Quantum Leap

Putting Medical Commission Bill on hold may risk rural healthcare

It is high time the country sees through the game of IMA, which is narrow-minded and not acting in the interest of public health and people.

 |  Quantum Leap  |  3-minute read |   16-01-2018
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The high-pitch campaign mounted by the trade union of allopathic doctors - Indian Medical Association (IMA) - has forced the government to refer the National Medical Commission (NMC) Bill to a parliamentary committee.

IMA even went on a day's strike on this issue. The association and its leadership have been painting this Bill - which is actually the boldest medical regulatory reform undertaken by the government in recent decades - as a draconian, anti-people measure. Sending the NMC Bill to the standing committee on health is surprising because it was this very committee which had first recommended replacing the corrupt Medical Council of India (MCI) with NMC in March 2016.


One of the main objections of IMA is the clause in the bill that will empower the proposed commission to licence professionals trained in other systems of medicine also to practise allopathy after they undergo a bridge course. The rationale behind this clause is that India needs urgent steps to overcome shortage of health workers in rural areas. And what has been proposed - a bridge course - is actually what the World Health Organisation (WHO) has been recommending for years for countries that face shortage of health workers. It is called "task shifting" and task sharing - which means "rational redistribution of tasks among health workforce teams". In task shifting, specific tasks are moved from highly qualified health workers to health workers with shorter training and fewer qualifications.

The concept of task shifting is actually not new and it has existed for many years. It has been tried and tested in India also, and the results have been encouraging. A few years ago, the ministry of health and family welfare had proposed a three-and-a-half year Bachelor of Rural Health and Care degree designed exclusively to train health workforce for rural areas. Such a workforce can not only meet immediate health needs in underserved areas but also prepare a second line of qualified care providers. The three-year course started in Chhattisgarh is a good example of task shifting. The state government had created a new body called Chhattisgarh Chikitsa Mandal (CCM) to regulate the new course. There was huge response to the course and hundreds of young people were trained and deputed as rural medical assistants in remote and tribal areas where no MBBS doctor would venture. But IMA - aided by a captive MCI - successfully killed the course by raising legal issues of licensing and jurisdiction. A similar course started in Assam was also blocked by vested interests.

There are other examples too. Dr Abhay Bang and Dr Rani Bang, working in tribal areas of Gadchiroli in Maharashtra, have shown that neonatal mortality caused due to infections such as sepsis can be brought down considerably through home-based care - including administration of antibiotics - provided by trained community health workers.

In West Bengal, informal care providers are being trained under a private initiative by the Liver Foundation. Its proponents argue that giving basic training to informal providers can actually save lives because at present they claim to be "doctors" and engage in harmful practices. It is high time the country sees through the game of IMA, which is narrow-minded and not acting in the interest of public health and people.

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Dinesh C Sharma Dinesh C Sharma @dineshcsharma

Journalist, columnist and author based in New Delhi.

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