Date 7th June 2011
To
Dr. Manmohan Singh,
The Prime Minister of India, New Delhi,
Fax number-11-23019545 / 91-11-23016857
Dear Prime Minister,
We, a concerned group of citizens and civil society members, express grave concerns over recent media report[i] regarding the selection of persons with multiple conflicts of interest as board-members of the Medical Council of India (MCI).
MCI is an apex body that regulates not just medical education in the country, but also acts as a watchdog to ensure that the Indian medical fraternity adheres to the highest level of ethics. However, it has not been playing its expected role. Considering the recent turn of events, we believe that MCI would be in a similar situation as it was when Dr. Ketan Desai was the president of MCI. Corrupt practices had sullied the image of the MCI[ii] and affected the credibility of the entire Indian medical fraternity. We fear that unless tough measures are taken, the same situation will recur. People with unblemished backgrounds need to be involved in running the MCI otherwise the important role of oversight of medical ethics in India will remain unfulfilled.
As you are aware, at the time that Dr. Ketan Desai was arrested, the Central government promulgated the Indian Medical Council (Amendment) Ordinance 2010 suspending the MCI and giving itself the power to re-constitute the Council for one year. The Central Government then appointed a group of esteemed and well respected medical professionals to oversee the reform of medical education and the oversight of the medical community. During their year’s tenure, one of the foremost tasks of this re-constituted Council related to the revamping of medical education in the country. This work resulted in the key recommendation of the centralization of Medical Entrance Tests. In May, this year the time period under the 2010 Ordinance was to expire. However, the Central Government has promulgated another Ordinance extending the time of the re-constituted Council by another year. It has come as a surprise to the health community that along with the one year extension the government has seen fit not to re-appoint a single member of the original re-constituted Council and has made new appointments.
The manner in which the previous Council has been disbanded with and the appointment of the new members has caused considerable disquiet among the health community. There is a danger that the government’s actions will be seen as arbitrary and questions in the media about the potential conflicts of interest of the new Council members are already circulating.
India has a very large private health sector (perhaps the largest in the world) which has contributed positively in some ways, but has also exacerbated the problems of unethical practices like recommending unnecessary medical investigations and over-prescribing medicines. Today it accounts for 82% of outpatient visits, 58% of inpatient expenditure, and 40% of births in institutions[iii]. Private sector interest in medical education has also grown considerably and there is now significant overlap between doctors in the private sector, private hospitals and the medical education business. This gives us an idea of the extent of the problem which needs to be addressed. These practices need to be reigned in urgently so that exploitation of the common people can be stopped. To achieve this we need people of integrity to be at the helm of MCI and definitely not the type of persons that have been reportedly selected.
As the Prime Minister is also aware, the Supreme Court of India had recently given the go-ahead for the Common Medical Entrance Test as recommended by the previous Council[iv]. In a recent case involving another regulator, the Food Safety and Standards Authority of India, the Supreme Court has also made it evident that appointments by regulatory bodies cannot have conflicts of interest[v].
The MCI as the regulatory body for medical education and medical ethics cannot afford to be tainted yet again. Towards achieving the goal of transparency and accountability in the functioning of MCI, we suggest the following:-
1) An immediate review of the manner and reasons behind the disbanding of the original re-constituted Council and the new appointments made by the Health Ministry
2) Selection of individuals who have also worked in the field of medical education rather than selecting pure clinicians
3) Do not appoint and short-list persons with conflicts of interest including practitioners who are primarily from the private sector, that have ethical complaints pending against them or the hospitals they supervise, have private interest in decisions of the MCI including those related to medical education such as changes in the eligibility criteria or relaxation of norms for setting up of medical colleges, etc.
4) Create mechanisms for background checks of potential candidates and eliminate people who do not have a clean track record
5) Ensure that the decision making process, including the selection of board members is done through a free, non-arbitrary and transparent process
We urge you to look into this matter on a priority basis as it concerns the future of an important national Council. We trust you will take immediate action in this regard.
Yours truly,
1) Dr Mira Shiva, Co-convener, AIDAN, 9810582028, mshiva@nda.vsnl.net.in
2) S Srinivasan, , Co-convener, AIDAN, 9998771064
3) Anant Phadke, Medico Friend Circle, 9423531478
4) Prasanna, Co-convener, AIDAN, 9977216619
5) Gopal Dabade, , Co-convener, AIDAN, 9448862270
6) Naveen Thomas, headstreams, 9342858056
7) Prafulla, headstreams, 9611866200
8) Leena Menghaney, ITPC India, 9811365412
9) Kajal Bharadwaj, New Delhi,
10) Prabir Chatterjee, Medico Friend Circle, 09433310060,
11) Veena Shatrugna, Former Deputy Director, National Institute of Nutrition Hyderabad 500017, 09391111291,
12) Dr SL Pawar, Drug Action Forum – Karnataka, Ranebennur, 09449354415
13) Manisha Gupte, Pune
14) Padma Deosthali,CEHAT, 9892537994,
15) Dr. Anand Philip, http://anandphilip.com,
16) Dr S Sridhar, MFC, 9811516335,
17) Sunil Kaul, 9435122042,
18) Jagannath Chatterjee, Bhubaneswar.
19) Renu Khanna. SAHAJ.
20) Narendra Gupta, Prayas, Cell : +91.9414110328,
21) Sarojini, SAMA, New Delhi
22) Dhruv Mankad, NASIK 422002, Cellphone 9423178183
23) Dr Vandana Prasad, Community pediatrician and public health worker, 9891552425,
24) Amar Jesani, Mobile: +91- 9833073773,
References:
[i] MCI board smacks of conflict of interest, Mail Today (E-paper), 17th May 2011, http://epaper.mailtoday.in/Details.aspx?boxid=15354515&id=53362&issuedate=1752011
[ii] MCI boss Ketan Desai arrested, The Times of India, 23rd April 2010, http://articles.timesofindia.indiatimes.com/2010-04-23/india/28143618_1_gyan-sagar-medical-college-cbi-on-corruption-charges-mci-boss-ketan-desai,
[iii] The private sector in India, BMJ, http://www.bmj.com/content/331/7526/1157.full
[iv] Common test for medical courses, says Supreme Court, The Mint, 7 March 2011,
http://www.livemint.com/2011/03/07223907/Common-test-for-medical-course.html
[v] Supreme Court Order to FSSAI, http://indiaenvironmentportal.org.in/files/coke%20court_2_.pdf
All India Drug Action Network (AIDAN) 