Report of the Study Group constituted by President MCI on Indian Medical Services (Part 2)

IMS Study Group Report

Report of the Study Group constituted by President MCI on Indian Medical Services (Part 2)

Current status  

Long awaited constitution of Indian Medical Service is pending since last three decades while it was already passed by Parliament, Committee of Chief Ministers. All suggestions to remove hurdles were also recommended by subsequent committees but every time the nodal ministry i.e. Union Ministry of Health, has scuttled the implementation. The department of personal and administrative reforms in fact notified its formation on 25th Jan 1977 but later on cancelled it, which had since then got recommended by various committees and even 5th Central Pay Commission in 1997. 

Relevance

Country health system needs urgent galvanization by creation of long awaited Indian Medical Service (IMS). The chronology of events on constitution of Indian Medical & Health Service (IMHS) is as follows:

Year	Event
1954	Ashok Chandra Report in 1954 recommended the constitution of new All India Services in technical fields
1953-55	Need for more All India Services was felt by the State Reorganization Commission: reflected in their report – 1953-55
Aug-1961	Subsequent endorsement by the Chief Ministers Conference – August 1961
Dec-1961	Requisite resolution under Article 312 (1) of the Constitution of India passed by Rajya Sabha- December, 1961
1963	Chief Secretaries ‘Conference broad outlines of the proposed Indian Medical and Health service were discussed-1963
June 1966	A draft memorandum and drafts of the rules of regulating and cadre management were drawn up and discussed by the sub-committee of Central Council of Health June – 1996
Dec 1966	Draft Memorandum forwarded to the State Governments for comments – December 1966
May 1968	The Government of India Decided to constitute the All India Medical and Health Service excluding the States of Tamil Nadu, Karnataka and Nagaland – May 1968
Jan-1969	The recruitment rules – finalized – notification for format constitution of IM & HS w.e.f. February 1,1969 – January 1969
April-1970	Discussion of the issue (IM & HS) in the Consultative Committee of Parliament of Ministry of Health
July-1970	Consideration  of the issue by the Executive Committee of the Central Council of Health
Aug-1972	The Consultative Committee of Parliament discussed the issue in question. Hon’ble Minister of Health and Family Welfare informed the Hon’ble  Committee of Govt. would proceed with the constitution of IM & HS
5th Feb – 1976	The Eighty ninth report of the Estimates Committee of the Lok Sabha advised the Government of India to expedite and finalize the formation of All India Medical and Health Service
May-1976	The matter came up again for discussion in the conference of Chief Secretaries; Consensus of the conference: to form the Indian Medical and Health Service.
July,1976	The state governments were addressed to confirm their agreement to participate in the IM & HS
25th Jan-1977	The Department of Personnel and Administrative reforms notified for formation of IM & HS and later cancelled it.
March-1978	The Hon’ble Cabinet, Union of India, decided to constitute IM & HS
Apr-1978	The State Governments were informed accordingly
1986	The issue was re-examined in the Department of Personnel and Training
1987	The Hon’ble Cabinet, Union of India, reconsidered the question of the IM & HS and decided to consult the State Governments and ascertain their views
Sep-1990	High Power Committee “Tikku Committee” recommended the formation of ‘Indian Medical Service’
23rd Dec-1993	The Hon’ble Rajya Sabha discussed the issue and Smt. Margaret Alva, the Hon’ble Minister of State, Dept. of Personnel and Training assured the house to persuade the State Governments to accept the formation of IM & HS
1996	Prof. Bajaj Committee by MOH & FW, GOI, recommended vide para E.10.1 CONSITUTION OF INDIAN MEDICAL AND HEALTH SERVICES: “The committee reinforces in the strongest terms the need to constitute Indian Medical and Health Services without any further delay”
1997	The 5th Central Pay Commission vide its recommendation para 52-10 asks for constitution of Indian Medical AND HEALTH SERVICES: “ULTIMATE AIM”
2014	Ministry of Health DGHS is looking into it again and as usual Ministry of Health from lowest desk level onwards trying again to scuttle  the move of creation of “Indian Medical Service”
2017	Ministry of Health once again wrote to all the State Health Services / Chief Secretaries for their opinion for IMS.

