Straight from the Heart: National Medical Commission - After the storm

The Union Cabinet has effectively ended the era of Medical Council of India.
The citadel of modern medicine which initiated every young man and woman to the noble profession to alleviate the pain and suffering will now cease to exist.
The glorious era of MCI, which produced doctors of international caliber to serve the humankind as global doctors will come to an end. It will be replaced by a near total Government department called National Medical Commission.
IMA has been opposing NMC in its present form.
Devoid of federal character, this non-representative half non-medical body will be a poor substitute for the MCI. NMC will not represent the medical profession of India.

1. Anywhere in the world, medical profession is bestowed with reasonable autonomy. Patient care and Patient safety are the main benefits of such autonomy. 
2. Regulators need to have autonomy and be independent of the administrators.  The National Medical Commission will be a regulator appointed by the administrators under their direct control.      
3. It abolishes Medical Council of India and along with it possibly the section 15 of IMC Act, which says that the basic qualification to practice modern medicine is MBBS.
4. It takes away the voting right of every doctor in India to elect their medical council. Medical Council of India is a representative body of the medical profession in India.  Any registered medical practitioner in the country can contest the election and every qualified doctor can vote.Abolishing a democratic institution and replacing it by a body in which majority are nominated by the Government is certainly a retrograde step.
5. It allows the private medical colleges to charge at free will nullifying whatever solace NEET brought. The Government can fix the fee for only 40 percent of the seats in private medical colleges.
6. Instituting a Medical Licentiate exam after qualifying in final MBBS exam is an injustice. It is highly insensitive to the plight of medical students who even otherwise must undergo a long and tortuous academic career chequered with highly competitive exams.
7. The federal character of MCI is not found in NMC.All the state Governments have representation in MCI. Only 5 states in rotation will have representation in NMC. It will take two decades for a state to re-enter NMC.
8. All universities teaching medicine are members of MCI. This has been abolished in NMC.
9. All state medical councils, which are sovereign bodies constituted by state legislatures have been made subservient to NMC striking a blow to the federal nature of the nation.
10. Professional organizations like IMA are registered under Societies Act. In no way their independence and freedom of action could be subjected to Government control. In fact, they remain the only whistle blowers, being the voice of voiceless in the issues of Health. Such corrective forces are part and parcel of the democratic forces in the country. NMC has been vested with powers to control all professional bodies.
11. IMA has a representative in DNB board but not in NMC.
12. It inducts non-medical people into the highest body of medical governance changing its perspective and character forever.
13. It introduces schedule IV to allow AYUSH graduates to get registration in Modern Medicine.
14. It opens the floodgates of PG seats in modern medicine to AYUSH graduates in future by providing registration to them in schedule IV.
15. It directly affects Patient Care and Patient Safety by allowing graduates of other systems to practice modern medicine.
16. This is not the first time that the Government has made such a move. In 2005, the then Union health minister, Dr Anbumani Ramadoss, tried unsuccessfully to bring in a legislation to dissolve the MCI and set up another council under the control of the Health Ministry. The parliamentary standing committee rejected it because any regulatory body should be devoid of Government control or else it would lose its independent regulatory mechanism. It is pertinent to note that in its exhaustive report, the standing committee took exception to the attempt by the Government of India to centralize the powers with it and reduce a Body of Experts created for a distinct purpose by a Parliamentary enactment into a Department working under the Government of India.

IMA appeals to the Prime Minister to recall the Bill and rectify these anomalies.
The Parliament has a larger role to protect the interest of the medical profession of the country. The welfare and the independence of the profession are linked to the welfare of the people.
Dr K K Aggarwal- National President, IMA
Dr Ravi Wankhedkar- National President-Elect
Dr RN Tandon - Hony Secretary General IMA
Dr R V Asokan - Chairman Action Committee

