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NMC: Exposing How It Is Failing Patients and Shielding Doctors

NMC: The National Medical Commission's systemic biases, lack of transparency, and regulatory failures leave patients without recourse while protecting doctors.

By Prema Sridevi
New Update
NMC favours doctors over patients

NMC: Exposing how it is failing patients and shielding doctors | Representative image | Courtesy: Special arrangement

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NMC, the National Medical Commission is a statutory body in India tasked with regulating medical education, medical professionals, institutes, and research. This commission replaced the Medical Council of India (MCI) in September 2020. The MCI, plagued by corruption and a host of other issues, had long been criticised for its inefficiencies and lack of transparency. The establishment of the NMC was seen as a necessary step to rectify these deep-rooted problems and usher in a new era of improved oversight and governance in India's medical field.

Sadly, the NMC could not erase the taint left by the MCI. In fact, the National Medical Commission has institutionalised the very wrong practices that the MCI used to conduct behind closed doors, but now it does so openly. Instead of acting in the best interests of the citizens, as mandated in its own mission statement, the Commission appears to be serving the interests of doctors and hospitals. 

Despite its lofty mission statement, the National Medical Commission has often fallen short of its professed goals. The Commission claims to ensure the availability of adequate and high-quality medical professionals in all parts of the country, promote equitable and universal healthcare, and encourage a community health perspective that makes medical services accessible to all citizens. It also pledges to encourage medical professionals to adopt the latest research in their work and contribute to ongoing studies. 

Additionally, the National Medical Commission promises to objectively assess medical institutions periodically in a transparent manner, enforce high ethical standards across all aspects of medical services, and maintain an effective grievance redressal mechanism.

However, in practice, the Commission frequently appears to deviate from these principles. Instead of upholding the public interest, the commission seems to prioritise the interests of medical practitioners and hospitals. This troubling reality suggests that the Commission, in performing its duties, often forgets its own mission statement, thus compromising its integrity and failing the citizens it was designed to serve.

Rules to Protect Patients or Negligent Doctors?

Here is a stark example of how the NMC's rules and regulations are negatively impacting the lives of patients on the ground. Uttam Chand Meena lost his wife, Gargi Meena, in 2018 due to alleged medical negligence. Gargi had a minor stomach pain and went to Saroj Super Speciality Hospital in Delhi for medication. However, instead of providing her with medicines, the hospital's doctors performed surgery on her, and she eventually died. Following Gargi Meena’s death, her husband, Uttam Chand Meena, has been tirelessly seeking justice for his wife, running from pillar to post in a desperate attempt to hold those responsible accountable.

Gargi Meena
Victim Gargi Meena moments before the surgery following which she passed away | Photo courtesy: Family

Uttam Chand Meena approached the Delhi Medical Council in 2019 regarding the negligence of the doctors. The DMC's 2021 order in this case clearly states that the doctor in question failed to exercise a reasonable degree of skill, care, and knowledge expected of a prudent doctor in managing the case. The order also highlights that the anaesthetist failed to exercise due diligence in record-keeping, and the physician was not diligent in the management of the patient. Despite these findings, the DMC's order only imposed a 30-day suspension on the main doctor, while the anaesthetist and the physician received merely a warning. This lenient action left Uttam Chand Meena disheartened and questioning the effectiveness of the regulatory system meant to protect patients.

"I was devastated by the Delhi Medical Council’s order of 2021. Medical negligence killed my wife, and the doctor received only a 30-day suspension while the anaesthetist and physician were merely given a warning. So, you kill a patient and only get warned not to do it again? I decided to approach the National Medical Commission in 2021. But almost three years later, the Commission still hasn't pronounced my order. They are just delaying it. I then approached the Delhi High Court, and the court issued an order at the beginning of 2024 asking the NMC to wind up the matter and pronounce an order. Even when the court asks you to wrap up, you won't. Who is the National Medical Commission really serving?" asks Uttam Chand Meena. 

The Problem Isn't Just Delays, It's the Law Itself

The matter does not end here. The larger issue in this case, and many others, is not just that the National Medical Commission has been delaying the pronouncement of orders. Even if we cut some slack to the Commission, the actual problem is far more serious. The problem is that the Commission changed the law itself, ensuring that patients who have an issue with the state medical council’s orders cannot appeal, while doctors retain the right to appeal. This legal shift fundamentally skews the balance of justice in favour of medical practitioners, leaving patients and their families without an avenue for recourse.

