Part of: Mains GS Paper II- Issues relating to development and management of Social Sector or Services relating to Health, Education, Human Resources.
Key pointers:
The Union Cabinet Friday cleared the National Medical Commission (NMC) Bill, ending the era of Medical Council of India (MCI) as the apex medical education regulator conducting annual inspections, and paving the way for an exit exam for medical graduates.
According to the Bill, a 25-member commission selected by a search committee headed by the Union Cabinet Secretary will replace the elected MCI.
The move is based on recommendations of the Ranjit Roychowdhury Committee and a Parliamentary standing committee — both concluded that a regulator elected by the fraternity it would monitor cannot be effective.
The Bill also provides for the introduction of a licentiate (exit) examination within three years of its passage by Parliament. Such a move would make the medical sector the first in the country’s higher education system to have a common entrance test (National Eligibility cum Entrance Test), counselling and exit examination.
On the ground, the Bill represents a radical shift from the present system in which medical colleges are subject to annual inspections on physical, infrastructural and bed-patient norms.
Under the NMC, which includes a Medical Advisory Council where states will be represented, colleges need permission only once for establishment and recognition.
Apart from removing the need for annual renewal of recognition, colleges can, on their own, increase the number of seats subject to the present cap of 250, and start PG courses.
The Medical Assessment and Rating Board constituted by the central government can, however, conduct inspections.
Under the NMC Bill, if a college is found to be in violation of norms, such as those governing teachers, laboratories, patients, etc., it can be fined sums ranging from half of the cumulative fees it charges from students to 10 times that amount.
The ex-officio members of the NMC will include the director of AIIMS, New Delhi; Director General of Health Services; and nominees of PGI Chandigarh, JIPMER Puducherry, TMCH Mumbai, and NEIGRIHMS Shillong.
The 64-member medical advisory council will have one member from each state and UT (nominated by the Home Ministry); chairman UGC; director NAAC, etc.
There will be four boards under the NMC for UG and PG medical education, ethics, ratings and assessment.
Part of: Mains GS Paper II- Welfare schemes for vulnerable sections of the population by the Centre and States and the performance of these schemes; mechanisms, laws, institutions and Bodies constituted for the protection and betterment of these vulnerable sections.
Key pointers:
Meghalaya became the first state in India to operationalise a law – The Meghalaya Community Participation and Public Services Social Audit Act, 2017- that makes social audit of government programmes and schemes a part of government practice.
The legislation will be applicable to 11 departments and 21 schemes.
A social audit facilitator will be appointed to conduct the audit directly with the people. He will present findings to the Gram Sabha, who will add inputs and the result will finally go to the auditors.
So far, social audits of government programmes have been done at the initiative of civil society organisations. These social audits had no official sanction.
Benefits:
It will make it easier to correct course as the scheme is rolling along; the audit is not after all the money has been spent.
It gives people a direct say in how money will be spent and fills an information gap for officers as they are directly in touch with the ground.
The legislation provides a legal framework for allowing citizens’ participation in the planning of development, selection of beneficiaries, concurrent monitoring of programmes, redress of grievances, and audit of works, services, and programmes on an annual basis.
Part of: Mains GS Paper III- Indian Economy and issues relating to planning, mobilization of resources, growth, development and employment.
Key pointers:
The Union Cabinet gave nod to a Rs 2,600 crore special package for employment generation in the leather and footwear sector.
The two sectors has the potential to generate 3.24 lakh jobs in three years and assist in the formalisation of 2 lakh jobs.
The package involves implementation of central scheme ‘Indian Footwear, Leather & Accessories Development Programme’, with an expenditure of Rs 2,600 crore during 2017-18 to 2019-20.
The scheme would lead to development of infrastructure for the leather sector; address environmental concerns specific to the leather sector and facilitate additional investments, job creation and production.
Moreover, the enhanced tax incentive would attract large-scale investments in the sector and reforms in labour laws in view of seasonal nature of the sector will support economies of scale.
In a separate decision, the government also approved capital investment subsidy amounting to Rs 264.67 crore to four industrial units located in North-East, including Sikkim. The decision was taken at a meeting of the Cabinet Committee on Economic Affairs.
Conservation, environmental pollution and degradation, environmental impact assessment
Need for Green maifesto
In news:
According to the just-released Global Carbon Budget report, India is expected to record a two-per cent increase in carbon emission this year.
The PM (particulate matter) pollution levels reached alarming levels, with the children and the elderly facing the risk of permanent lung defects, forcing schools to be shut down and sales of air masks and purifiers going through the roof during Diwali month in capital city of Delhi.
In a span of a month, as a country and as a capital, we have tried to deal with the issue of air pollution in myriad ways — from domestic use of mild explosives, farmer stubble burning in Punjab and Haryana and vehicle emissions.
Caring about environment- both good politics and good governance:
As large parts of the northern and central India struggle to breathe, it is time to bring a breath of fresh air to the pollution problem. While civil society and citizens can and do play a critical role in solving environmental issues, institutional action is critical — from political establishments and the executive alike. Caring about the environment has now become both good politics and good governance. Why?
Pollution costs India dearly — according to the Lancet Commission, 2.51 million Indians died in 2015 due to pollution-related causes.
We rank No. 1 in pollution-related deaths and 25 per cent of all deaths are caused due to pollution.
Moreover, according to a 2013 World Bank report, air pollution alone costs India 8.5 per cent of its GDP due to welfare costs and lost labour income.
Pollution has also entered the public discourse. Indians (especially urban Indians) are now increasingly concerned with the issue.
