May 30, 2010

Bill on medical education regulator NCHRH likely in monsoon session

The National Council for Human Resource in Health (NCHRH) Bill - aiming to set up an agency to regulate health education in the country - is likely to be tabled in the monsoon session of parliament, a health ministry official said Wednesday.

'The bill is likely to be tabled in the monsoon session,' the official told IANS. 'It was to be brought much earlier. However, it will now be tabled in the coming session.'

This comes a day after the health ministry openly opposed the inclusion of medical education in the National Council for Higher Education and Research (NCHER), which will be an overarching body under the Human Resource Development ministry to oversee higher education in the country.

Once created, the NCHRH will overtake the functions of all councils overseeing health education, including the Pharmacy Council, Dental Council, Nursing Council, and Rehabilitation Council besides the already dissolved Medical Council of India.

Currently a six-member panel headed by eminent gastro-enterologist S.K. Sarin has been appointed to oversee the work of MCI for one year.

The formation of NCHRH was announced in the president's speech to the joint session of parliament last year. It was also included in the 100-day agenda of the health ministry.

A 15-member task force headed by then health secretary Naresh Dayal also came up with a draft which was circulated to the state governments for comment.

'The draft has been circulated to state governments and we have received a response from 13 states so far,' the official said.

Coming out against the inclusion of medical education under NCHER, Health Minister Ghulam Nabi Azad and Health Secretary Sujatha Rao Tuesday said the ministry will continue the regulation of medical education through the proposed NCHRH.

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Soon, your mediclaim could cover overseas hospitals too

Medical care at overseas hospitals could well be within your reach with a number of health insurance providers planning to launch a premium health cover shortly.

Health insurance providers, both private and state-owned , are readying products targeted at high networth individuals that would provide a cover of about Rs 50 lakh.

“We are working on the details of the product and will soon file it with the regulator for approval,” said M Ramadoss, chairman and managing director, New India Assurance.

Insured will have the option to be treated at hospital of his choice, both in India as well as overseas. Insurance companies, however, will also provide a suggested list of network of hospitals. Insurance companies will not insist on customers exploring the domestic option first.

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HRD, Health Ministries to sort out turf war over Medical Education

With uncertainty continuing over the jurisdiction of medical education, the Ministries of Health and Family Welfare and Human Resource Development on Tuesday made a beginning towards sorting out the issue by deciding to study the drafts of the two proposed regulatory bodies — the National Council for Human Resource in Health (NCHRH) and the National Commission on Higher Education and Research (NCHER).

The members of the two proposed overarching regulatory bodies would meet to discuss the roles of the two proposed entities to ensure there was no conflict, sources in the two Ministries said.

While the task force of the NCHER – promoted by the Ministry of Human Resource Development – has been in existence, the NCHRH – set up by the Ministry of Health and Family Welfare -- task force was disbanded after it submitted its report and draft Bill last year.

Reconstituted

The Union Health and Family Welfare Secretary Sujatha Rao, who discussed the turf issue of medical education with her counterpart in the HRD Ministry, also approved reconstitution of the NCHRH task force, which is also expected to make some amendments to the NCHRH draft Bill in the wake of MCI developments.

The six members of the just-constituted Board of Governors of the Medical Council of India (MCI) also attended the meeting convened at the initiative of Ms. Rao to get clarity on the role of the NCHER in higher education, possible overlapping of authority and some other possible ambiguities.

The HRD Ministry made a presentation on the proposed NCHER and clarified that the aim was to restore powers to universities and not usurp power for the NCHER. Both the bodies can co-exist without stepping on to each other's turf was the overwhelming sentiment.

Those present at the meeting sought a road map for the two proposed bodies to remove ‘confusion' over their respective roles. Several suggestions also came up during discussions which would be discussed in the future meetings.

NCHRH to be set up

Talking to journalists after the hour-long meeting, Ms. Rao said there was no question of transferring medical education to the HRD Ministry. “Medical science cannot be divorced from actual health policy,” she said, adding that the Health Ministry would set up a NCHRH which will look into health education and set standards and regulation for health sciences and research.

