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 This Act was repealed and replaced with a new Act in 1956.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!
As of April 23, Delhi has 2,248 cases of COVID-19. After Maharashtra and Gujarat, Delhi has the highest number of cases in the country. On March 22, when the number of cases rose to 29, the Delhi government announced lockdown in the state until March 31, to contain the spread of COVID-19. This has been followed by a nation-wide lockdown by the central government between March 25 and May 3. In this blog, we summarise some of the key measures taken by the state government in response to COVID-19 so far.
Before the lockdown
On March 8, with three cases of COVID-19 in the state, the Department of Health and Family Welfare decided to carry out an awareness drive at various crowded places during Holi. Along with it, the government also took several other steps for mitigating the spread of COVID-19 in the state. Some of these measures are summarised below.
Health Measures
Disinfecting the vehicles: On March 11 and 12, the government ordered to disinfect minibuses, school buses and school cabs daily.
The Delhi Epidemic Diseases, COVID-19 Regulations, 2020: On March 12, with six cases of COVID-19, the Delhi government notified The Delhi Epidemic Diseases, COVID-19 Regulations, 2020. These regulations are valid for a year. Key provisions include:
(i) All government and private hospitals should have dedicated flu corners.
(ii) home quarantine for people who have travelled through the affected areas, and
(iii) Certain persons authorised under the Regulations, with the approval of the State Task Force, can take necessary measures to contain the spread of COVID-19, such as: (i) sealing a geographical area, (ii) restricting the movement of vehicles and people, and (iii) initiating active and passive surveillance of COVID-19 cases.
Movement Restrictions
Educational institutions: On March 12, the government ordered the closure of all educational institutions up to March 31. The students writing examinations were allowed to attend them along with the staff. However, on March 19, the government ordered the postponement of exams until March 31.
Public gatherings:
Restaurants and private establishments: On March 19, all restaurants were ordered to discontinue sitting arrangements until March 31. Private establishments were ordered to allow their employees to work from home till March 31.
Delhi-Kathmandu bus service: On March 20, the government suspended the Delhi-Kathmandu bus service, officially known as the Maitri Bus Sewa.
During the lockdown
On March 22, when the number of cases rose to 29, the Delhi government announced the lockdown in the state until March 31. The lockdown involved: (i) suspending the public transport services, (ii) sealing borders with Haryana and Uttar Pradesh, (iii) suspending all domestic and international flights arriving in Delhi, and (iv) banning the congregation of more than five persons at any public place. This was followed by a nation-wide lockdown enforced by the central government between March 25 and April 14, now extended till May 3.
Starting from April 20, the central government allowed certain activities in less-affected districts of the country. However, the Delhi government, on April 19, announced that there will not be any relaxation in the lockdown in Delhi, until another comprehensive assessment which will be made on April 27.
Welfare Measures
The Delhi government announced several welfare measures to address the difficulties being faced by people during the lockdown. Key measures include:
Night shelters: The Delhi Urban Shelter Improvement Board is providing free meals to the homeless people staying in the night shelters. On March 25, a hunger helpline was set up which directs the needy people to the nearest night shelter for food.
Hunger Relief Centers: On March 26, the government directed the District Magistrates to set up at least two hunger relief centres in every municipal ward for providing 500 meals twice (lunch and dinner) every day at each centre.
Financial assistance: The government is providing one-time financial assistance of Rs 5,000 to drivers of vehicles such as autos, taxis, and e-rickshaws.
Compensation to family members: The Delhi government will be giving compensation of one crore rupees to the family members of the employees who may die due to COVID-19.
Health Measures
Additional manpower: On March 24, the government ordered the hospitals and institutions under the Department of Health and Family Welfare to engage up to 25% additional manpower in outsourced services such as sanitation, security, and nursing assistants.
Wearing masks made compulsory: On April 8, the government made it compulsory for all people to wear masks in public places, offices, gatherings, meetings, and personal vehicles.
Identification of paid quarantine facilities: On April 13, the government ordered all district magistrates to identify paid quarantine facilities in their respective districts for housing the people who would like to use private facilities on payment basis.
Creation of a multi-sectoral dedicated team: On April 13, the government ordered for the creation of the Corona Foot Warriors and Containment Team at every booth. The government aims to enhance ground level intervention through them.
Setting up Helpline: On April 17, the Department of Health and Family Welfare set up a dedicated 24x7 Whatsapp number for receiving complaints and requests from the people related to COVID-19.
Measures related to Media
The government took the following steps to control the spread of fake news related to COVID-19:
For more information on the spread of COVID-19 and the central and state government response to the pandemic, please see here.