Scope and mandate

• The All India Services continue to be one of the premier Institution to uphold the unity of the Country
• The members of the All India Services have lived up to the Vision as envisaged by the framers of the Constitution.
• The All India Services ensure integrity, cohesion, efficiency and coordination with administration of the country.
• The common recruitment and training will ensure uniform standard of administration in the states
• The availability of experience gained in different parts of the country, to the highest administrative at the centre, is an assets by itself
• An ‘esprit de corps’ or Professional fellow feeling will develop amongst fellow professional members with the constitution of the All India Medical and Health Services (IM & HS).
• The much sought after staff support will come forth laterally from fellow IM & HS Officers
• The discipline of the cadre will also ensure loyalty and support from his subordinate officers
• The effective leadership acquired  through placements right from the sub-divisional, District Provincial up to Central level will help in smoothening the health care delivery system
• The varied administrative experiences along with professional skills in medical, public health and medical education and research will stand in good stead for the incumbents in discharge of their duties and responsibilities.
• The positive gains by the Indian Medical Service of yesteryears are very important for analysis of the existing pattern of public health practices and for developing perspective.
• The creation of IM & HS would lead to qualitative improvement in medical and health services in the Country
• The National Health Program schemes and projects would get implemented better
• The standards of medical profession rather the medical services to the countryman would be elevated and improved to a better standard.
• The Central and State Governments would get wide scope for selecting suitable officers for manning senior posts
• The centre and the state governments will be mutually benefitted due to rich experiences gained by the officers of the IM & HS from his posting
• It would promote National Integration and provide a bull work against the forces of disruption, parochialism and regionalism
• It would serve as a catalytic agent in realizing the universal goal health for all by next decade on a uniform basis

It is a matter of record that a note to Department of Personal and Training is to be sent urgently to re-notify RRs for IM & HS the initiative for which is now pending with Ministry of Health & Family Welfare for more than six decades in spite of positive nod from all higher levels and incorporation of desired modifications should be made effective.

Relevance

There is grave situation of exodus of doctors from services, attrition of health manpower. This is static or further deteriorating in spite of special cabinet approved committees like Javed Choudhary Committee and High Court order. Every month Doctors are retiring without replacements and new recruits are hardly joining. Due to this health manpower crunch, the whole health delivery system is crumbling, ailing population is suffering and Post Graduates seats are getting surrendered for the non-availability of teachers.  Retirement of each Medical Professor without replacement leads to loss of six Post Graduate seats along with it. Specialists have reduced to about 50% of the sanctioned strength and medical officers catering to the primary and general health including national health programs are retiring without replacements. 

It is true that the Govt. acknowledges and is already aware of the grave situation and keenly interested in taking positive steps to expedite it, however what is restricting is difficult to decipher. 

RECOMMENDATIONS

Taking stock of the entire situation, it is recommended that the Govt. of India through the same mode, manner and modality vide which Indian Administrative Services came to be created, create an Indian Medical Services to cater to the larger cause of healthcare services in the country from the point of view of efficacious management and meaningful administration.

·         The terms, service conditions, the modality of recruitment, allocation and allotment of cadre would be akin to the one as is applicable to the Indian Administrative Services personnel.

·         The eligibility for appearing for the entrance examination for the Indian Medical Services would be a graduate degree in health professional sciences as recognized in the governing schedule.

The committee records its gratitude to the President MCI for having taken the prompt initiative and constituted the present Study Group.

The committee recorded its thankfulness to Dr Rajeev Sood, Member MCI for his suggestions to the said group.

Report submitted to the President MCI for needful on an urgent and timely basis.

Sd/- Dr Ved Prakash Mishra Chairman

Sd/- Dr KK Aggarwal National President, IMA Member of the Study Group

Sd/- Dr Vinay Aggarwal Former National President, IMA Member  of the Study Group

Sd/- Dr RN Tandon Honorary Secretary General IMA Member of the Study Group