Union HRD Secretary (Higher Education) Vibha Puri Das said: “We discussed the NCHER and how we can work in tandem with the other Ministries. They (Health Ministry officials) are very positive about how to bring about the best possible reforms and what will be the best possible way forward so that we can improve the quality of higher education.”

Asked about the objections raised by the Health Ministry to the proposal for inclusion of health education under the NCHER, Ms. Das said the HRD Ministry was yet to take a final view on functions of the proposed body. “We are discussing and working towards an agreed solution, It needs to cleared that what the NCHER would do and what the NCHRH would do, she said.

The six members of the just constituted Board of Governors of the MCI also called on the Union Health and Family Welfare Minister Ghulam Nabi Azad here.

Talking to reporters later, Mr. Azad said the Ministry would have no say in granting recognition to medical colleges as absolute powers had been given in this regard to a six-member panel.

“The six-member panel which replaced the MCI will be an autonomous body with double powers. It will include the powers of MCI and also that of the Health Ministry,'' he said.

“As such no recommendations from the Ministry will be sent to them nor will these be entertained by them. As used to happen earlier where the Ministry had a final say, now the panel's decision will be considered final."

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'Rate' doctors on website

The ultimate tool for patients has just arrived. Patients in the UAE capital city of Abu Dhabi can now find a doctor, check credentials at the click of a button and also 'rate' them.
A new website launched by the Health Authority-Abu Dhabi (HAAD) displays the doctor's nationality, photograph, gender, experience and qualifications.

The service also called Minhaal, is a directory that lists conditions, symptoms and treatments.

Dr Jamal Al Kaabi, head of customer services and corporate communications and HAAD, said he hoped the increased transparency would improve health services.

"The public has the right to choose the doctor they find 'suitable' for their needs, he said adding that the doctor's directory will ensure all licensed professionals are accessible to everyone," he said.

There are 5,142 doctors, 8,142 nurses and 5,630 clinical and administrative staff working across Abu Dhabi.

It is available in Arabic and English.

Visitors to the site can click on general symptoms, such as loss of appetite, abdominal pain or nerve pain, and find a list of possible ailments.

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May 25, 2010

EU seizure of Indian drugs improper: WHO

India's complaint against the European Union on the unjust seizure of cheap generic drug consignments meant for Latin America and African nations has received a boost, with the World Health Organisation terming such action “misuse of rules” against counterfeit medicines.

In a statement issued in Geneva, the WHO on Thursday rapped the EU for seizing the Indian generic drugs in transit for patent violation. “Let me be very clear. WHO deplores such things. WHO deplores that this has happened,” said Hendrick Hogerzeil, who heads the essential medicines programme at the United Nations health agency.

“We had asked both the Netherlands and the EU at that time what was happening, and we ask them to make sure that this does not happen again. It was an improper, unfortunate use of counterfeit legislation.”

In the last more than one year, EU member-countries, especially the Netherlands, had seized or halted several shipments of Indian-made generic medicines bound for Latin America and Africa.

India, along with Brazil, protested against these seizures and made known to the EU its strong displeasure against the move through trade and diplomatic channels, terming it a violation of international rules. Although India has held several rounds of talks with EU representatives, nothing seems to have come of it despite repeated assurances that the wrong would be undone. Consequently, the two countries went to the WHO and filed formal separate complaints, claiming that developed countries were using the cover of a fight against counterfeit medicines to protect pharmaceutical giants and suppress legitimate generic drugs.

India and Brazil have asked the EU and the Netherlands to enter into dispute settlement consultations over the alleged violation of global rules.

The two countries raised the issue in 2008 also when Dutch customs authorities detained Indian generic drugs at the behest of leading Western pharmaceutical giants.

