India suffering critical shortage of doctors: NMC Bill may finally give rural poor access to affordable healthcare

Debobrat Ghose
India has less than one doctor for every 1,000 citizens, which is less than the World Health Organisation (WHO) standard that prescribes a doctor population ratio of 1:1,000.

India has less than one doctor for every 1,000 citizens, which is less than the World Health Organisation (WHO) standard that prescribes a doctor population ratio of 1:1,000.

In July 2017, Union minister of State for health Anupriya Patel had told Parliament that as per information provided by the Medical Council of India (MCI), there were a total 10,22,859 allopathic doctors registered with the MCI or with state medical councils as of 31 March, 2017.

Given these statistics, it can safely be assumed that a sizable number of India's population are denied timely medical healthcare €" and they are likely to be the poor strata of society. It is therefore surprising that the Indian Medical Association (IMA) has already labelled the proposed National Medical Commission (NMC) Bill as "anti-poor" and "anti-people".

"The NMC Bill in the present form is not acceptable. This is anti-poor, anti-people, non representative, undemocratic and anti-federal in character," newly-appointed IMA national president Dr Ravi Wankhedkar said on Tuesday.

The IMA has already written to Prime Minister Narendra Modi and the Union health minister, urging them to redraft the bill and rectify some of its provisions to protect the interests of medical practitioners. It claimed that the provision in the bill which allows AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy) graduates to practice modern medicine after completing a bridge course will promote quackery.

"The bill purported to eradicate corruption is designed to open the floodgates of corruption. A bill to regulate the medical education and practice without the concurrence of the medical profession will be a disaster," Wankhedkar added.

But does the IMA have any answer as to why is there so much corruption in the existing medical system, where qualified doctors with MBBS, MD and MS degrees are calling the shots? Or why so many disasters continue taking place in private super-speciality hospitals where AYUSH graduates don't treat patients? Does Wankhedkar have any answer as to why is there public loot in private nursing homes and hospitals?

With registered medical practitioners refusing to serve in rural areas, the IMA's claim about the bill being "anti-poor" seems a little hollow €" if the national body is so concerned about the poor, why doesn't it enforce rural service for all its members for a stipulated period?

It's no secret that for providing treatment, a large number of nursing homes and private hospitals charge exorbitant amounts from patients €" in the name of diagnosis, investigations, medicines, ICU facilities, etc.

The worst sufferers in this vicious cycle are the poor and marginalised sections of society. A large number of patients have even moved courts filing suits against such hospitals. There are not thousands, but lakhs of poor people in far-off rural areas who don't have access to timely healthcare, due to the sheer unavailability of qualified doctors.

In the past, various governments had tried to send medical practitioners to villages, but their efforts met with less success and more failure. Various incentives failed to enthuse even medical graduates (MBBS students) to serve in rural centres. All over the country, thousands of vacancies for doctors continue to remain unfulfilled.

Through the NMC Bill, the Centre intends to come up with a solution where an AYUSH graduate, after completing a "bridge course", can serve poor patients in rural areas. At present, there are thousands of AYUSH graduates across the country who are treating patients in far-flung remote areas. The government wants them to enhance their skills and make them professionally capable, so that they can deliver better quality services in rural areas, places where the medical graduates and post-graduates do not tread at all.

There had been incidents in the past, when qualified doctors practicing allopathy strongly criticised AYUSH practitioners, but this reeks of classist supremacy. It's a known fact that medical facilities offered by large reputable private hospitals are beyond the reach of most citizens. Government hospitals, meanwhile, are in a deplorable condition. To the extent that in one government hospital in Uttar Pradesh, even eye surgeries were conducted by torchlight!

However, noted cardiac surgeon and chairman of Narayan Health, Dr Devi Shetty, told News18 on Tuesday that the bill was being misinterpreted and Ayurvedic doctors were not going to be allowed to practice Allopathy. "It is not part of the bill. If Ayurvedic doctors are allowed to be allopathic practitioners, it is unacceptable. And I think it is being misinterpreted," Shetty said.

Urban-centric doctors needn't worry just yet, especially since the NMC Bill has been referred to a Parliamentary Standing Committee. It's only after this announcement that the IMA called off its 12-hour nation-wide strike. Till then, no one bothered about the serious patients across the country, who remained unattained.

Shetty has a point. The government needs to clarify what it wants from the bill €" mention exactly what relief the bill would provide to the poor patients, rather than handing over an opportunity to the Opposition backed by the doctors' lobby to dump the bill.

As Shetty rightly said, the bill should be supported because it was good for the people of India. "We should look at what is good for 60 percent of the rural population. I think the government should clarify certain points. They have to clarify exactly what it is. There is a lot of ambiguity. Some kind of amendment or clarification is needed. But this bill will make a big difference in delivering health in rural India," Shetty observed. View More