The medical field witnessed major ramifications in its regulatory structure in the recent times. Age-old laws were repealed, and new laws were introduced in the field of medical education system, Indian system of medicine and allied healthcare profession. The National Medical Commission Act 2019, National Commission for Indian System of Medicine 2020 and National Commission for Allied and Healthcare Profession Act 2021 were introduced to keep the medical field in pace with the time.
National Medical Commission Act 2019:
Prior to September 2020, the medical education in India was governed by Indian Medical Council Act 1956 (IMC Act) and the Medical Council of India (MCI) was the statutory body constituted under IMC Act which regulated and standardised medical education in India. The 92nd report submitted by the Department-Related Parliamentary Standing Committee on Health and Family Welfare in the year 2014 raised the need of revamping the statutory MCI. The committee commented on MCI’s failure in producing quality medical professional in the country due to its failure in maintaining uniform standards in medical education, development of merit in admission especially in private institutions etc. The Committee, being convinced that MCI can no longer be entrusted with the regulation of medical education and mere amendment to IMC cannot solve the issues faced, recommended for the constitution of National Medical Commission with four separate boards delegated with separate responsibilities. The Hon’ble Supreme Court, in Modern Dental College and Research Centre & Ors vs. State of Madhya Pradesh & Ors (AIR 2016 SC 2601) had also directed the Central Government to take appropriate actions based on the Committee Report. Thus, the National Medical Commission Act 2019 (NMC 2019) was enacted and notified in August 2019, effective from 9th September 2020 repealing MCI Act.
The NMC 2019 provides for the constitution of National Medical Commission and four autonomous boards namely- the Under-Graduate Medical Education Board; the Post-Graduate Medical Education Board; the Medical Assessment and Rating Board; & the Ethics and Medical Registration Board. In addition, the NMC 2019 provides for maintenance of national and state register of medical professionals, recognition of medical institutions within and outside India, conduct of National Eligibility cum Entrance Test for admission to undergraduate and post graduate medical education and a National Exit Test for granting license to medical professionals. The National Medical Commission was constituted effective from 25th September 2020 dissolving MCI.
National Commission for Indian System of Medicine 2020:
The medical education of Indian system of medicine and practice was regulated by Indian Medicine Central Council Act 1970 (IMCC Act) and Central Council for Indian Medicine (CCIM) was the regulatory body. An amendment bill was introduced in the year 2015 to streamline issues of granting license to medical colleges, membership etc. However, this bill was not passed. Later, the Central Government constituted a Committee on Reform of Indian Medicine Central Council Act 1970 and Homeopathy Central Council Act 1973. This committee commented that as IMCC Act was drafted in line with the IMC Act, the challenges faced by the IMC and CCIM were similar and therefore proposed a replacement of IMCC Act and the constitution of National Commission for Indian System of Medicine (NCISM). The committee also recommended the inclusion of Naturopathy, Yoga and Unani under the purview of NCISM.
Pursuant to the committee report, National Commission for Indian System of Medicine Act 2020 (NCISM Act) was legislated and notified on 20th September 2020. NCISM provides for the constitution of NCISM and its autonomous boards namely (i) Board of Ayurveda; (ii) Board of Unani, Siddha and SoWa-Rigpa; (iii) the Medical Assessment and Rating Board for Indian System of Medicine; and (iv) the Board of Ethics and Registration for Indian System of Medicine. The NCISM also legislates for conduct of (a) National Eligibility cum Entrance Test, and (b) National Exit Test before obtaining practice license. Legal recognition is also accorded for the constitution of state medical council(s), and maintenance of national and state register for practitioners, & recognition of medical institutions within and outside India.
National Commission for Homeopathy Act 2020:
The National Policy on Indian Systems of Medicine and Homeopathy 2002 commented that homeopathy training institutes lacked qualified teachers and the quality of training is not of requisite standard. Later, the Committee on Reform of Indian Medicine Central Council Act 1970 and Homeopathy Central Council Act 1973 also recommended the replacement of Homeopathy Central Council Act 1973 (HCC Act).
In the above background, HCC Act was repealed, and National Commission for Homeopathy Act 2002(NCH Act) was enacted on 20th September 2020. Similar to NCISM Act, HCC Act provides for the (i) constitution of a National Commission for Homeopathy, Homeopathy advisory council and autonomous boards(ii) establishment of National Eligibility Cum Entrance Test, National Exit Test, Post- Graduate National Entrance Test and National Eligibility Test for Teachers for Homeopathy (iii) constitution of State Medical Council (iv) maintenance of central and state registers for practitioners (v) recognition of medical institutions within and outside India.
National Commission for Allied and Healthcare Profession Act 2021:
With the aim to implement a patient centric approach and multidisciplinary team approach, Department-Related Parliamentary Standing Committee on Health and Family Welfare in its 117th Committee Report proposed the National Commission for Allied and Healthcare Professions Bill, 2020. Furtherance to which, the National Commission for Allied and Healthcare Profession Act 2021(NMAHP Act) was enacted in March 2021 with the aim to provide a regulatory framework for the education and services by allied and healthcare professionals, assessment of institutions, maintenance of a central ad state register. The NMAHP Act defines allied health professional as:
“an associate, technician or technologist who is trained to perform any technical and practical task to support diagnosis and treatment of illness, disease, injury or impairment, and to support implementation of any healthcare treatment and referral plan recommended by a medical, nursing or any other healthcare professional, and who has obtained any qualification of diploma or degree under this Act, the duration of which shall not be less than two thousand hours spread over a period of two years to four years divided into specific semesters”.
Like the other two enactments, the NMAHP Act provides for the constitution of a commission and autonomous boards. The commission will be National Commission for Allied and Healthcare Profession, the autonomous boards are – (i) Under-graduate Allied and Healthcare Education Board; (ii) Post-graduate Allied and Healthcare Education Board; (iii) Allied and Healthcare Professions Assessment and Rating Board; and (iv) Allied and Healthcare Professions Ethics and Registration Board. In addition, this law also provides for constitution of individual state councils for allied healthcare professional.
The constitution of national commissions and autonomous board, maintenance of central and state registers are the common provisions under the three legislations briefed above, which aims bringing in administrative changes in medical education and profession. Similar to the All-India Bar Examination, the certification exam conducted by Bar Council of India for lawyers, these legislations have also introduced National Exit Test for medical practitioners in modern and Indian system of medicine, as well as for allied health care professions to ensure quality in medical profession. It is apparent from the objectives of these legislations that the government intends to bring in uniformity and transparency in all fields of medicine.