Under the WHO dispute settlement provisions, the EU will have to enter into consultations with India and Brazil as a first step and amicably resolve the issue within two months. If they fail to reach an agreement through Article 4 consultations, the two countries can call for the establishment of a dispute settlement panel to adjudicate the alleged violations of trade rules by Brussels.

According to Indian officials, Dutch customs seized at least 19 consignments of generic drugs in 2008 and 2009; of these 16 originated in the Netherlands.

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May 23, 2010

NCHER will not be super regulator

Prime Minister Manmohan Singh appears to be disinclined to accept the idea of setting up the proposed National Commission for Higher Education and Research as the higher education’s super regulator.

Despite best efforts by HRD minister Kapil Sibal, medical education and law will be kept out of the purview of NCHER.

In the aftermath of the Ketan Desai-Medical Council of India scandal, the HRD ministry had sought to bring medical education within the ambit of the NCHER.

The Prime Minister’s Office is learnt to be of the view that medical education should be kept under the purview of the health ministry-sponsored National Council for Human Resources in Health (NCHRH).

The HRD ministry had cited the Yashpal Committee recommendation and that of the National Knowledge Commission to set up a regulator that would have jurisdiction over the entire spectrum of higher education. However, the PMO is clear that the such reports and recommendations cannot override government policy as enunciated in the President’s address last June.

The HRD ministry’s efforts to garner total control over the higher education segment has also been opposed by health minister Ghulam Nabi Azad, law minister Veerappa Moily, state governments and educationists.

The HRD ministry’s efforts are not new. In the UPA I government, Mr Sibal’s predecessor Arjun Singh too sought to put in place a higher education super regulator. Mr Singh’s efforts ran into dangerous territories as health ministry was then shepherded by Ambhumani Ramadoss of PMK and agriculture by NCP’s Sharad Pawar.

The HRD ministry, however, is not giving up its effort to get a larger mandate. To build support for the proposed regulator, the HRD ministry has planned a retreat meeting on May 29.

The meeting will discuss NCHER with experts for further fine tuning. It will then take the draft bill to the Central Advisory Board of Education, which is meeting on June 18 and 19. The idea is to create a critical mass of support for the proposed super regulator.

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Doctors must possess six virtues, says Abdul Kalam

Former President A. P. J. Abdul Kalam on Thursday highlighted the six virtues that doctors have to possess since a doctor is expected to work with compassion.

The six virtues, he said, are — generosity, ethics, tolerance, perseverance, concentration and being intelligent.

Dr. Kalam was speaking at a function held at the Meenakshi Mission Hospital and Research Centre (MMHRC) here to commemorate the ‘10 years of operations of Smile Train in India' doing corrective surgeries for persons affected by cleft lip/palate.

The function also marked the completion of 5,000 corrective surgeries at the MMHRC in partnership with Smile Train, USA.

Citing from a book titled ‘Medicine and Compassion,' the former President said that these six virtues are expected of medical practitioners. “The virtues will empower the health providers with a humane heart. The doctors have to put these virtues in to action,” Dr. Kalam stressed.

Seeing the children who underwent corrective surgeries for cleft lip and palate, he said that “the work done by Smile Train doctors proves how the suffering and distortion can be rectified and how the lost smiles could be brought back on the faces of affected children and their parents.” Dr. Kalam lauded the good work done at the MMHRC through Smile Train initiative.

“By doing free surgeries, the hospital in Madurai was able to instil a sense of confidence among the affected families in southern districts. Good hearts have to become partners in this mission,” he observed.

TWO LAKH SURGERIES

Sathish Kalra, Regional Director, Smile Train, said that two lakh reconstructive surgeries were done in India so far in the last 10 years. “This year alone, 50,000 cleft lip/palate surgeries are planned and the coverage will be all over the country,” he said.

Mr. Kalra said that Smile Train initiative in India was started in year 2000 and totally 170 treatment partnerships were set up with 250 surgeons participating in the cause. Subodh Kumar Singh, a Varanasi-based plastic surgeon associated with the Smile Train project, said that free surgeries were able to bring a positive change in the lives of cleft lip children. “This is a successful mission/model which can be used for other ailments,” he said.

