LEGISLATIVE NOTE. No. 3/LN/Ref/Feb/2018. National Medical Commission Bill, 2017

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1 MEMBERS' REFERENCE SERVICE LARRDIS LOK SABHA SECRETARIAT NEW DELHI LEGISLATIVE NOTE For the use of Members of Parliament NOT FOR PUBLICATION No. 3/LN/Ref/Feb/2018 National Medical Commission Bill, 2017 Prepared by Shri Rajesh Khurana, Additional Director (23035340) and Shri Rajkumar Patton, Junior Library Assistant of Lok Sabha Secretariat under the supervision of Smt. Kalpana Sharma, Joint Secretary and Dr. P. J. Antony, Director. The Legislative Note is for personal use of the Members in the discharge of their Parliamentary duties, and is not for publication. This Service is not to be quoted as the source of information as it is based on the sources indicated at the end/in the context.

NATIONAL MEDICAL COMMISSION BILL, 2017 INTRODUCTION The National Medical Commission Bill, 2017 (NMC) 1 according to the Indian Medical Council Act, 1956 aims at interalia providing for a medical education system that ensures availability of adequate and highly qualified medical professionals; encouraging medical professionals to adopt latest medical research in their work and to contribute to research; providing for periodic assessment of medical institutions, facilitating maintenance of a medical register for India and enforcing high ethical standards in all aspects of medical services; encouraging flexibility in adapting to the changing needs and providing for effective grievance redressal mechanism for matters connected therewith or incidental thereto. The Bill seeks to establish four autonomous boards viz. Under-Graduate Medical Education Board (UGMEB), Post-Graduate Medical Education Board (PGMEB), Medical Assessment and Rating Board (MARB) and Ethics and Medical Registration Board (EMRB) under the proposed National Medical Commission. Distribution of responsibilities among different structures of a Regulatory Body as envisaged in the NMC Bill will avoid concentration of power and ensure necessary checks and balances. SPECIAL FEATURES OF THE BILL Constitution of the National Medical Commission: The Bill sets up the National Medical Commission (NMC). Within three years of the passage of the Bill, the State governments will establish State Medical Councils at the State level. The NMC will consist of 25 members, appointed by the central government. A Search Committee will recommend names to the central government for the posts of Chairperson, and part time members. These posts will have a maximum term of four years. The Search Committee will consist 1 The National Medical Commission Bill, 2017 was introduced by the Minister of Health and Family Welfare, Mr. J. P. Nadda in Lok Sabha on December 29, 2017. A four member committee headed by Vice Chairman NITI Aayog framed a draft National Medical Commission (NMC) Bill that provides for constitution of NMC in place of MCI. The Bill has been approved by the Cabinet in its meeting held on 15.12.2017.

of seven members 2 including the Cabinet Secretary and three experts to be nominated by the central government (of which two will have experience in the medical field). Medical Advisory Council: The Bill envisages that the Central Government will constitute a Medical Advisory Council. The Council will be the primary platform through which the States/Union Territories may put forth their views and concerns before the NMC. Further, the Council will advise the NMC on measures to enable equitable access to medical education. Autonomous boards: The Bill sets up certain autonomous boards under the supervision of the NMC. Each autonomous board will consist of a President and two members, appointed by the central government. These boards are: (i) the Under-Graduate Medical Education Board (UGMEB) and the Post-Graduate Medical Education Board (PGMEB): These Boards will be responsible for formulating standards, curriculum, guidelines, and for granting recognition to medical qualifications at the undergraduate and post graduate levels respectively, (ii) the Medical Assessment and Rating Board (MARB): The MARB will have the power to levy monetary penalties on medical institutions which fail to maintain the minimum standards as laid down by the UGMEB and the PGMEB. The MARB will also grant permission for establishing new medical colleges, and (iii) the Ethics and Medical Registration Board: This Board will maintain a National Register of all licensed medical practitioners, and regulate professional conduct. Only those medical practitioners whose names are included in the Register will be allowed to practice medicine. Entrance examination: There will be a uniform National Eligibility-cum-Entrance Test for admission to under-graduate medical education in all medical institutions regulated by the Bill. The NMC will specify the manner of conducting common counselling for admission in all such medical institutions. 2 Members of the NMC will include: (i) the Chairperson, (ii) the President of the Under-Graduate Medical Education Board, (iii) the President of the Post-Graduate Medical Education Board, (iv) the Director General of Health Services, Directorate General of Health Services, (v) the Director General, Indian Council of Medical Research, and (vi) five members (part-time) to be elected by the registered medical practitioners from amongst themselves from the prescribed regional constituencies under the Bill.

