Thursday, November 17, 2016

Letter to Prime Minister by IMA - Satyagraha 2016



To Shri Narendra Modi
Honorable Prime Minister of India
Respected Sir;
Indian Medical Association is the largest Medical Association of the world. IMA is a voluntary body constituted by doctors practicing modern system of medicine. It represents the collective consciousness of over 2.7 Lakh doctors in all the 686 districts of India organised in 30 state and 1765 Local Branches. Indian doctors have contributed significantly in achieving Millennium Developmental Goals and are now working hard to achieve sustainable developmental goals including reduction in maternal mortality, infant mortality, road traffic accident deaths, HIV, TB and Malaria. IMA is actively participating in Swachh Bharat Swasth Bharat Abhiyan and Pradhan Mantri Surakshit Matratav Abhiyan.
IMA as a nation builder has volunteered its services for the success of all the national programmes. We are concerned about the threats perceived by the profession in general and hardship suffered by individual doctors in particular. To be able to participate in various national health programmes and continue giving our best to the community, we need your intervention in the following:
 • Anywhere in the world, medical profession is bestowed with reasonable autonomy. This autonomy is to provide the flexibility required to keep pace of the rapidly advancing science. Patient care and Patient safety are the main benefits of such autonomy. Regulators need to have autonomy and be independent of Administrators. The proposed National Medical Commission will be a regulator appointed by Administrators under their direct control. IMA supports suitable amendments in the existing IMC Act. IMA is against scrapping it totally and making it a non autonomous body.
 • It abolishes Medical Council of India (MCI) and along with it, the section 16.1.b of MCI Act which says that the basic qualification to practice modern medicine is MBBS.
 • It takes away the voting right of every doctor in India to elect their medical council. The MCI is a representative body of the medical profession in India. Roughly 2/3rd of its members are elected through various electoral processes. Any registered medical practitioner in the country can contest the elections and every qualified doctor can vote. Abolishing a democratic institution and replacing it by a totally nominated body is certainly a retrograde step and is unacceptable.
 • It allows private medical colleges to charge at free will nullifying whatever solace NEET brought.
 • Inducting non-medical persons in the highest regulator of medical profession takes away the perspective and character of the sacrosanct institution.
 • Instituting a Medical Licentiate exam after qualifying in final MBBS exam is an injustice and as such is insensitive to the plight of medical students who even otherwise have to undergo a long and tortuous academic career chequered with highly competitive exams.
 • Professional organizations like IMA are registered under Societies Act. In no way their independence and freedom of action could be subjected to Government control through National Medical Commission. In fact, they remain the only whistleblowers, being the voice of voiceless in the issues of Health. Such corrective forces are part and parcel of the democratic forces in the country.
 • This is not the first time that the Government has made such a move. In 2005, the then Union Health Minister, Dr Anbumani Ramadoss, tried unsuccessfully to bring in a legislation to dissolve the MCI and set up another council under the control of the Health Ministry. IMA, along with other professional bodies, opposed this move. Nevertheless, the legislation was drafted and placed before the cabinet for approval to bring in an ordinance. The Prime Minister’s Office referred this bill to a standing committee of Parliament on health. The standing committee rejected it on the ground that any regulatory body should be devoid of Government control or else it would lose its independent regulatory mechanism.
 • It is pertinent to note that in its exhaustive report the standing committee took exception to the attempt by the Government of India to centralize the powers with itself and reduce down a Body of Experts created for a distinct purpose by a Parliamentary enactment into a Department working under the Government of India.
 • There is a paradigm shift in the behavior of the society towards doctors and health staff. Medical Professionals need protection in work place. This can be addressed by notifying doctors and health staff under the category of Deemed Public Servant. A Central Law on the lines of “Delhi Medicare Service Personnel & Medicare Service Institutions Act” or 17 such State Laws protecting doctors and health staff is the need of the hour.
 • Being a social profession, the fee of doctors is reasonable and often capped by Mediclaim, CGHS, PSUs and the market forces. Medical Profession expects quid pro quo capping in compensation when it is awarded against a doctor. Already compensation for a mishap in a clinical trial has been capped.
 • The hospitals today are being governed by Clinical Establishment (Registration and Regulation) Act 2013. This has ushered in License Raj in a sector which has brought much laurels to India. The Licensing character of the bill should be replaced by accreditation. The Act also envisages fixing of various charges in the hospital and setting protocols for various illnesses. Both are unacceptable. It is also prayed that at least single doctor clinics should be exempted from CEA.
 • IMA demands a single window registration for hospitals and health care establishments under state medical councils. IMA also wants a single window regulation for medical negligence under the State Medical Council.  
 • IMA is for stringent punishment to any doctor who indulges in sex selective abortions. However, IMA is against penal provisions under PCPNDT Act or under other Acts where doctors are booked for clerical mistakes.
 • Practicing modern medicine is not beyond risk and it takes 10 years of learning. There is no way by a six months or 1 year course, AYUSH doctors or others could be trained to practice modern system of medicine. In an emergency, improper treatment can lead to death. IMA has been raising these points with the Ministry repeatedly. IMA even announced a Satyagraha which was scheduled on 16th of November, 2015 but on the intervention of Shri J P Nadda, Hon’ble Minister of Health & Family Welfare, it was postponed and an Inter-Ministerial Committee was formed on 13th November, 2015 with a mandate to come out with a solution within 6 weeks. But nothing has happened so far. IMA is now forced to organize a Satyagraha on 16th November 2016, The International Day for Tolerance and expects the Government’s intervention to solve the problems of medical profession once for all. Our demands are for the welfare of the community and to help the Government in implementing its programs.
 We are confident that our issues will get mentioned in your next “Mann Ki Baat”. We hope to get our issues solved in the next six weeks. 
With kind regards 
Yours sincerely 
Dr S S Aggarwal (National President) Dr K K Aggarwal (National President-Elect) Dr Marthanda Pillai (Immediate Past National President) Dr Ravi Wankhedkar (National President-Elect 2018) Dr R N Tandon, Hony Secretary General-Elect Dr R V Asokan Chairman Action Committee 

Copy to: President of India Health Minister of India Chief Minister of the State Health Ministry of the State District Magistrate DC

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