State medical council needs a touch that heals

mumbai: `a den of corruption'' is how the supreme court referred to the medical council of india while dismissing the apex medical regulatory body''s president ketan desai on graft charges last week.
if the testimony of harassed complainants and activists is anything to go by, the state medical councils are not much better off.
the maharashtra medical council (mmc) is a case in point.although not yet described in such harsh terms, critics freely note that the body is "governed by vested interests and that its functioning leaves a lot to be desired".
at present, there is a case pending against the mmc in court which questions the council''s `fraudulent electoral process''. the last election to the council in 1999 was contested on allegations of large-scale rigging. in fact, the election itself was being carried out after seven years, although it is supposed to be a five-yearly event.
the mmc is supposed to be a watchdog of the medical profession in the state deciding on complaints of negligence and malpractice against its doctors, registering doctors and regulating medical education. "but, as is obvious from the state of affairs, the council has been lax in performing its duties, at least for the last ten years," says dr sanjay nagral of the forum for medical ethics.
at present, the state does not even have a proper medical council. the previous body was dissolved in 1999, after irregularities in mmc''s electoral process were contested in court. a state-appointed administrator, dr s.m. sapatnekar, has been in charge of the council''s daily functioning since january 2000.
it could be a telling comment on the state of the previous mmc that when dr sapatnekar took over, there were 142 cases pending before the council, some dating back to 1989. the `care-taker'' mmc, in the one-and-a-half years of its functioning, has managed to deal with 111 cases, even wrapping up 27 complaints. a commendable feat, say observers, considering that the council can only hold hearings over weekends, when lawyers are free from high court assignments.
on the other hand, the erstwhile mmc was plagued by a host of ills. "it did not take its regulatory role seriously at all," says dr nagral. "for instance, when the kidney transplant racket came to light in the city some years ago, the mmc did not even bother to initiate a suo moto investigation. our forum even met the council in this regard, but nothing came out of it." a far cry from bodies like the general medical council of the uk, "which are so active initiating investigations into medical matters, taking up cases and airing its views on current concerns."
the council''s lax regulation is also visible in the state of medical education. "many private colleges have shoddy infrastructure and impart substandard education, but the mmc has never dealt with them seriously," notes another observer. in the past, there have been times when under pressure from politicians, the mmc recognised colleges which did not have mci sanction, say sources.
but while critics are quick to call mmc a lethargic body "driven by vested interests", they agree that the mmc''s dismal financial status hinders its functioning to a large extent. funded solely through registration fees collected from doctors, the council works on a shoestring budget. "every five years, the mmc has to send letters to 64,000-odd doctors for re-registration. but it does not even have the funds to carry out this basic function," says dr arshad ghulam moh''d, who was a petitioner in the case against mmc. as a result, the mmc becomes dependent on the state for funds__a factor that severely undermines its autonomy, he adds.
moreover, the 22-member council has only nine elected members. "as the rest are government nominees, the mmc becomes further vulnerable to political influence. this is another reason why the mmc has not touched ill-equipped medical colleges run by politicians," says an observer.
after the high court petition, the government did frame a new set of rules for elections to the mmc. these are yet to be approved by the subordinate legislature before fresh elections can be conducted. but, as dr sapatnekar says, new electoral rules alone will not streamline the mmc''s functioning.
"there are basic flaws within the system, which have made the mmc so toothless," he notes. for one, the mmc is not authorised to either fine a guilty doctor or give a jail sentence. "the least it can do is to issue a warning and the severest punishment is cancelling the doctor''s registration. here again, there is no enforcement body to monitor whether the de-licensed doctor is still practising," says dr sapatnekar.
to heal the mmc, various provisions in the act have to be amended in the first place, giving more power to the body, say observers. that apart, complainants also have to share some of the onus of bringing the guilty to book, experts say.
as dr sapatnekar points out, many times, cases have to be adjourned merely because either the respondent or the complainant fails to turn up for the hearing. "one can''t just file a complaint and sit back. the situation has come to such a pass that we actually have to call up the parties and ask them to fix a suitable date for the hearing," he adds.