National Medical Commission (NMC) UPSC

National Medical Commission (NMC)

NMC has been setup under National Medical Commission Act (NMC Act), 2019 which repealed the Indian Medical Council Act, 1956.

• It was recommended by Prof. Ranjit Roy Chaudhury committee (2015).

Composition of National Medical Commission (NMC)

NMC will consist of 25 members, appointed by the central government. A Search Committee will recommend names to the central government for the post of Chairperson, and the part time members.

Members of National Medical Commission (NMC)

• Chairperson (must be a medical practitioner), 
• Presidents of the Under-Graduate and Post-Graduate Medical Education Boards, 
• Director General of Health Services, Directorate General of Health Services,
• Director General, Indian Council of Medical Research, and
• five members (part-time) to be elected by the registered medical practitioners from amongst themselves from states and union territories for a period of two years.

Functions of National Medical Commission (NMC)

1. framing policies for regulating medical institutions and medical professionals, 
2. assessing the requirements of healthcare related human resources and infrastructure, 
3. ensuring compliance by the State Medical Councils of the regulations made under the Act,
4. framing guidelines for determination of fees for up to 50% of the seats in private medical institutions and deemed universities which are regulated under the Act.

It supervises following autonomous boards setup under the Act.

• Under-Graduate Medical Education Board and Post-Graduate Medical Education Board to set standards and regulate medical education at undergraduate level and postgraduate level respectively.
• Medical Assessment and Rating Board for inspections and rating of medical institutions and
• Ethics and Medical Registration Board to regulate and promote professional conduct and medical ethics and also maintain national registers of (a) licensed medical practitioners and (b) Community Health Providers (CHPs).

NMC may grant a limited license to certain mid-level practitioners who may prescribe specified medicines in primary and preventive healthcare.

Positive aspects of National Medical Commission (NMC)

• Transparency: Members of NMC will have to declare their assets at the time of assuming office and when they leave. They will also have to submit a conflict of interest declaration.

• Independence in working: Members will have to serve a two-year cooling-off period after their tenure. This could be waived by the government if required. MCI members could be re-nominated or re-elected. NMC chairperson and others members nominated cannot be renominated.

• Separation of functions: Unlike MCI which has been criticised for concentration and centralisation of all regulatory functions in one single body, NMC has four autonomous boards under it.

• Non-opaque functioning: Medical Assessment and Rating Board under NMC will give rating to all medical colleges which will be available in public domain. This will prevent opaque functioning under MCI.

Concerns with National Medical Commission (NMC)

• Lesser elected representatives: Compared to the 70% figure of elected representatives in the MCI, only 20% members of the NMC will be elected representatives.

• Against federal setup: MCI’s decisions were not binding on state medical councils, NMC’s ethics board exercises jurisdiction over state medical councils on compliance related to ethical issues.

• Limited representation of states: Previously, all the State governments had representation in MCI while in the NMC, only few States in rotation will have representation. States’ representation is primarily in the medical advisory council which is only advisory body. 

• Greater control of executive: While action could be taken against the MCI president only on the direction of a court, NMC Act enables the central government to remove the chairperson or any other member of the NMC.

• Absence of independent appellate body: Central government is the appellate authority for almost all decisions taken by the commission and also, Centre has the power to give the commission and boards policy directions.

• Absence of diverse stakeholders: Two-thirds of the members in the NMC are medical practitioners. Expert committees have recommended that the regulator should consist of more diverse stakeholders in order to reduce the influence of medical practitioners in regulating medical education and practice.

• Fee regulation: MCI had no powers to regulate fees. NMC will be “framing guidelines” for determining fees on 50% of seats in private colleges. NITI Aayog Committee (2016) was of the opinion that a fee cap would discourage the entry of private colleges, thus, limiting the expansion of medical education in the country.