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DOCTORS’ DILEMMA

Will troubles never cease for the Medical Council of India (MCI)? The body, which is responsible for maintaining standards in medical education, recognising or derecognising medical qualifications and institutions and so on, has been in limbo ever since the arrest of its president Dr Ketan Desai on charges of corruption in 2010. But despite the effort to establish a more transparent and accountable MCI through the Indian Medical Council (Amendment) Bill 2013, the bill itself remains mired in controversies.

Since the amendment bill, introduced in the Rajya Sabha on August 19, was not passed in the monsoon session of Parliament, the ministry of health and family welfare promulgated the Indian Medical Council (Amendment) Second Ordinance, 2013, to ensure that the board of governors, which has been helming the MCI since 2010, could continue to run the body.

However, the main sticking point — of both the bill and the ordinance — is that they mandate elections to the MCI’s national level unit. In fact, the Indian Medical Association (IMA), a body of registered medical practitioners across India, is planning to go to court mainly to challenge the MCI’s electoral processes. Critics say given that most states have not had elections to the state units of the MCI, it is undemocratic to hold elections at the national level.

A writ petition was filed at the Calcutta High Court recently by three city doctors, contesting the MCI’s decision to hold a general body meeting of its elected and nominated members to choose the council’s president, vice-president and other senior officials. The writ submits that since it has been notified that the state medical council election will be held on December 19, the MCI could not “deny democratic and legal rights of the petitioners, candidates of MCI election from West Bengal, to vote or run for the post of next MCI president/vice-president by holding the process prior to the completion of MCI election from West Bengal”.

Apparently, only seven states (Chhattisgarh, Sikkim, Goa, Bihar, Haryana, Tamil Nadu and Gujarat) have so far elected their representatives to the local chapters as well as the MCI, while others are yet to hold polls. For instance, the Arunachal Pradesh Medical Council is expected to elect its representative in January, 2014.

“There are many states which are not holding elections,” says Dr Vijayakumar K, president of the IMA. “So the present council of the MCI only has nominated members — and not democratically elected representatives. Yet the MCI is supposed to elect two-thirds of its members, while the rest can be nominated.”

However, the MCI says that the general body meeting to choose the president and other senior members of the body’s national council is on schedule. Elections have not been stayed despite the writ petition.

Indeed, the government has been keen to hold elections to the MCI and reconstitute it, as it were. In its report submitted on November 20, the Parliamentary standing committee on health notes that the health ministry had asked all the state governments, state universities, state medical registers, etc. to complete the election process and send nominations for the national council of the MCI. It says, “The ministry was committed to completing the election process and having an elected Council in position as soon as it could.”

However, Dr Kunal Saha, who was recently awarded Rs 11 crore as compensation in a landmark medical negligence case, has written to the Union health minister, Ghulam Nabi Azad, objecting to the nomination of 17 members associated with Dr Ketan Desai and the nomination of Desai himself from Gujarat. He writes, “There is little doubt that the nomination/election of the 17 doctors, who previously helped Dr Desai to gain control of the MCI, to the next MCI would further erode public trust in the healthcare delivery system.”

It’s not just the steamrolling of elections to the MCI that has infuriated a lot of people. There are strong reservations about several other aspects of the bill. For instance, the bill seeks to insert a new proviso in Section 3 of the principal act. It says that wherever there is a health university in a state, that university shall elect one representative for every 10 medical colleges affiliated to it. It adds that a health university with fewer than 10 medical colleges affiliated to it will also be eligible to elect one representative.

“Membership of the MCI is being redefined,” says Dr Fuad Halim, CPI(M) leader and a medical practitioner based in Calcutta. “This redefinition of membership will favour states with a higher number of private medical institutes. This goes against the federal structure of the council.”

But even as many stakeholders point to the unfairness of the election process, others feel that some of the amendments will dilute the MCI’s autonomy. For instance, Section 30 A of the bill lays down conditions under which the Centre can remove the MCI president, vice-president or any other member. They can be removed if they have been convicted of “an offence involving moral turpitude” or “have acquired such financial or any other interest in any medical institution falling within the purview of the Council” and likely to “affect prejudicially” their functioning. They can also be removed if they wilfully or without sufficient reason fail to abide by the directions issued by the Centre and in the public interest. It also says the Centre’s power to direct the Council on policy matters including amending and revoking rules and regulations made by the MCI is final.

All this has raised worries that if the amendments go through, the government will have an unfair hold over the MCI. “The proposed amendments imply that the government has the power to dissolve the committee at any time it likes,” says Dr Vijayakumar. “The government seems to invest itself with more power to control the MCI — if these provisions are enacted, the council will stop functioning as an autonomous body.”

The bill also seeks to amend sub-section (2) of Section 3 of the act so that no person can hold the post of president or vice-president for more than two terms.

But some experts feel these changes are cosmetic. Says Dr Kunal Saha, “Ironically, the legislators have left a gaping hole even in these trivial changes. While the same doctor may not be MCI president after two terms, there is nothing to prevent him from becoming president after a gap of a single term. In other words, a devious president may simply step aside after plundering the MCI for two terms only to leave it to one of his cronies in the council, and then come back for another term!”

It remains to be seen how the Centre addresses these concerns and whether or not it is able to put the MCI back on its feet as a clean and transparent body.