More Observations on the National Medical Commission Bill 2017


Dr K K Aggarwal    21 December 2017

  1. Composition  of  the  National  MedicalCommission:
    • Section4 provides for the composition of the National Medical Commission, which will have a) a chairperson b) 12 Ex-officio Members c) 11-part time members d) an Ex-Officio Member Secretary.
  • Thus,it would have an effective membership of 25 along with the Chairman of which only 5 members will be elected (Part Time Members who will be elected by the registered medical practitioners from among themselves from such regional constituencies and in such manner as may be 
  • Assuch it is evident that the proposed commission will have 1/5th members (20% elected members and 80% appointed / nominated members). It is for this reason it will not have a desired ‘representative character’ with reference to ‘elected and nominated
  • / appointed members’
  • Thecomposition of the various autonomous boards prescribed under the Bill does not include any elected member there  As such, the relevance of elected members vis-a-vis their authority and jurisdiction is a big question mark left unanswered.
  1. Functions of theCommission: 
  • The functions vested with the Commission under the Act are genericand cosmetic in  There under it is to exercise appellate jurisdiction with respect to decisions of the autonomous boards except that of the EMR Board as brought out at Section 10
    • (g). However, at Section 30(4) it is stated that a medical practitioneror professional who is aggrieved by the decision of the EMR board may prefer an appeal to the Commission within 60 days of the communication of the such decision, which is contradictory.
  • Further,Section 30 (4) of the proposed act provides an appellate jurisdiction exclusively to a medical practitioner or professional to prefer an appeal with the commission if aggrieved with the decisionof the EMR  However, the said clause is absolutely silent in regard to providing appellate jurisdiction to the complainant, which is a substantial omission with reference to equity and providencefor justice.
  • Functionally commission would be framing guidelines for determinationof Fee in respect of such proportion of seats not exceeding 40% in the private medical institutions and deemed universities which are governed under the provisions of this 
  • Thisoperationally means that the fee regulation would be limited to a maximum of 40% seats in the private medical institutions and deemed universities, which is difficult to understand as to why such a ceiling and furthermore it could be anything from nil up to 40% which is paradoxical in 
  1. Separate National Register:

Under section 31(8) the EMR Board shall maintain a separate National Register including the names of licensed Ayush Practitioners who qualifies the bridge course referred in Section 49(4) in suchmanner as may be specified by Regulations. By  an

  • explanation,Ayush Practitioner has been defined as a person who is a practitioner of Homeopathy or a practitioner of Indian Medicine as defined in Clause (e) of Sub-section 1 of section 2 of theIndian Medicine Central Council Act, 
  • Section 49(4) contemplates bridge courses even for the practitionersof homeopathy to enable them to prescribe such modern medicines at such level as may be prescribed. This is materiallyinconsistent with the definition of the word ‘medicine’ as depicted at section 2(j) wherein it is defined as ‘medicine means modern scientific medicine in all its branches and include surgery and obstetrics but does not include veterinary medicine and surgery’.

Assuch these are the flood gates that have been opened up in terms of the statutory provisions for backdoor entry into medical profession entitling practicing modern 