The National Medical Commission Act of 2019 was introduced to ensure the availability of high-quality medical professionals across the country, promote equitable and universal healthcare with a community health perspective, make medical services accessible to all citizens, promote national health goals, and enforce high ethical standards in all aspects of medical services. Although the Act begins with these commendable goals, a closer examination reveals troubling provisions. 

Controversial law
30 (3) of  the National Medical Commission Act of 2019

One of the most controversial aspects in Section 30 (3) states: "A medical practitioner or professional who is aggrieved by any action taken by a State Medical Council under sub-section (2) may prefer an appeal to the Ethics and Medical Registration Board against such action, and the decision, if any, of the Ethics and Medical Registration Board thereupon shall be binding on the State Medical Council, unless a second appeal is preferred under sub-section." This clause effectively allows medical practitioners (doctors) to appeal decisions made by State Medical Councils, while patients are left without a similar recourse, creating an imbalanced system that favours medical professionals over those they are meant to serve.

Patients Left Vulnerable by Biased Medical Laws

Uttam Chand Meena, in the case of Gargi Meena’s death, also had concerns about the educational qualifications of a concerned doctor. "The Delhi Medical Council did not want to entertain my complaint. They said it is the duty of the MCI to check and verify the qualifications of the doctor. So I appealed before the National Medical Commission, and the Commission told me that they couldn’t hear my case because of Section 30 (3) of the National Medical Commission Act of 2019," he explains.

Meena then took this fight to the highest court in the country. In 2023, he filed a public interest litigation (PIL) in the Supreme Court challenging the controversial Section 30 (3) of the National Medical Commission Act of 2019. Meena’s PIL does not stop there; it also brings to light another contentious rule under the National Medical Commission Registered Medical Practitioner (Professional Conduct) Regulations 2023. This regulation has raised significant concerns about the lack of accountability and oversight in the medical profession, further undermining patients' rights. 

Appeals rules
Appeal regulations of the National Medical Commission Registered Medical Practitioner (Professional Conduct) Regulations 2023 

Under these regulations, Section 44 stands out as one of the most controversial. This section addresses the appeals process and clearly states that a Registered Medical Practitioner, meaning the doctor, has the right to file an appeal before the Ethics and Medical Registration Board (EMRB) within 60 days from the date of the order issued by the respective state medical council if they are aggrieved by the decision. 

This controversial rule again grants doctors the right to appeal before the EMRB but remains conspicuously silent about the patients' right to appeal. This omission has drawn huge criticism as it underscores a systemic bias favouring medical professionals over the very patients they are meant to serve. The lack of a parallel provision for patients seeking to challenge state medical council decisions further entrenches this imbalance, leaving individuals like Meena with limited recourse in their quest for justice.

Not Just Meena: Uncovering More Victims of the Law

In February 2022, another victim of medical negligence, Sujata Mitra from Kolkata, found herself disheartened by the West Bengal Medical Council’s order in her case. Seeking justice, she filed an appeal before the National Medical Council’s Ethics and Medical Registration Board (EMRB).

However, in March 2022, the Commission’s Ethics and Medical Registration Board responded that her appeal was non-maintainable, citing Section 30 (3) of the National Medical Commission Act of 2019. This section, which restricts patients' rights to appeal, left Sujata without a path to challenge the decision, exposing yet another instance of the systemic bias embedded in the current regulatory framework.

National Medical Commission rejects appeal
NMC Rejects Another Medical Negligence Victim’s Appeal | Courtesy: Special arrangement 

In the letter, the Commission states, "The National Medical Commission, in its meeting held on 16.10.2021, reiterated that based on the NMC Act of 2019, appeals from only medical practitioners or professionals should be allowed as appeals before the Ethics and Medical Registration Board (EMRB) under Section 30 (3) of the National Medical Commission Act of 2019. Accordingly, it has been decided by the EMRB that all appeals from non-medical practitioners or professionals filed on or after the coming into force of all provisions of the National Medical Commission Act of 2019, with effect from 25th September 2020, shall be returned in pursuance of the provision under Section 30 (3) of the NMC Act of 2019." 

As a result, Sujata Mitra’s appeal was returned. This decision exposes the regulatory framework's inherent bias, leaving victims lik

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