Sixteen years is a long wait for legal recognition. But holders of the Community Medical Service diploma in West Bengal have at last been allowed by the Supreme Court to treat patients as well as prescribe medicines and issue certificates. This could be a long overdue relief for rural Bengal, where healthcare facilities have been inhumanly inadequate. But this will be a workable compromise only if the state and those who avail themselves of the services of these new medical personnel exercise a certain informed vigilance. It is possible that in Bengal’s villages, this might be too much to ask for. Poverty, illiteracy and every kind of under-development are endemic to rural India. In healthcare, as in education, there is not only a serious failure to develop and sustain infrastructure, but also the real problem of the unwillingness of “proper” doctors to serve in the villages. And this is not only in West Bengal. Last year, the chief minister of Madhya Pradesh decided that it would be better for the hapless rural population to have trained quacks than untrained ones. So his government went about training the huge unorganized sector of rural quacks in all sorts of medical and paramedical skills. The legalization of diploma-holders in West Bengal is along similar lines, and also addresses the Indian Medical Council’s hesitation in the past to give them full recognition.
It is, however, difficult not be somewhat apprehensive about the degree of awareness with which desperately poor, illiterate and ill villagers will avail themselves of the services of these medical personnel. After all, they are not proper doctors, and legal recognition is not the same thing as a complete and specialized medical education or experience. It is certainly true that most of these doctors are part of localized systems of knowledge and practice in the rural areas, and often provide much-needed services. But the state might need to educate its villages in being able to distinguish between different degrees and kinds of medical knowhow. Besides, the government should not feel complacent about having worked out a solution to its failures in providing proper healthcare in the villages. Legalizing diploma-holders can only be part of a much wider drive to tackle a pervasive and complicated crisis. The quality of education provided to those who enrol for these diplomas must also be scrupulously monitored. Otherwise, this medical service could also get into the mire of inefficiency and corruption that continues to dog the government’s healthcare system.