When Dr. Harsh Vardhan was appointed the union health minister, he made some incisive and critical remarks on the functioning of the Medical Council of India (MCI). His remarks gained credibility because he was a practicing doctor who wanted to initiate reforms within the medical profession. Vardhan openly criticised the MCI for its corruption, calling for a radical reform of its structure and composition. He said that by taking on the health portfolio he had “inherited a poisoned chalice,” in an open acknowledgement of the depth of corruption in medical education and practice. He was bold and forthright in demanding reforms and transparency within the MCI. In a press conference held on his 100th day of the ministry, he promised a radical restructuring of the MCI. But soon after making these observations, he was unceremoniously removed from the health ministry.
As a former member of the ethics committee of the MCI, it was clear to me that the ‘medical mafia’ had a hand in his removal.
The need to reform the MCI was broached once again with a report by the joint parliamentary committee, which was set up last year. The committee undertook the task with seriousness and due diligence, and was extremely forthright in its diagnosis of the maladies affecting the MCI. Based on evidence collected through depositions, the report documented the corruption in medical education and the rise in unethical practices by doctors. Clearly, any restructuring or revamping of the MCI would require that these two issues be addressed.
As part of the process to reform the MCI, a committee was set up under the auspices of Niti Aayog. The committee prepared a Bill, which, among other things, included provisions such as providing admission through a common entrance exam for government and private medical colleges, and the introduction of a qualifying exam for doctors when they enter the job market. Importantly, the committee also suggested replacing the MCI with a national medical commission. This recommendation fails to address two major concerns: the corruption in medical education and the decline in ethical standards in medical practice due to its rampant commercialisation.
Given the unregulated commercialisation of medical education and health services, it is surprising that the committee recommended the setting up of ‘for profit’ medical colleges. What is the rationale behind this move, given that there exists a serious crisis in the quality of medical education due to poor infrastructure, and inadequate human resources in government and private medical colleges?
The committee’s rationale is unconvincing and distorted. According to it, “given the shortage of providers and in recognition of the fact that the current ban on for-profit institutions has hardly prevented private institutions from extracting profits, albeit through non-transparent and possibly illegal means, it was felt that any restriction on the class of education providers would be counter-productive”.
Many questions arise from this recommendation. Who are the potential investors – Indian and foreign – in medical education? Is this a way of protecting the interests of the largely private sector in several states? Is this a demand from corporate hospitals that have set up nursing and technician training courses? What has been the role of the ‘medical mafia’ that has been controlling the MCI? Given that they have some clout with all the major national political parties, what has been their role in shaping the new Bill?
The present leadership of the MCI has been silent on the Bill, but there has been a systematic attempt to discredit the report of the joint parliamentary committee. Dr. Jayshreeben Mehta, the president of MCI, has said the parliamentary committee did not given her a fair hearing before finalising its report.
Is Mehta trying to backtrack on her statement to the committee that there is corruption in the MCI under pressure from her peers? Or is this her way of detracting attention from the documentation of the deep corruption within the medical body?
Jairam Ramesh, a member of the parliamentary committee, has said that he plans to move a privilege motion against Mehta for her allegations against it. In the interest of the future of medical education, we hope that he does keep up the pressure to weed out the corruption that is deeply entrenched in the MCI and the medical profession.
Rama V. Baru is a professor at the Centre of Social Medicine and Community Health at Jawaharlal Nehru University.