Dr KK Aggarwal
The Ministry of Health and Family Welfare has released
FAQs on the National Medical Commission (NMC) Bill 2019, perhaps in a bid to
allay the prevailing apprehensions regarding certain aspects of the Bill such
as Clause 32, NEXT.
“Clause 32: Limited License to practice at Mid-level as
Community Health Provider:
India has a doctor-population ratio of 1:1456 as compared
with the WHO standards of 1:1000. In addition, there is a huge skew in the
distribution of doctors working in the Urban and Rural areas with the urban to
rural doctor density ratio being 3.8:1. Consequently, most of our rural
and poor population is denied good quality care leaving them in the clutches of
quacks. It is worth noting that at present 57.3% of personnel
currently practicing allopathic medicine does not have a medical
qualification.
The ambitious Ayushman Bharat initiative announced by GoI
in this year’s Budget Speech needs 1,50,000 mid-level providers within the next
3-5 years to provide comprehensive primary and preventive care. It will take
7-8 years to ramp up the supply of doctors, therefore, in the interim we have
no option but to rely upon a cadre of specially trained mid-level providers who
can lead the Health and Wellness Centres.
There are international examples of Health Systems
permitting such Community Health workers. Countries such as Thailand, United
Kingdom, China, and even New York have permitted Community Health Workers/Nurse
Practitioners into mainstream health services, with improved health outcomes.
Since we have shortage of doctors and specialists, the
task shifting to Mid- level Provider will relieve the overburdened specialists. This
is merely an enabling provision to grant limited licence only in primary
and preventive healthcare to practice medicine at mid-level to such
persons, who qualify such criteria as may be specified by regulations which
will have an overwhelming representation of Doctors. Chhattisgarh and Assam
have experimented with the Community Health Workers. As per independent
evaluations (carried out by Harvard School of Public Health), they have
performed very well and there is no ground of concern if the quality of
personnel is regulated tightly.”
(Source: PIB, Ministry of Health & Family Welfare,
Aug. 6, 2019)
Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of
Medical Associations in Asia and Oceania
(CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of
India
Past National President
IMA
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