A king may consider the advice of his councillors and the demands of his people but can do whatever he wants. It turns out, so can a group of ministers in a democracy. Everyone who presented their views to the Parliamentary Standing Committee on Health had one thing to say—the government’s mind is made up. And it looks like that it is in the favour of probably the most controversial legislation proposed by the Modi government—the National Medical Commision Bill.
The committee has been asked to submit its report soon, ideally by the end of this week. “The bill will go through. It may take longer than planned. It may have minor modifications. But the health sector would transform, even if it means biting a bitter pill,” said a government executive in the know who requested not to be named.
The bitter pill is the frustration of Indian doctors, who, under the banner of the Indian Medical Association (IMA), went on a 12-hour strike to make their point on 2 January. IMA represents over 2,00,000 Indian doctors. Behind closed doors, the doctors representing IMA were fuming because they were left out of the process of making the bill. They were not alone, the public health experts feel left out, too. Although they were invited by NITI Aayog to contribute, their suggestions never made it into the final bill.
What is it about this one legislation that has them up in arms? Put simply, it is this bill’s intention to dilute the rigour, skill and qualification needed to treat a patient. Written by a three-member committee, none of whom are doctors themselves, the bill is a quick fix to meet Indian healthcare’s biggest challenge—the shortage of doctors.
The government plans to make a few big moves to make access-to-health its political achievement. A budget announcement last Friday to provide health insurance cover of Rs 5,00,000 to 100 million families was one. Passing the National Medical Commission Bill is next on its agenda. And it is willing to do just anything to have its way. The process of writing the bill shows how.
While the erstwhile Planning Commission wrote five-year plans, committee reports and white papers to assist legal change, its successor NITI Aayog has now started encroaching on ministry territory, starting with writing the bill. This is the first time that NITI Aayog has written a legislation, which, as it turns out, benefits hospitals more than patients.
The think tank has proposed to lower the quality of doctors, deregulate the medical education industry, and let Ayurveda or Homeopathy doctors prescribe allopathic medicines after taking a bridge course, officially. In short, it has attempted to quickly fix the problem of doctor shortage in India. Will NITI Aayog be the first Indian think tank to bring in legal change despite stiff opposition?