There will be a National Licentiate Examination for the students graduating from medical institutions to obtain license for practice. The National Licentiate Examination will also serve as the basis for admission into post-graduate courses in medical institutions. Functions of the National Medical Commission: Functions of the NMC include: framing policies for regulating medical institutions and medical professionals; assessing the requirements of healthcare related human resources and infrastructure; ensuring compliance by the State Medical Councils of the regulations made under the Bill; framing guidelines for determination of fees for up to 40% of the seats in the private medical institutions and Deemed Universities which are regulated as per the Bill. Source Consulted: 1. National Medical Commission, Bill 2017, Lok Sabha 2. National Medical Commission (Unstarred Question No. 1988) dated 29th December, 2017.

ANNEXURE I STATEMENT OF OBJECTS AND REASONS Medical education is at the core of the access to quality healthcare in any country. A flexible and wellfunctioning legislative framework underlying medical education is essential for the well-being of a nation. The Indian Medical Council Act, 1956 which was enacted to provide a solid foundation for the growth of medical education in the early decades, has not kept pace with time. Various bottlenecks have crept into the system with serious detrimental effects on medical education and, by implication, on delivery of quality health services. 2. The Department-related Parliamentary Standing Committee on Health and Family Welfare in its ninety-second Report has offered a critical assessment of medical education in India. The Standing Committee has recommended for a decisive and exemplary action to restructure and revamp the regulatory system of medical education and medical practice and to reform the Medical Council of India in accordance with the regulatory structure suggested by the Group of Experts, chaired by Dr. Ranjit Rai Choudhary, which was constituted by the Central Government. The Standing Committee endorsed separation of functions by forming four autonomous boards and recommended appointment of regulators through selection rather than election and to bring a new comprehensive Bill in Parliament for this purpose, as the existing provisions of the Indian Medical Council Act, 1956 are outdated. 3. The Hon'ble Supreme Court in its judgment dated 2nd May, 2016 in the Civil Appeal No. 4060 of 2009 titled Modern Dental College and Research Centre and Others versus State of Madhya Pradesh and Others has directed the Central Government to consider and take appropriate action on the recommendations of the Rai Choudhary Committee. 4. Accordingly, it is proposed to introduce the National Medical Commission Bill, 2017 which, inter alia, seeks to provide for (a) constitution of a National Medical Commission for development and regulation of all aspects relating to medical education, medical profession and medical institutions and a Medical Advisory Council to advise and make recommendations to the Commission; (b) constitution of four Autonomous Boards, namely: (i) the Under-Graduate Medical Education Board to regulate medical education at undergraduate level and to determine standards thereof; (ii) the Post-Graduate Medical Education Board to regulate medical education at postgraduate level and to determine standards thereof; (iii) the Medical Assessment and Rating Board to carry out inspections and to assess and rate the medical institutions; and (iv) the Ethics and Medical Registration Board to regulate professional conduct and promote medical ethics amongst medical practitioners and medical professionals and to maintain a national register of all licensed medical practitioners and a national register of AYUSH practitioners who have qualified the bridge course; (c) recognition of medical qualifications granted by universities and medical institutions in India and outside India and also for recognition of medical qualifications granted by statutory and other bodies in India as listed in the Schedule; (d) holding of a uniform National Eligibility-cum-Entrance Test for admission to undergraduate medical education and the National Licentiate Examination for admission to postgraduate medical education and for enrolment to the National Medical Register; (e) holding of joint sitting of the Commission, the Central Council of Homoeopathy and the Central Council of Indian Medicine to enhance the interface between Homoeopathy, Indian Systems of Medicine and modern systems of medicine;

(f) the repeal of the Indian Medical Council Act, 1956 and for dissolution of the Medical Council of India by providing that on such dissolution, i. the chairman and other members of the said Council shall be deemed to have vacated their respective offices and will be entitled to compensation not exceeding three months' pay and allowances; ii. the officers and employees appointed on deputation shall stand reverted to their parent cadre; iii. the officers and other employees employed on regular or contractual basis by the said Council shall cease to be the officers and employees of said Council and shall be entitled to such compensation not less than three months' pay and allowances for the premature termination of employment as may be provided by rules; iv. the manner of seeking permission to establish a new medical college. 5. The Bill seeks to achieve the above objectives. NEW DELHI; JAGAT PRAKASH NADDA The 22nd December, 2017.