S. Gurushankar, vice-chairman, Meenakshi Mission Hospital and Research Centre, said that the hospital has been participating in a good social cause through Smile Train by taking it as an opportunity to reach out to thousands of cleft-lipped children waiting for corrective surgeries.

N. Panchavarnam, Project Director, The Smile Train Regional Centre, MMHRC, Sam C. Bose, honorary consultant and an eight-year old girl from Chennai, Indumathi, who had a successful surgery for cleft lip, were among those who spoke.

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May 22, 2010

NCHER may include medicine, law

With the ordinance to dissolve the Medical Council of India being approved by the President, a case is being made for medical education to come under the purview of the proposed National Council for Higher Education and Research (NCHER).

Highly placed sources told that both Medicine and Law related education are likely to be placed under the purview of the NCHER which is set to subsume the multiple regulatory authorities like the All India Council for Technical Education (AICTE) and University Grants Commission among others.

While both the Veerappa Moily-led Law ministry and the Azad-led Health Ministry have raised objections to allowing the NCHER to regulate Medicine and Law education, a new proposal is in the works offering the two ministries representation in the body. “There is a strong case for including Medicine and Law in the NCHER’s ambit. Discussions are on and a solution is to allow representatives of the two Ministries on the NCHER,” said a highly placed source.

The President’s address to Parliament when the UPA-II formed the government last year had given an assurance of creating a separate National Health Council for governing medical education. However, the above proposal embodying the same intent coupled with the corruption exposed in the MCI is reason enough to justify a policy shift, say sources.

Incidentally, noted academic Prof Yashpal, who headed the committee on Rejuvenation of Higher Education that recommended the setting up of the NCHER, had objected when the proposal to exclude Medicine from the NCHER's ambit was moved. He had said that excluding medical education would defeat the very purpose of setting up the body as it was meant to provide a single point authority on higher education.

The NCHER draft bill, meanwhile, has undergone several discussions also factoring in recommendations made by an expert task force set up by the Ministry on the issue. The Bill will now be taken up at the State Education Ministers' conference next month and then by the Central Advisory Board of Education (CABE) before being introduced in Parliament in the Monsoon Session.

The draft NCHER Bill proposes a national database of those eligible and qualified to be appointed as V-Cs or heads of educational institutes. The Commission will have seven members and a Chairman - all appointed by the President of India on the recommendations of a selection committee which will be headed by the Prime Minister and include the Lok Sabha Speaker, Leader of Opposition in Lok Sabha, Minister in charge of higher education and minister in charge of medical education.

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Medical Council of India: The Rise and Fall

The Ketan Desai-fuelled MCI scandal and the Ordinance signed by the President of India Pratibha Patil empowering the government to dissolve or reorganize the MCI have triggered debates regarding the establishment of an efficient medical regulatory body to carry out the functions hitherto executed by the Medical Council of India.

Established in 1934 under the Indian Medical Council Act, 1933 (now repealed), the Medical Council of India geared up remarkably to meet the challenges of rapid development in medical education in India, post Independence. The new Indian Medical Act was enacted in 1956 and further modified in 1964, 1993 and 2001.

The Indian Medical Council's main objectives are to maintain uniform standards of medical education at the undergraduate and post graduate level, recommending the recognition/de-recognition of medical qualifications of medical institutions in India or abroad, maintaining a permanent registry of doctors with recognized medical qualifications and ensuring ethical practices in the medical profession.

Following the arrest of MCI President Ketan Desai on corruption charges and the President’s Ordinance, the government has formed an interim Board of governors headed by Dr. S.K. Sarin, Dept. of Gastroenterology, G.B. Pant Hospital, New Delhi, as a stop gap measure to carry out the functions of the MCI.