National Health Policy 2017 approved by Cabinet

National Health Policy 2017 approved by Cabinet Focus on Preventive and Promotive Health Care & Universal access to good quality health care services The Health Ministry has formulated the National Health Policy 2017, after a gap of 14 years, to address the current and emerging challenges necessitated by the changing socio-economic and epidemiological landscapes since the last National Health Policy was framed in 2002. The Cabinet has approved the National Health Policy 2017. The policy informs and prioritizes the role of the Government in shaping health systems in all its dimensions investment in health, organization and financing of healthcare services, prevention of diseases and promotion of good health through cross-sectoral action, access to technologies, developing human resources, encouraging medical pluralism, building the knowledge base required for better health, financial protection strategies and regulation and progressive assurance for health. The roadmap of this new Policy is predicated on public spending and provisioning of a public healthcare system that is comprehensive, integrated and accessible to all. The Policy seeks to reach everyone in a comprehensive integrated way to move towards wellness. It aims at achieving universal health coverage and delivering quality health care services to all at affordable cost. The policy is patient centric and empowers the patient for resolution of all their problems. The policy, has at its centre, the person, who seeks and needs medical care. The policy also looks at reforms in the existing regulatory systems both for easing manufacturing of drugs and devices, to promote Make in India, as also for reforming medical education. The policy envisages a time-bound Implementation Framework with clear deliverables and milestones to achieve the policy goals. It also seeks to ensure improved access and affordability of quality secondary and tertiary care services through a combination of public hospitals and strategic purchasing in healthcare deficit areas from accredited non-governmental healthcare providers, achieve significant reduction in out of pocket expenditure due to healthcare costs, reinforce trust in public healthcare system and influence operation and growth of private healthcare industry as well as medical technologies in alignment with public health goals. The policy emphasizes reorienting and strengthening the Public Health Institutions across the country, so as to provide universal access to free drugs, diagnostics and other essential healthcare. • The broad principles of the Policy are centered on professionalism, integrity and ethics, equity, affordability, universality, patient-centered and quality of care, accountability and pluralism. • The main objective of the National Health Policy 2017 is to achieve the highest possible level of good health and well-being, through a preventive and promotive health care orientation in all developmental policies, and to achieve universal access to good quality health care services without anyone having to face financial hardship as a consequence. • The policy seeks to move away from Sick- Care to Wellness, with thrust on prevention and health promotion. • It envisages providing larger package of assured comprehensive primary health care through the ‘Health and Wellness Centers’ and denotes important change from very selective to comprehensive primary health care package which includes care for major NCDs, mental health, geriatric health care, palliative care and rehabilitative care services. • It advocates allocating major proportion (two-thirds or more) of resources to primary care followed by secondary and tertiary care. • It also aspires to provide at the district level most of the secondary care which is currently provided at a medical college hospital. • In order to provide access and financial protection at secondary and tertiary care levels, NHP 2017 proposes free drugs, free diagnostics and free emergency care services in all public hospitals. • National Health Policy 2017 affirms commitment to pre-emptive care (aimed at pre-empting the occurrence of diseases) to achieve optimum levels of child and adolescent health. It envisages school health programmes as a major focus area as also health and hygiene being made a part of the school curriculum. • The policy looks at stronger partnership with the private sector and advocates a positive and proactive engagement with the private sector for critical gap filling towards achieving national goals. It envisages private sector collaboration for strategic purchasing, capacity building, skill development programmes, awareness generation, developing sustainable networks for community to strengthen mental health services, and disaster management. The policy also advocates financial and non-incentives for encouraging the private sector participation. • The policy proposes raising public health expenditure to 2.5% of the GDP in a time bound manner. • It aims to ensure availability of 2 beds per 1000 population distributed in a manner to enable access within golden hour. • The Policy advocates a progressively incremental assurance-based approach. • The policy envisages a three dimensional integration of AYUSH systems encompassing cross referrals, co-location and integrative practices across systems of medicines. This has a huge potential for effective prevention and therapy that is safe and cost-effective. • Yoga would be introduced much more widely in school and work places as part of promotion of good health. • It seeks to strengthen the health surveillance system and establish registries for diseases of public health importance, by 2020. • It also seeks to align other policies for medical devices and equipment with public health goals. • Under a ‘giving back to society’ initiative, the new Health Policy supports voluntary service in rural and under-served areas on pro-bono basis by recognized healthcare professionals. • It also advocates extensive deployment of digital tools for improving the efficiency and outcome of the healthcare system and proposes establishment of National Digital Health Authority (NDHA) to regulate, develop and deploy digital health across the continuum of care. • The Policy has also assigned specific quantitative targets aimed at reduction of disease prevalence/incidence under 3 broad components viz. a) Health status and programme impact, b) Health system performance and c) Health systems strengthening, aligned to the policy objectives. Some key targets that the policy seeks to achieve are - • Life Expectancy and healthy life a. Increase Life Expectancy at birth from 67.5 to 70 by 2025. b. Establish regular tracking of Disability Adjusted Life Years (DALY) Index as a measure of burden of disease and its trends by major categories by 2022. c. Reduction of TFR to 2.1 at national and sub-national level by 2025. • Mortality by Age and/ or cause a. Reduce Under-Five Mortality to 23 by 2025 and MMR from current levels to 100 by 2020. b. Reduce infant mortality rate to 28 by 2019. c. Reduce neo-natal mortality to 16 and still birth rate to “single digit” by 2025. • Reduction of disease prevalence/ incidence a. Achieve global target of 2020 which is also termed as target of 90:90:90, for HIV/AIDS i. e,- 90% of all people living with HIV know their HIV status, - 90% of all people diagnosed with HIV infection receive sustained antiretroviral therapy and 90% of all people receiving antiretroviral therapy will have viral suppression. b. Achieve and maintain elimination status of Leprosy by 2018, Kala-Azar by 2017 and Lymphatic Filariasis in endemic pockets by 2017. c. To achieve and maintain a cure rate of >85% in new sputum positive patients for TB and reduce incidence of new cases, to reach elimination status by 2025. d. To reduce the prevalence of blindness to 0.25/ 1000 by 2025 and disease burden by one third from current levels. e. To reduce premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 25% by 2025. (Source: Press Information Bureau, 16th March, 2017) Dr KK Aggarwal National President IMA and HCFI

