In an unprecedented move, a Parliamentary panel has rejected the bill to set up an overarching regulator for India's health sector and asked the Health Ministry to draft a new legislation that addresses the apprehensions raised by states and other stakeholders.
The Parliamentary Standing Committee on Health and Family Welfare has objected to the fact that the proposed regulator in the bill neither provides any representation to state governments despite health being a state subject nor does it provide for elections to appoint members of the regulator.
The Committee has also asked the Health Ministry to include medical research (currently covered by Higher Education and Research Bill 2011 of the HRD Ministry) under the proposed medical regulator.
"The Bill cannot be recommended in the present form. We recommend to the Ministry to withdraw the Bill and bring forward a fresh bill after sufficiently addressing all the views and concerns expressed by stakeholders," the panel said
in its report on the 'National Commission for Human Resources for Health Bill 2011' (NCHRH Bill).
The NCHRH Bill, introduced in Rajya Sabha on December 22 last year, was forwarded to the panel for consideration.
The Bill rejected by the Committee seeks to dissolve the four existing health regulators ┐- the Medical Council of India, the Dental Council of India, the Pharmacy Council of India and the Nursing Council of India -- by repealing the parent Acts under which these bodies were set up.
The idea behind the Bill is to create an overarching National Commission for Human Resources for Health which would then have all the power to approve new medical institutions and courses.
Under the Bill, the proposed Commission suggested of setting up three constituent bodies -- the National Board of Health Education, the National Evaluation and Assessment Committee and the National Councils like the MCI, the DCI and the PCI.
The Parliamentary Committee, however, has taken note of the concerns expressed by representatives of the existing regulating councils who claimed their role under the new law had been relegated to merely maintenance of medical registers.
"We note the concerns expressed by Councils that their autonomy and democratic setup have been taken over under the bill. We feel these apprehensions need to be appropriately addressed by the government. Also the concern that there is no element of election in the composition of the commission and its constituents also needs to be addressed. This part has been objected to by the states also," the panel report said.
The Parliamentary panel also decided against going in for clause-by-clause consideration of the bill, saying it did not require that attention as it had serious loopholes.
To start with, the Committee rejected the composition of the Commission which gives no representation to states.
"We are aware that health is a state subject but health education figures in the Concurrent list. However composition of the commission gives no representation to states. We recommend to revisit the institutions of national commission, national board and national evaluation and assessment committee to give representation to states," the report said.
The Parliamentary panel also questioned the fact that the Bill is silent on the selection of Commission members and members of its constituents as it only says, "the chairperson and members shall be appointed in such manner as may be prescribed.
The Parliamentary panel said the selection process has been made very ambiguous and this issue must be addressed by the Health Ministry.
"The Bill says chairperson and members of the Commission and its constituents can be removed by the Central government, which too is a very ambiguous provision. Such power should be vested with the President as is the case in the Higher Education and Research Commission Bill, 2011," it said.
The panel has also rejected the provision of the Bill which allows for instruction of medical education in distance mode, saying such instruction has to be through a regular course.
Another provision of the Bill which came under criticism is the one that says 'in cases where no order in establishment of an institution for imparting health education or a new course of study has been given by the Commission for one year, it would be deemed to be approved by the Commission in the form it was submitted'.
"This clause is susceptible to misuse and must be made much more stringent," the panel said.
The Bill is likely to impact the availability of health professionals and infrastructure, it said.