Social media outrage, memes and other forms of satire on the subject shows a clear trend. Rigorous surveys tend to corroborate the mood — as per a 2015 Pew Research, 73 per cent of Indians were “very concerned” about global climate change.
Way forward:
Firstly, there is a need for a Green Manifesto when political parties gear up for elections at least in urban India. Not only is that a moral imperative, it is also tactically suave.
The recent manifestos of most major parties did not give sufficient space to a green agenda. There is a need to have a separate environment vision document especially for urban India.
Given the recent events political parties should expect environment to become a focal campaign point, at least in cities.
A glimpse of this coming change can be seen in some of the more recent documents albeit from relatively young political parties.
There are lessons to be learnt from the west. In the American context, candidates are compelled to articulate their respective positions on the matter.
There is a need for an environment roadmap from the administration and the executive.
The Niti Aayog could set green goals akin to the UNDP’s Millennium Development Goals.
The National Green Tribunal (NGT) needs to be revamped and armed with more scientists and environmentalists.
As some have suggested India should have a federal green agency akin to the US EPA. Certain government measures are welcome steps — for example, the vision to sell only Electric Vehicles by 2030.
A developing country which continues to face dual challenges of unemployment and poverty, needs to balance environment concerns with needs for rapid large-scale industrialisation.
That economic engine along with accelerated urbanisation will put immense pressure on India’s Green Report card — and that is a juggling act political leaders and administrators will need to master.
Conclusion:
Every Indian has a right to life and according to Articles 21 & 48 of the Constitution, a clean environment is part of that right.
Neglecting pollution concerns not only violates fundamental rights but it also has economic, human and political costs.
The Indian voter is ready with open doors for an environment conscious politician to walk in. But this time, the concern has to be real, the manifesto substantial and the promises delivered.
Connecting the dots:
Caring about environment is both good politics and good governance. In this light, there is a need for green manifesto in India.
NATIONAL
TOPIC:General Studies 2:
Statutory, regulatory and various quasi-judicial bodies.
Government policies and interventions for development in various sectors and issues arising out of their design and implementation.
Issues relating to development and management of Social Sector or Services relating to Health, Education, Human Resources.
Regulating private hospitals in India
In news:
Private hospitals have been in the news lately for all the wrong reasons.
The Delhi Government has cancelled the license of Max Hospital, finding the hospital administration guilty of medical negligence. Fortis Gurugram presented a bill of Rs. 16 lakh for the 15-day dengue treatment of seven-year-old Adya who lost her life subsequently.
Instances of suspected medical negligence and exorbitant bills are not unusual. The problem needs a systemic and sustained solution.
Rules and beyond
The Clinical Establishments Act, 2010 was enacted by the Centre for registering and regulating all types of public and private clinical establishments in the country, including single-doctor clinics.
Thus far, the Act has been adopted by Uttar Pradesh, Rajasthan, Bihar, Jharkhand and Assam; however, it has taken effect only in four States, namely Arunachal Pradesh, Himachal Pradesh, Mizoram and Sikkim.
Healthcare in India is plagued by tremendous information asymmetry. Patients as buyers of healthcare services and doctors as providers are definitely not equal players. Patients and their families often have little choice but to assume that their doctor knows best.
While we can put in place external checks and balances, the need for the medical profession to self-regulate and adhere to the highest ethical standards is most important.
In this regard, the role of the Medical Council of India (MCI) has been grossly inadequate.
The Act provides for the creation of a regulatory authority at the State and district levels. Other key elements include the grading of clinical establishments, adoption of standard treatment guidelines and protection of patient rights.
The National Health Policy, 2017 recommends the setting up of an empowered medical tribunal for the timely resolution of complaints pertaining to medical negligence, excessively high cost of treatment and unfair practices.
Way forward:
The adoption and implementation of this Act in letter and spirit will be a significant step towards curbing malpractices such as overcharging and minimising instances of negligence.
Citizens also need to be empowered so that they understand their rights and the recourse available to them in case something goes wrong.
It is, therefore, imperative that citizens are educated about diseases, possible complications and approximate treatment costs.
In some parts of the country Jan Sunwais are organised during which citizens have the opportunity to report their experiences with health providers in the presence of government officials, NGOs and community leaders.
Such interventions should be replicated as they not only increase citizen participation but also make health governance more accountable and responsive to local communities.
The National Medical Commission Bill, 2016 proposes to address the issue of medical ethics.
It emphasises the need for developing a competency-based dynamic curriculum in consultation with stakeholders such that medical graduates not only have appropriate knowledge and skills, but also values and ethics for providing health care.
It proposes to establish the Board for Medical Registration which will also be responsible for prescribing the standards of professional conduct and framing a Code of Ethics for medical practitioners.
We need to focus on building a strong public health system.
The National Health Policy, 2017 and NITI Aayog’s Three-Year Action Agenda make several important recommendations for strengthening public health, including the creation of a focal point in the Union Health Ministry and a dedicated public health cadre, among others. These need to be implemented on a war footing.
Conclusion:
Given India’s dual disease burden and the fact that 50 per cent of deaths are now due to non-communicable diseases, we need to do more to keep people healthy and reduce the need for costly hospital treatment. Never before has the proverb prevention is better than cure been more relevant for the country. When it comes to tackling medical negligence or profiteering, one-off actions are unlikely to have a lasting positive impact. We need to attack the roots instead of just hacking at the leaves.
Connecting the dots:
Given India’s dual disease burden and the fact that 50 per cent of deaths are now due to non-communicable diseases, we need to do more to keep people healthy and reduce the need for costly hospital treatment. Discuss.
