose production of toxic chemicals exceeds the threshold would be required to register.
  •  The Act established a National Authority to implement the provisions of the Convention.  It empowers the central government to appoint officers of the National Authority as enforcement officers. The Bill broadens the central government’s power by allowing it to appoint any of its officers as enforcement officers.  The Committee recommended that eligibility criteria, such as technical qualifications and expertise, for these officers should be set under the rules.  The Committee also recommended that officers should be given suitable training before their appointment.  The Rajya Sabha has incorporated the suggestion of prescribing eligibility criteria under the Bill.

The Lok Sabha passed the Bill on August 30, 2012 without any amendments.  The standing committee report and its summary may be accessed here and here.