The Supreme Court has given the Centre a deserved rebuke by using its extraordinary powers and setting up a three-member committee headed by former Chief Justice of India R.M. Lodha to perform the statutory functions of the Medical Council of India. The government now has a year to restructure the MCI, the regulatory body for medical education and professional practice. The Centre’s approach to reforming the corruption-afflicted MCI has been wholly untenable; the Dr. Ranjit Roy Chaudhury expert committee that it set up and the Parliamentary Standing Committee on Health and Family Welfare in the Rajya Sabha had both recommended structural change through amendments to the Indian Medical Council Act. Now that the Lodha panel will steer the MCI, there is hope that key questions swept under the carpet at the council will be addressed quickly. Among the most important is the need to reduce the cost of medical education and increase access in different parts of the country. This must be done to improve the doctor-to-population ratio, which is one for every 1,674 persons, as per the parliamentary panel report, against the WHO-recommended one to 1,000. In fact, it may be even less functionally because not all registered professionals practice medicine. In reality, only people in bigger cities and towns have reasonable access to doctors and hospitals. Removing bottlenecks to starting colleges, such as conditions stipulating the possession of a vast extent of land and needlessly extensive infrastructure, will considerably rectify the imbalance, especially in under-served States. The primary criterion to set up a college should only be the availability of suitable facilities to impart quality medical education.
The development of health facilities has long been affected by a sharp asymmetry between undergraduate and postgraduate seats in medicine. There are only about 25,000 PG seats, against a capacity of 55,000 graduate seats. The Lodha committee is in a position to review this gap, and it can help the Centre expand the system, especially through not-for-profit initiatives. There is also the contentious issue of choosing a common entrance examination. Although the Supreme Court has allowed the National Eligibility-cum-Entrance Test, some States are raising genuine concerns about equity and access. A reform agenda for the MCI must include an admission procedure that eliminates multiplicity of entrance examinations and addresses issues such as the urban-rural divide and language barriers. The Centre’s lack of preparedness in this matter, even after it was deliberated by the parliamentary panel, is all too glaring. The single most important issue that the Lodha committee would have to address is corruption in medical education, in which the MCI is mired. Appointing prominent persons from various fields to a restructured council would shine the light of transparency, and save it from reverting to its image as an “exclusive club” of socially disconnected doctors.