  1. Dismantling Screening Test:
  • Section32(2) clearly stipulates that ‘no person who has obtained medical qualification from a medical institution established in any country outside India and is recognized as a medical practitioner in that country shall, after the commencement of this Act and the National Licenciate Examinations becomes operational under sub- section 3 of section 15, be enrolled in the National register unless hequalifies the National Licenciate 
  • Itis strange that a filter in the name of screening test was placed was to ensure that the degree holders from medical institutions outside country are tested in regard to their required level of
  • knowledgeand upon clearance of the screening test were required to do one-year internship for the hands-on training under supervision in a recognized medical college to ensure that he is capableof rendering healthcare services to the people at large in the Indian 
  • Uponthe promulgation of the National Medical Commission Bill 2017, the Indian Medical Council Act, 1956 would stand repealed and therefore the clause 13 thereat prescribing screening test would be rendered to 
  • Section15 (3) of the proposed bill stipulates that “The National Licenciate examination shall become operational on such date, within three years from the date of commencement of this act, as may be appointed by the Central Govt., by Notification. This operationally means that till such time the National Licenciate examination is notified, the Indian possessing foreign Medical qualificationwould be entitled to seek permanent registration and practice medicine without any screening rider or  As such, during the interregnum a vacuum would be created, and the same would be filled inwhat manner is not provided for anywhere in the proposed Bill.
  • Itis imperative to note that there are several students who have sought admission to medical institutions outside India after procuring eligibility certificate by the Medical Council of India and therefore, are legitimately entitled to appear for the screening test after acquiring foreign graduate medical 
  • Further,the foreign qualifications which are there in the existing schedule in a limited number appended to the Indian Medical Council Act, 1956, with the annulment of the said Act would also become redundant.
  • Byremoval of the said filter and in the teeth of the liberal provision incorporated at section 32(2) of the Bill, it will open floodgates for the compromised degree holders to practice without they being testedfor the desired levels and country will be flooded with half- baked and ill-equipped medical practitioners playing havoc with the health of Indian population at 
  1. Composition of Autonomous Board:
  • TheSection 17(1) of the proposed Act stipulates that each autonomous board shall consist of President and two  The composition does not provide for inclusion of any elected member therein whichgoes to indicate that the membership of the said Boards would be totally appointed / nominated without any representation of an elected member and thus they would not have any representative character asis desired and warranted.
  1. Discretionary Powers for relaxing prescribed regulatory conditions:
  • UnderSection 29 (d) a proviso is provided which entitles the MAR Board to relax the criteria for opening of the medical colleges at its discretion with the previous approval from the Central Government which yields not only a wide authority but also provides adequate scope for availing the discretion for extraneous  More so the regulatory stipulations which are mandatory in nature and binding in character cannot be open for any concession or condonation vide discretionary authority.
  • Thesaid discretionary authority is not only vested with the autonomous board but also is with the Central Govt. as well. Such duel / double discretions to waive the applicability of statutory stipulationsgoverning prescribed requirements per se bad in the eyes of the 
  1. Permission to practice without qualifying the National LicenciateExamination:
  • Provisoto Section 33(1)(d) stipulates that ‘the commission may permit a medical professional to perform surgery or practice medicine without qualifying the National Licenciate Examination, in suchcircumstances and for such period as may be specified by regulations’.
  • Thisoperationally means that without ascertaining of the required levels and certification thereto the commission would be permitting people to practice surgery and medicine is nothing less thanlegalizing quackery in an operational 
  1. Removal of embargo on Foreign Citizens practicing inIndia:


  • A proviso to section 33(1)(d) clearly stipulates that ‘a foreign citizenwho is enrolled in his country as a medical practitioner in accordance with the law regulating the registration of medical practitioners in that country may be permitted temporary registration in India for such period and in such manner as may be specified by a Regulation’.
  • Anuninhibited permission to practice medicine by a foreign citizen without any reasonable restrictions is harboring intrinsic dangers in 
  1. Imposition ofPenalty.:
  • Undersection 26(1)(f) it is provided that MAR Board take such measure, including imposition of monetary penalty, against a medical institution for failure to maintain the minimum essential standards specified by the UGME Board or the PGME Board, as the case may be, in accordance with the regulations made under this Act.
  • Itis further provided that the “medical institution which has been imposed a first-time monetary penalty fails to take any corrective action, the MAR Board may impose a second-time monetary penalty for continued failure which shall be higher than the first- time penalty and on continued failure, impose a third-time monetary penalty which shall be higher than the second-time penalty:
  • Providedfurther that all the three monetary penalties imposed under the first proviso shall not be less than one-half, and not more than ten times, the total amount charged, by whatever name called, bysuch institution for one full batch of students of undergraduate course or postgraduate course, as the case may be:
  • Providedalso that even after the imposition of third-time penalty, if the failure continues, the MAR Board shall forward its report to the Commission recommending to withdraw the recognition granted to the medical qualification awarded by that medical institution.
  • The material point for consideration is that all the three monetary penaltiesare not to be less than one half and not more than ten times the total amount charged by a such institution for one full batch of students of undergraduate course or postgraduate course as the case may  Apart from the heavy computation the contemplation of batch of students of undergraduate course or postgraduate course fall short of indicating required specifics.
  1. Central Govt. empowered to issue directions:
  • Although,autonomy is expected to be a hallmark of the National Medical Commission Bill, 2017 and the Boards there under are called as, “Autonomous Boards” in reality the same is a misnomer as under section 44(1) in the said proposed Bill the Central  would be entitled to give directions to the Commission and autonomous boards on all the questions of policy which would be binding for the commissionand autonomous Boards to comply. Further it is clearly stipulated that the decision of the Central Govt. whether question is one of the policy or not would be final and is not open for any require of any type.
  • Section45 of the proposed bill further stipulates that the Central  would be within its rights to give such direction it may deem necessary to the State Govt. for carrying out all or any of the provisions of this Act and State Govt. shall comply with such directions is also undermining the authority of the State Govt. and is inconsistent with the cardinal principles governing the federal polity as stipulated in the Constitution of India.

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