Building consent: On PG Medical Education Regulations 2021
A consensus on the Postgraduate
Medical Education Regulations 2021 is a must
The Indian Medical Association
(IMA), the largest organisation of doctors in India, has demanded that the
National Medical Commission (NMC) withdraw the draft Postgraduate Medical Education
Regulations 2021. In its current form, it notes that there shall be common
counselling for admission in all medical educational institutions to all
Post-graduate ‘Broad-Specialty’ courses (Diploma/MD/MS) on the basis of the
merit list of the National Exit Test. Currently, admissions to such programmes
are based on the post-graduate NEET. Half the seats to the various courses are
based on the all-India quota and the rest are admitted by the State
governments, which comply with reservation norms. The IMA contends that the
draft regulations leave States with no power or discretion to manage admissions
to State medical colleges, which rely on State funds. If States did not have
the freedom to decide on student intake, they would find it hard to provide quality
medical services to the local population. The proposed regulations follow from
the provisions of the National Medical Commission Act, 2019, that itself
replaced the Medical Council Act of India and was a subject of extreme friction
between medical professionals and the Centre. In both instances, the heart of
the objection is States’ discomfort with ceding powers to the Centre. The
familiar argument of the States is that health care is a State subject. Through
the decades, while the Centre plays the critical role of funding and conceiving
targeted programmes to ameliorate disease and improve overall health-care
standards, the matter of implementation has always been left to the States.
The Centre has an important role
in setting standards and amplifying best practices so that minimum — but ever
improving — standards of health care are delivered across all States. Much like
cadres of the IAS are deputed to States based on centralised examinations,
there is, in principle, no reason for such a system not to be effective, but
the Centre needs to be extremely responsive to States’ views on the same. The
very real problem, laid bare during the pandemic, is the shortage and extremely
uneven availability of quality health care. Through the years, attempts are being
made to improve this by trying to bridge alternative systems of medicines with
modern medicine, but these have always been marred by political and religious
overtones, and a convergence seems unlikely in the near future. The import of
the proposals should not be made hostage to a Centre-States power struggle.
Efforts must be made to build more consensus involving stakeholders, such as
the IMA, State medical councils and representatives of health-care groups.
TH Editorial, 12-08-2021
