How NITI Aayog & MCI are letting corporates into medical education
Now that the Medical Council of India (MCI) has allowed corporates and 'for-profit' institutions to open medical colleges in the country, the government is two steps away from officially opening the floodgates for the market to enter medical education - a big business already.
As of now, private medical colleges are run only by registered 'not-for-profit' trusts and societies. But the fact that they rake in huge profits by the way of donations and scams has been periodically reported. There are 462 medical colleges in India offering the undergraduate MBBS degree, of which more than half are in the private sector.
An investigation conducted by Reuters in 2015 found that more than one out of every six medical colleges had been accused of cheating, while at least 69 colleges between 2010 and 2015 were accused of "accused of significant failings, including rigging entrance exams or accepting bribes to admit students", nearly all of them private.
In fact, the MCI, and earlier, the NITI Aayog, used this same fact to justify the decision - that since the private colleges are already making profits in a "non-transparent" and "illegal" way, it would make sense to allow for-profits to openly make money from medical education.
The MCI passed this resolution at a general body meeting on 22 November in Delhi. While the doctors reportedly acknowledged that the fees charged by these colleges would skyrocket, they took solace in the fact that at least they would pay income tax.
The MCI resolution now awaits approval from an Oversight Committee (OC) appointed by the Supreme Court as well as from the Ministry of Health and Family Welfare.
This resolution has come at a time when the MCI is facing an uncertain future.
The winter session of Parliament is in progress and one of the key Bills that is scheduled to be presented for passage is the National Medical Commission Bill, 2016, which seeks to replace the MCI with a national medical commission (NMC).
In May 2016, the Supreme Court had appointed a three-member OC to oversee the MCI's functioning for at least a year, after a Parliamentary Standing Committee report in March 2016 stated that the medical education and profession in the country was suffering from corruption and "total system failure".
Instead, the committee, headed by former Chief Justice of India RM Lodha, allowed several private colleges to run, despite finding glaring deficiencies in their quality and infrastructure, some even committing outright fakery.
The experts that Catch spoke to were appalled - though not surprised - by this decision of the MCI, a statutory body meant to regulate medical education in the country.
They said both accessibility and quality of medical education and medical services in the country would be massively damaged by the move.
"Mulk ko barbaad kar rahe hain (they are destroying the country)", said a senior doctor from AIIMS in Delhi, the country's topmost medical college and hospital, which is under the public sector and is funded by the government.
"Health and medical services are the responsibility of the government. But the government is already reducing funding for public-sector medical colleges and hospitals. By allowing profit-making companies to open shop, they are going to take medical education beyond the reach of the common people," he said.
Currently, India is among the countries with the lowest public expenditure on healthcare. "The National Health Policy of 2002, during the NDA's rule, had recommended eventually increasing the Budget allocation for health to around 3% of the GDP. But even now, we continue to spend just about 1.3% of the GDP on health, " he says.
The doctor says the government should invest in public hospitals and colleges, and create more facilities. "Private hospitals may offer higher salaries, so doctors may go there to advance their careers," he said.
"This is being done on the pretext that the country needs more doctors, but what about affordability? Doctors are meant for people. But the government only cares about the interests of the rich and the privileged. This is an anti-people government."
The rhetoric of quality
Once again, the MCI used the rhetoric of quality, saying that corporates entering the field will mean more funding and will "improve standards to the level of Harvard and Oxford universities", as some doctors were quoted as saying.
On the question of quality, he says the best medical colleges in the country were the public sector ones, not private. Even medical entrance tests have consistently proved that students prefer government medical colleges.
Another important fallout is that since these corporate colleges would charge prohibitively high fees, students would need to take loans to study there.
And the need to pay off the debts would lead to these students charging very high fees when they start practising themselves.
"This will compel doctors to become mercenaries. The humane goals of the medical profession will become a forgotten thing from the past," said Professor Anil Sadgopal, former dean of Delhi University's Faculty of Education and member of the All India Forum For Right To Education.
"The best medical colleges and hospitals in the country are funded by the government. Consider AIIMS or the Tata Memorial Hospital, the best cancer hospital in the country, which is funded by the Department of Atomic Energy."
Sadgopal also pointed out that under Article 39 of the Constitution, material resources like land could only be allotted for the public good and not for private profit.
"If this is allowed, the government would violate both Sections (b) and (c) of the Article as this would obviously lead to concentration of further wealth in the hands of profit-making companies and increase inequality," said Sadgopal.
"In any system, something improves only when it starts to pinch the privileged sections. Our governments are systematically destroying public institutions, because the privileged can afford the private ones," says the doctor from AIIMS.
Edited by Aleesha Matharu