Maharashtra: ‘Bring hospitals, nursing homes under medical council’

MUMBAI: The Maharashtra Medical Council Act, which governs only doctors, should have hospitals, nursing homes and diagnostic facilities under its ambit, proposes a draft amendment to the law framed in 1965 to regulate the medical profession and act as an ethical watchdog.

A panel recently finalised the draft after working for six months since it was felt that health institutions must be brought under the law’s jurisdiction in the light of rising complaints against hospitals.

“The Act is half a century old and needs reforms to keep up with the changing times. Often, when patients complain to us against hospitals, our hands are tied as we have no control over healthcare institutions. Hence, people had to approach the police, BMC or courts,” said Dr Shivkumar Utture, president of the Maharashtra Medical Council, a quasi-judicial body constituted under the Act.

Nursing homes and hospitals presently come under the Bombay Nursing Home Act, which, insiders say, doesn’t go beyond granting licences. The proposed amendment will give consumers a chance to approach the council that has medical experts, rather than go to the police or courts, who eventually need to seek a medical opinion but through a long-drawn process.

Another significant proposal is the total transformation of the Continued Medical Education (CME) programme to take into consideration a doctor’s hours spent in volunteering for rural work, contribution to reputed journals, authoring a book around medicine, among others. CMEs, which doctors must attend to gather points for renewal of their registration every five years, are at present, mostly about attending conferences that have, over the years, been criticised for the heavy involvement of pharmaceutical companies. The programme will be renamed Continuing Professional Development (CPD).

Utture said it will be the first major amendment to the Act, following multiple changes effected through notifications. The proposal will be shortly submitted to the medical education department before the opinion of the law department is sought.

The four-member panel that worked on the amendments has also sought expansion of the council’s manpower to cope with the jump in workload. Utture said from 18,000 doctors registered in 1965, the council presently has nearly 1.4 lakh members. “But the staff strength has almost remained the same, making it challenging to dispose of cases in a timebound manner,” he said. Since 1989, the council has received over 1,700 complaints of medical negligence against doctors, of which 935 have been disposed of. The council now receives an average of 170-200 cases annually.

Changes have also been recommended on how the ethics committees should hear cases of medical negligence to make the process free of biases. One of the important ones is that no member of the ethics committee belonging to a region can be part of the panel if the accused doctor is from the same region. The proposal also talks about diluting the powers of the council president, who had the authority to decide whether a medical negligence complaint should be heard by an ethics committee or dismissed outright.

Tightening of rules around registration of medical interns — now being introduced through notification — is also covered by the amendment proposal. The council has written to deans across the state underlining that medical interns must seek provisional registration without which they wouldn’t be given a permanent one.

Public health activists welcomed the changes and hoped they wouldn’t be ornamental. Dr Abhay Shukla of Jan Arogya Abhiyan backed sweeping reforms and said the council must reflect on the near absence of non-medical experts. “The UK’s General Medical Council has a dozen members, of whom 50% are not doctors. The MMC must have former judges, members from civil society and others to have a better balance. Currently, it’s a doctors’ club with no incamera hearings or access to lawyers,” he said. Shukla also backed boosting of manpower to reduce pendency of cases.