Usha Sharma – Mumbai
The Indian Medical Association (IMA) is opposing the Health Minister of Maharashtra’s proposal of a one-year pharmacology course for non-MBBS doctors to allow them to conduct medical practices in the State. The Health Minister has proposed a modern medicine certification course for non MBBS doctors in the ongoing monsoon session at the Maharashtra State Assembly.
Reacting to the announcement, IMA wrote a letter on July 19, to the Union Health Minister, State of Maharashtra Raj Bhavan, State of Maharashtra Mantralaya, Health Minister Mantralaya, Ministry of Health Education Mantralaya and Ministry of Cultural Affairs Mantralaya explaining the seriousness of the issue with its far reaching consequences and doctors’ concerns.
The letter from the IMA does not only pertain to the practice of allopathic doctors but is from a larger conceptual viewpoint viz. that the life of the common man is being endangered and empowering doctors who are practicing in Ayurvedic, Unani and Homeopathic medicines to prescribe medicines without undertaking an appropriate course of anatomy, physiology, pathology, microbiology and other related subjects for a perfect diagnosis of the disease is very dangerous to the life of the common man.
The IMA letter also highlights that introducing such a course is not only ‘illegal, unlawful and highly unconstitutional’ but also cannot stand scrutiny in a Court of Law. It further points out that the law and Maharashtra University of Health Sciences (MUHS) does not recognise the ‘concept of a certification course’ as a course can be only a degree or a diploma as per Schedule 7 of the Constitution of India, they are legislations enacted by the Central Government in the nature of Indian Medical Council Act, 1956.
The IMA letter cautions that if the proposed ordinance and/or legislation is approved by the legislative assembly and legislative council, it would be in conflict with
the provisions of the Medical Council Act and in the absence of any assent by the President of India under Article 254 of the Constitution of India, it would be unconstitutional and illegal.
As one of the signatories of the letter, Dr Jayesh Lele, State Secretary, IMA said, “There are many judgments from the Supreme Court as well as from various States against the cross-pathy medical practices.”
On the other side of this debate is Dr K Tripathi, President, National Integrated Medical Association who rationalised the Maharashtra Health Minister’s proposal saying, “We feel that after inclusion of a proposed one year course the legal competency issue can be easily solved. This will allow graduates of the Indian System of Medicine (ISM) to be legally competent and the government can also access these graduates for rural areas where we have a scarcity of qualified doctors.”
The IMA has alleged in its letter that there is no shortage of doctors in rural Maharashtra, saying that the IMA has about 191 branches in the state and even in the remotest rural area like Gadchiroli, doctors are available. Lele strongly feels that it is not correct to allow ‘under taught doctors’ to prescribe modern allopathic medicines under the pretext that there are less doctors in rural areas. ‘This is a kind of back door entry into the allopathic practice,’ states the IMA letter.
The IMA letter goes on to state that many rural areas do not have any hospitals and when hospitals are available at the district level, there is no sufficient infrastructure to run them. It strongly highlights that what is lacking is not the availability of doctors in rural areas but availability of infrastructure for the healthcare of poor people to be established. It is seen that most rural areas do not even have primary health centers established by the Government.
Tripathi however emphasises that the proposed course will be beneficial for the National Rural Health Mission (NRHM) scheme as it will increase the number of competent doctors in society and provide better access to healthcare.
“The core agenda behind opposing the proposed course is to create a monopoly on the medical services, making healthcare services more costly and out of reach of the common people. This shows that the IMA is showing their professional jealousy towards us,” feels Tripathi. IMA expects the Government to refrain from introducing any such act or ordinance and suggests that the Government should instead focus on taking steps to strengthen the infrastructure in the rural health programme.