Separation of Regulatory Powers: NITI Aayog

The Medical Council of India was set up in 1934 under the Indian Medical Council Act, 1933.
This Act
was repealed and a new Act, The Indian Medical Council Act, 1956, was enacted. This latter Act was
further amended in 1964, 1993 and in 2001.
The objectives of the Indian Medical Council, as per the Act, are as follows:
1. Maintenance of uniform standards of medical education, both undergraduate and postgraduate.
2. Recommendation for recognition/de-recognition of medical qualifications of medical institutions
of India or foreign countries.
3. Permanent registration/provisional registration of doctors with recognised medical qualifications.
4. Reciprocity with foreign countries in the matter of mutual recognition of medical qualifications.
It also undertook the promotion of medical ethics; ensuring ethical medical practice and punishing
wrong-doers; providing guidance to medical professionals on good medical practice, and advice on novel
forms of treatment bristling with ethical implications (the use of embryos in medical research and the use
of stem cells in clinical practice being just two recent examples) do not feature in the stated objectives
Issues of MCI
 Separation of regulatory powers
 The council regulated medical education as well as medical practice leading to the
centralization of all regulatory functions in one single body.
 There should be a separation between the regulation of medical
education from regulation of medical practice. Expert committee- Ranjit Roy
committee 2014 –recommended structural re-configuration of the council by separation
of power.
 Composition of MCI
 Most of the members of the MCI were elected.

 NITI Aayog Committee (2016) noted that there will be a conflict of interest if members
are elected. Because if the regulator is elected by the same fraternity that it would
monitor, it will become ineffective and also prevents the entry of skilled professionals for
the job. The Committee recommended the appointment of regulators through an
independent selection process than elections.
 Fee Regulation
 MCI is authorized for fee regulation of private colleges.

 NITI Aayog Committee (2016) recommended against this practice as it will lead to
corruption and increased capitation fees. Fee cap will discourage the entry of genuine
private colleges, limiting the expansion of medical education in the country. Disallowing
for-profit medical education has driven profit-taking underground with various kinds of
inventive fee structures by medical colleges.
 Professional conduct
 Standing Committee on Health (2016) had observed that the focus of the MCI was
only on licensing of medical colleges and no emphasis given to the enforcement of
medical ethics in education and on instances of corruption noted within the MCI.
 Committee recommended that the areas of medical education and medical practice should
be separated in terms of enforcement of the appropriate ethics for each of these stages.
Thus, MCI had evolved into a body that had become a powerful rationing authority, controlled by those
who it is supposed to be regulating, that is powerful medical colleges and medical professionals.
NMC Act versus the IMC Act

The table contained hereinbelow highlights the differences between the NMC Act and the IMC Act.
S. No. NMC Act IMC Act
The Governing body under the NMC Act is the

1. The Governing body under the IMC Act is the MCI.
NMC.
MCI is majorly comprised of members who

All the members of the NMC will be appointed or
2. are elected from amongst members of the medical
nominated by the Central Government.
faculty of Universities and State Medical Registers.
Section 5 of the NMC Act provides for the

composition of a seven- member Search
Committee, which shall include, the Chairperson,
part-time Members (in terms of Section 4(1) and
3. No such provision is provided under the IMC Act.
4(4)(a) of the NMC Act) and the Secretary (in
terms of Section 8 of the NMC Act), who shall be
appointed by the Central Government upon the
recommendation of the Search Committee.
Section 6(6) of the NMC Act provides that the

Chairperson and every member of the NMC shall
make declaration of his assets and liabilities at the
time of entering and leaving office. Moreover, the
Chairperson and each member is also required to Declarations of this nature were not required under the
4.
declare their professional and commercial IMC Act.[2]
engagement or involvement in the prescribed form
and manner. Such aforementioned declarations
shall also to be published on the website of the
Commission.
5. With the aim of promoting transparency, Section No such provision is provided under the IMC Act.
6(7) of the NMC Act provides that the Chairperson
or members, post leaving the respective offices,
shall not accept any employment[3] for a period of
two years
Section 15 of the NMC Act provides for a NEXT

(as elaborated above). It is pertinent to note that
the said examination has been deemed to be the
6. basis on which a person with a foreign medical No such provision is provided under the IMC Act.[4]
qualification shall obtain a licence for practising
medicine as a medical practitioner and for
enrollment in the state/ national register.
 Repeal of IMC Act: Section 61 of the NMC Act clarifies that notwithstanding the repeal
of the IMC Act, the educational standards, requirements and other provisions of the IMC
Act, and the rules and regulations made thereunder, shall continue to be in force and
operate till new standards or requirements are specified under the NMC Act or new rules
or regulations are made thereunder.
Key Highlights of the Act
 The Act provides for the constitution of a National Medical Commission (hereinafter
referred to as ‘Commission’) which shall be a corporate body having perpetual
succession. The Commission shall perform the functions as mention in the Act. The
Commission shall be empowered to lay down policies for maintenance and regulation of
medical institutions and medical professionals. The Commission is also empowered to
frame guidelines for determining the fees and related charges in respect of 50%
seats in private medical institutions and deemed universities.
 The Act further provides for constitution of a Medical Advisory Council. The Council
shall be a platform for the States and Union Territories to put forth their views and
concerns before the Commission. The Act provides for National Eligibility-cum-Entrance
Test at undergraduate level and National Exit Test for grant of license after completion of
course for granting of license.
 The Act establishes other regulatory bodies and committees such as Advisory Board,
Search Committee, Under Graduate Medical Education Board, Post Graduate Medical
Education Board, Medical Assessment and Rating Board and Ethics and Medical
Registration Board for regulating and structuring formal medical education.
 The Act specifically states that no person shall be allowed to open a new medical college
or commence a new post graduate course or increase the number of existing seats without
the prior permission of the Medical Assessment and Rating Board (hereinafter referred to
as ‘MARB’). For obtaining the permission the applicant will be required to submit a
scheme to the MARB in the prescribed form accompanied by the prescribed fees. The
scheme can either be approved or disapproved by MARB within 6 months of receiving
the receipt of application. If no decision is made by MARB within 6 months the applicant
can then appeal to the Commission. A second appeal to the Central Government can be
preferred if the scheme is disapproved by the Commission too. The criteria for approval
or disapproval of the scheme depends upon several factors such as: adequate availability
of financial resources, adequacy in medical faculties and other necesrsary resources,
adequate hospital facilities and other facilities as may be prescribed.
Community health service providers can now be granted a limited license to practice. These
health service providers can only prescribe specified medicine for primary and preventive
healthcare.
Conclusion
Medical education and medical professionals affect everybody directly or indirectly. The Act
provides a comprehensive framework for development of the same in India. The compliance for
opening up a medical college is now been made clearer and the provision for appeal gives an
equal representation to the applicant for being heard. There are many students who complete
their medical education outside India, the position of their qualification has also been clarified
now. The provision of limited license to community service providers will now help to curate
faster medical attention and is a step towards the betterment of the society.

Separation of Regulatory Powers: NITI Aayog

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The Medical Council of India was set up in 1934 under the Indian Medical Council Act, 1933.

 Most of the members of the MCI were elected.

 MCI is authorized for fee regulation of private colleges.

NMC Act versus the IMC Act

S. No. NMC Act IMC Act

The Governing body under the NMC Act is the

MCI is majorly comprised of members who

Section 5 of the NMC Act provides for the

Section 6(6) of the NMC Act provides that the

Section 15 of the NMC Act provides for a NEXT

Key Highlights of the Act

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