MCI’s Credibility Dips

Central Bureau of Investigation (CBI) arrested MCI’s President Ketan Desai, on charges of seeking a 2-crore bribe for granting recognition to a private medical college in Punjab. For Ketan Desai this is a repeat—he was convicted for corruption and removed from his office as MCI’s President in 2001 when the Delhi High Court observed that the MCI was “a den of corruption.” Highlighting the MCI’s shortfall in another area, the Estimates Committee of 2005 has noted that the MCI has bungled the maintenance of the Indian Medical Register (IMR) resulting in a faulty list of medical practitioners in India after 1993.

Medical Education—Tug of War

The onus of overseeing medical education in India continues to be a bone of contention between the government of India’s Health Ministry and Human Resource and Development (HRD) Ministry. In June last year, the President of India had announced that both the proposed National Commission for Higher Education (NCHER) and the National Council for Human Resources in Health (NCHRH) would function under the purview of the Health Ministry. The recent draft of the (NCHER) Bill proposes to bring medical education in India under the purview of the Union Human Resource and Development Ministry. The Health Ministry however, is keen on retaining medical education under its wing— NCHRH.

With private parties setting up medical colleges as business ventures and given the green signal by a corrupt medical council, the standards of medical education in India will be diluted with the system churning out substandard doctors who can ‘buy’ a medical degree. But dismantling an expert autonomous body like the MCI in haste for the sins of a few corrupt members is seen as an extreme move by many, including the Indian Medical Association (IMA) which has strongly opposed the government’s decision to dissolve the MCI. The greater fear is that the medical regulatory body’s responsibility in the hands of bureaucrats could make matters worse. According to experts, corrective measures, proper checks and balances within and outside the MCI, ensuring sincere, efficient and public-minded healthcare professionals are at the helm will restore dignity to the MCI and enable it to function in a clean, transparent and accountable manner.

MCI Crisis-What Next?

India has produced some of the most skilled doctors in the world and the current MCI crisis has to be resolved quickly and effectively to restore credibility to Indian medical education and practice in the eyes of the world. Despite the shame, the MCI crisis has finally made it imperative to overhaul the system that dictates one of the largest healthcare services in the world. Healthcare in India has huge gaps with shameful incidences of ‘medical negligence’ and rampant corruption hampering effective healthcare delivery to India’s huge population.

The cloud over the medical system in India has come at a time when Medical tourism is picking up in India and attracting patients from around the world seeking relief from chronic ailments. Cost effective expert treatments in modern medicine and alternative therapies are the pride of India, in addition to world class hospitals equipped with medical experts and state of the art equipment and facilities for accurate diagnosis and treatment of various diseases and disorders. Hopefully, the meeting scheduled at the end of this month by the Health ministry and HRD ministry to set things right should bring a favorable decision to end the turmoil kicked off by Ketan Desai and his partners in crime.

While it is imminent that medical education in India will be de-linked from the Medical Council of India’s purview, the fate of the once exemplary apex body for doctors and medical students in India now hangs in balance. After the Ketan Desai fiasco that tarnished the image of the Medical Council of India the one question that looms large is, “What next?”

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May 21, 2010

Indian Medical Association opposes MCI's dissolution

The Indian Medical Association (IMA), the national body of medical professionals, has opposed the dissolution of Medical Council of India (MCI).

"Centre's decision to dissolve the Medical Council of India and replacing it with a panel is highly objectionable," IMA's national president Dr G Samaram said in a press release in New Delhi Saturday.

He said this step is "highly dangerous" and may damage the standards of medical education and medical colleges.

He also feared that this may lead to politicisation of education in the country.
Samaram said that instead of scrapping the entire body, the person in question should be punished.
Meanwhile, President Pratibha Patil on Saturday gave her assent to an ordinance dissolving scam-tainted MCI and replace it with a seven-member panel of eminent doctors.

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EU confronted on herbal medicines & chemicals ban

India has taken up with European Union the issue of its traditional medicine and chemical industries that are set to face various import restrictions in the European Union. In its on-going bilateral free trade agreement negotiations with the trade bloc, India has sought dilution of the proposed controls to ensure continued exports to the region.

