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A critical review of the Compulsory Rural Service in AP Medical Practitioners Registration (amendment) Bill 2013


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A critical review of the Compulsory Rural Service in AP Medical Practitioners Registration (amendment) Bill 2013

  1. 1. AP Medical Practitioners Registration (Amendment) Bill 2013 Points to ponder
  2. 2. When an act is amended….  Any legislation needs to substantiate the necessity for an amendment of an existing act by evidence, wide consultations and state it in the “Statement of Objects & Reasons”  You can see how arbitrary the statement says about the need for the amendment – which speaks tons about the competencies of those at helm of affairs – when dealing with such an important aspect related to people's health.
  3. 3. What a statement of Objects and Reasons! Most well drafted ever...! Do you agree?
  4. 4. Statement of Objects and Reasons for the amendment  Current Medical Education is significantly URBAN ORIENTED  It is based towards a heavily diagnostic approach compared to a clinical approach 1. Who made medical education urban oriented? 2. Where are the Rural Medical Colleges? 3. Why so much apathy towards recruitment of remotely placed medical colleges like Anantapur, Nizamabad? 4. What about the dwindling standards of medical education and ever increasing vacancies, even in reputed Govt. Medical Colleges like Osmania, Gandhi etc.? What the bill says? Points to ponder !
  5. 5. Problems of people in rural areas  People in the rural area facing many a problem due to  Lack of awareness about diseases and their prevention  Lesser access to medical facilities  Lack of adequate number of doctors 1. What happened to the three tier health care delivery system, which is based on Primary Health Care approach, which is supposed to bring in this awareness, among other things? 2. What is the Govt commitment in terms of budgetary allocations, initative in filling up the vacant positions in the Govt Medical Colleges & Hospitals, or upgrading the facilities for PHCs like physical infrastructure, uninterrupted supply of drugs, etc? 3. What about other basic facilities like roads, schools etc? Doctors are not trained to lay roads. What the bill says? Points to ponder !
  6. 6. Social Responsibility  It is a social responsibility on the part of the medical profession to provide the required medical facilities to the people in rural areas 1. Is social responsibility only concern for doctors and not other professionals? 2. Are no budgetary allocations done for other professional fields? 3. How can doctors provide medical facilities? Providing the medical facilities is the prerogative of the Govt. The doctors can only provide medical services in a setting of systematic support. 4. Is the selection of medical graduates / post-graduates based on the assessment of their motto for service or socially responsible attitude? Or is it based on highly competitive exams where getting maximum marks counts as merit, if not having maximum bank balance? What the bill says? Points to ponder !
  7. 7. Better education  The clinical experience & exposure to a number of patients increase the efficiency of the doctors 1. Since when regulating medical education – has become a state subject, going beyond the purview of Central Govt. Act of Medical Council of India Regulations? 2. Better clinical experience and exposure to greater number of patients needs to be provided during the duration of the course (5 and 1/2 years of MBBS or 3 yrs of MD / MS or 2 yrs of PG diploma). If this is not achieved there is need for introspection of what is going wrong and correct the mistakes, not just increase another year of scientifically unjustified service provision? What the bill says? Points to ponder !
  8. 8. Because others did it..  It is considered quite imperative to introduce Compulsory Rural Service to UG / PG Medical & Dental Students, as is being implemented in certain states like Kerala, TN, Gujarat & Chattisgarh 1. How can it be considered imperative to implement the same bonded service, if it is already being implemented in some other states in India? 2. Is there any evidence that Compulsory Rural Service is effective in making health services more accessible to the rural people? 3. 3. Have the models implemented in the above states have been scientifically studied by the authorities before framing the amendment? Why the said states proposed Bonded Service? What was their existing Public Health infrastructure? What problems arose after they started implementing the schemes? How they modified the policies? Are they really Compulsory Bonded Service today? What the bill says? Points to ponder !
  9. 9. Because it is authorized by Central Government  As per Govt of India and Medical Council of India Regulations  Accordingly orders were issued in GO.Ms.No 165, Health, Medical & Family Welfare (E1) Dept. Dated 20-7- 2010 1. You can fool the members in both the Houses by passing false statements that this Compulsory Rural service is as per GoI and MCI Regulations. But not us, the doctors. Where are the recommendations? In fact the MLAs of Telugu Desham Party staged a walkout when this amendment was passed. 2. If whims and fancies of few is equivalent of GoI and MCI regulations, then it may be stated that there is no scope for Medical Fraternity in scientifically and professionally regulating their education and work. Everyone have an opinion and say in this issue of bonded service, except we the doctors. Do we, doctors, have a voice? What the bill says? Points to ponder !
  10. 10. What do you have to say? How do we get to be heard? Think… You!We need ..