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The Saansad Adarsh Gram Yojana was launched last week, for the development of model villages.  Under the Yojana, Members of Parliament (MPs) will be responsible for developing the socio-economic and physical infrastructure of three villages each by 2019, and a total of eight villages each by 2024.

The first Adarsh Gram must be developed by 2016, and two more by 2019.  From 2019 to 2024, five more Adarsh Grams must be developed by each MP, one each year.  This implies that a total of 6,433 Adarsh Grams, of the 2,65,000 gram panchayats, will be created by 2024. Key features of the Yojana are outlined below.

Objectives

Key objectives of the Yojana include:

  1. The development of model villages, called Adarsh Grams, through the implementation of existing schemes, and certain new initiatives to be designed for the local context, which may vary from village to village.
  2. Creating models of local development which can be replicated in other villages.

Identification of villages

MPs can select any gram panchayat, other than their own village or that of their spouse, to be developed as an Adarsh Gram.  The village must have a population of 3000-5000 people if it is located in the plains, or 1000-3000 people if located in hilly areas.

Lok Sabha MPs can choose a village from their constituency, and Rajya Sabha MPs from the state from which they are elected.  Nominated members can choose a village from any district of the country.  MPs which represent urban constituencies can identify a village from a neighbouring rural constituency.

Funding

No new funds have been allocated for the Yojana.  Resources may be raised through:

  1. Funds from existing schemes, such as the Indira Awas Yojana, Pradhan Mantri Gram Sadak Yojana, Mahatma Gandhi National Rural Employment Guarantee Scheme, and Backward Regions Grant Fund, etc.,
  2. The Member of Parliament Local Area Development Scheme (MPLADS),
  3. The gram panchayat’s own revenue,
  4. Central and State Finance Commission Grants, and
  5. Corporate Social Responsibility funds.

Implementation

A Village Development Plan must be created for each Adarsh Gram.  While each village will develop a list of activities to be carried out, based on its own resources and requirements, possible activities have been listed in the guidelines for the scheme.  For example, Adarsh Grams can work towards providing universal access to basic healthcare facilities, promoting diversified livelihoods through agriculture related livelihoods and skill development, providing pension for all eligible families, housing for all, and promoting social forestry.

The table below outlines key functionaries at the national, state, district, and village level and their responsibilities.

Table 1: Roles and responsibilities of key functionaries

Level Functionary Key roles and responsibilities
National Member of Parliament
  • Identify the Adarsh Gram
  • Facilitate the planning process
  • Mobilise additional funds
  • Monitor the scheme
  Two committees, headed by the Minister of Rural Development, and Secretary, Rural Development, respectively.*
  • Monitor the process of identification and planning
  • Review the implementation of the scheme
  • Identify bottlenecks in the scheme
  • Issue operational guidelines
  • Indicate specific resource support which each Ministry can provide
State A committee headed by the Chief Secretary
  • Supplement central guidelines for the scheme
  • Review Village Development Plans
  • Review implementation
  • Outline monitoring mechanisms
  • Design a grievance redressal mechanism for the scheme
District District Collector
  • Conduct the baseline survey
  • Facilitate the preparation of the Village Development Plan
  • Converge relevant schemes
  • Ensure grievance redressal
  • Monthly progress review of the scheme
Village Gram Panchayat and functionaries of schemes (at various levels)
  • Implement of the scheme
  • Identify common needs of the village
  • Leverage resources from various programmes
  • Ensure participation in the scheme

Note: *These committees will include members from other Ministries.

Sources: Saansad Adarsh Gram Yojana Guidelines, Ministry of Rural Development; PRS

Monitoring

A web based monitoring system will be established to enable the MP and other stakeholders to monitor the scheme.  Outputs relating to physical and financial targets will be measured each quarter.  A mid-term evaluation and post-project evaluation will be conducted through an independent agency.

More information on the scheme is available in the guidelines for the scheme, here.

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:

  • The Under-Graduate Medical Education Board (UGMEB) and the Post-Graduate Medical Education Board (PGMEB): These two bodies will be responsible for formulating standards, curriculum, guidelines, and granting recognition to medical qualifications at the under-graduate and post-graduate levels respectively;
  • The Medical Assessment and Rating Board: The Board will have the power to levy monetary penalties on institutions which fail to maintain the minimum standards as laid down by the UGMEB and the PGMEB.  It will also grant permissions for establishing new medical colleges; and
  • The Ethics and Medical Registration Board: The Board will maintain a National Register of all licensed medical practitioners, and regulate professional conduct.  Only those included in the Register will be allowed to practice as doctors.

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.