“While the traditional herbal medicine industry is going to face regulatory restrictions in EU from next year, the restrictions on chemicals, currently applicable on large exporters, is going to be extended even to small players over the next few years,” a commerce department official told ET.

The directive on traditional herbal medicinal products (THMP) that will be implemented across the EU in 2011 makes it compulsory for companies to show thirty years of traditional uses, including 15 years in the EU.

“This may result in a complete denial of market access for THMP,” the official said.

This is unacceptable to India, especially as it is being imposed by a region with which it is working on an agreement to ease goods, services and investment flow, the official added.

The commerce department has, therefore, included the issue of THMP in the FTA talks.

“We had taken up the issue at the recent meeting that we had with EU officials in Brussels and plan to pursue it further,” the official said. India has also asked the EU to relax its registration, evaluation and authorisation of chemicals (REACH) norms for the chemicals sector which will bring in small exporters in its ambit over the next eight years.

“At present, only companies that export 1,000 tonne and above are supposed to get their products tested as per the stringent REACH norms, but by 2018 any exporter who exports 1 tonne or more will have to follow the regulations,” the official said.

This will severely affect exports from India not just because the superior testing procedures increases costs for producers, but also due to the fact that there aren’t enough testing laboratories in India. India exports about $ 1 billion of traditional medicines, which is a small fraction of more than $80 billion of exports taking place worldwide. It’s chemical exports is much higher at $170 billion.

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May 20, 2010

Drive against Ketan Desai goes global

The complaint demanding the removal of Dr Ketan Desai as MCI president on charges of corruption and removing his name from the Indian Medical Register has picked up momentum.

Earlier this month, a nationwide signature campaign titled 'Remedy MCI' had started in the medical fraternity, which has formed a union to oppose the MCI's amendments drafted by Desai which favoured MNC pharmaceutical giants.

About 20,000 doctors from all over the country have joined the union, led by Dr Pankaj Singhal and Dr Paras Gangwal from New Delhi and Dr Vineet Garg from Ajmer.

The MCI is said to have started a campaign urging doctors to reject cash, gifts, or hospitality from drug companies, before it was discovered that Desai allegedly was the biggest bribe-taker.

The campaign is aimed at erasing Desai's name from the Indian Medical Register till the CBI inquiry is completed or permanently if the charges are proved. Dr. Singhal said: "The 'Remedy MCI' campaign strongly welcomes the dissolution of MCI and the decision to replace it with a seven-member panel. Because medical associations remained inert, we had to depend on the government to take steps against MCI - which we expected from independent bodies like IMA which are formed for the doctors, by the doctors and are of the doctors."

According to Dr. Singhal, the campaign has also got support of the global medical fraternity which feels cheated by Desai's activities and demands a reversal of all decisions taken by him at MCI.

Dr. Garg said: "We are roping in medicos from abroad who are equally affected by this MCI scam and many of them have voiced their support to the 'Remedy MCI' campaign."

However, Indian Medical Association (IMA) president Dr. Gopal Raju Samaram has opposed theMCI’s dissolution. Dr Samaram said: "The Centre's decision to dissolve the MCI is highly objectionable."

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India to have over 600 pvt management colleges by 2012

The number of private management institutions in the country is expected to double from the present 300 in the next two years, as the government has reduced its spending on higher education, an industry chamber study said.

"The number of private management colleges are expected to touch 600 mark from 300 now by 2012 as the public expenditure on higher education has been reduced which has encouraged investments by private sector," Assocham study said.

The study said another reason for increasing number of these colleges is that more and more students are opting for professional courses.

It also revealed that the number of engineering and medical colleges is likely to grow by 67 per cent and 47 per cent, respectively, by 2012 as demand for engineering and medical streams is also increasing.

"The number of engineering colleges in private sector is likely to reach 2,000 and medical colleges 200 in the next two years," Assocham president Swati Piramal said in a statement.