IMA leaders unite towards the cause of making emergency medical care more accessible in India

IMA leaders unite towards the cause of making emergency medical care more accessible in India Pledge to be the voices against rampant practice of female feticide at a National Leadership Meet in Jaipur New Delhi, August 13, 2016: A National Leadership Meet of the Indian Medical Association, the oldest and largest representative organization of doctors of modern scientific medicine is being held on Saturday in the pink city of Jaipur. The one-day meeting will see an attendance of over 100 heads of the national body. The main agenda of the National Leadership Meet is to evaluate and discuss issues of National importance affecting the functioning and efficacy of the medical community in the country and to put together a list of demands for the Central Government to action. Addressing a press meet in Jaipur Dr SS Agarwal – National President IMA and Padma Shri Awardee Dr KK Aggarwal – Honorary Secretary General IMA in a joint statement said, “Today the medical profession faces more challenges than ever before and we must stand together as a strong one voice against them. By standing as a unified force during the difficult times we are confident that we will succeed in our aim of restoring the nobility, honesty and integrity of the medical profession in India. The IMA stands for accountability and regulation of practice. But we are against inspector Raj, multiple registrations for a doctor, multiple levels of accountibility and multiple windows for the registration of a medical establishment. We believe that instead of regulatory bodies making laws, it is the duty of the medical association to make way for self-regulation”. The 100 IMA leaders present at the conference will also deliberate ways in which emergency medical care can be made accessible to each and every person irrespective of his/her economical background. All those present will take an oath to collectively work towards exposing all doctors and patients who indulge in the practice of female feticide. IMA welcome IRDA’s decision to have all medical establishments on panel with insurance companies to have entry level NABH and the surface transport ministries decision to create a separate fund for first aid for rode traffic accidents. IMA Rajasthan announced the launch of a Jan Aushadi Kendre that will provide low cost and quality drugs to the masses. IMA headquarters already run one at New Delhi. A few key asks collated by the National leaders during the meet include: • Single window registration of medical establishments • Central act protecting medical establishments against violence • While IMA is not against regulation, it is against the appointment of multiple agencies for investigation of medical negligence cases. Instead it believes that all cases of professional misconduct should first be evaluated by the state medical council and then either discharged or referred to various other penal agencies • IMA wants uniform increase in retirement age to 65 across states and centers and all medical establishments private or government including PSU’s • IMA wants every patient to be treated free in emergencies and feels that those who cannot afford should be taken care by the State. In cases where the State cannot provide that facility, they should be allowed to be treated at any private institution and get reimbursed at government rates. • IMA feels that clinical trials need to be promoted in the country and giving more powers to the ethics committee is the only answer. IMA has already applied for permission to set up an ethics committee at a National level • IMA announces that doctors across the country will adopt female child • IMA also announced that on 3v3ry 9th Private IMA doctors will provide free ante natal consultations to pregnant women.