Currently, there are 1,200 engineering colleges and 150 medical colleges across the country.

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Union Health Minister - Report card of Year one

Union Health Minister Ghulam Nabi Azad, 61, rode shotgun to the helm of a ministry then perceived to be facing its biggest public health challenge: controlling H1N1, a new influenza pandemic that had infected and killed thousands across the world.

Over the next few months, the flu caused more panic than infections, even as the Centre swung into action, setting up screening centres at airports and gave its nod to public and private testing and treatment centres.

But most people thought the health ministry did not move fast enough on H1N1 and other issues that matter, which led to it being voted the worst performing ministry, bagging 15.3 per cent of the total votes. It was voted sixth of nine best-performing ministries.
As many as 36.3 per cent people polled thought the ministry was “unimaginative and slow” in tackling H1N1, 19.7 per cent thought it was inconsistent in its response, while another 22.3 per cent said a bolder approach had been needed.

Only 21.7 per cent people polled — roughly one in five — thought its efforts had been effective and speedy.

If the Union health ministry failed its first big public heath challenge in public perception, it fared as badly on the roll-out of the National Rural Health Mission (NRHM), the UPA’s flagship programme to revitalise primary and secondary healthcare in rural India.
More than one in three people — 37.6 per cent — said that it had failed to improve the crumbling health infrastructure.

As many as 12.1 per cent wanted setting up of “AIIMS-like” hospitals speeded up, on which work finally started after Azad took over in 2009-10, which had been the deadline for the completion of the work. While 26.3 said people said Azad appears firmly incharge and another 21.8 per cent said he is in the loop on issues, the majority — 30.1 per cent — though he needed to be more imaginative.

“There are no two opinions about UPA-II performance on health being better than UPA-I. Anbumani Ramadoss’s performance was dismal compared to Azad. The all-party Parliamentary committee was always at loggerheads with Ramadoss,” said Amar Singh, former chairman, Parliamentary Standing Committee on Health and Family Welfare.

“Azad is hardworking and well-meaning, but his hands are tied because the health budget is very low. Though Central and state expenditure on health has increased, it has still not reached 2-3 per cent of the GDP as promised,” said Singh.

According to the Economic Survey 2010, the public spending on health was 1.45 per cent in 2009-10, as compared to 1.19 per cent in 2004-05. Manpower shortage remains the biggest hurdle, said Azad.

“There are no easy solutions. In some parts of the country, vacancies continue to be as high as 75 per cent, with states not being able to appoint a second nurse in the sub-centres ... In fact, some states are still struggling to appoint the first,” admitted Azad.

Link: Original Article

Jaypee group in healthcare foray

Infrastructure behemoth Jaypee Group, with revenues in excess of Rs 10,000 crore, is set to enter the healthcare industry.

The diversified group, with presence in power, cement, hotels and education verticals, will soon be launching its flagship hospital in Noida, Uttar Pradesh. Industry sources said the multi-speciality tertiary care hospital will be titled Jaypee Medical Centre Noida.

“It is a part of the group’s ambitious township project called Wish Town, spread across 1,162 acre, in Noida’s Sector 128. Featuring 415 rooms (500 beds), the medical centre will offer advance healthcare facilities and latest diagnostic services,” said a source.
Manoj Gaur, executive chairman and CEO, Jaiprakash Associates Ltd was not available for comments. A detailed questionnaire requesting financial details and future plans for the healthcare foray remained unanswered at the time of this article going to print.

Industry sources said the healthcare foray is a logical extension of the company’s realty business, which mainly comprises large township developments in north India. The group’s ambitious infrastructure projects include the Yamuna Expressway (formerly Taj Expressway), a six-lane (extendable to 8-lanes) access-controlled road that is expected to reduce travel time between Delhi and Agra, connecting them via Mathura.

“The group has five land parcels at various locations on the Yamuna Expressway development. These land parcels will largely be used for residential and commercial developments and are very likely to have education and healthcare facilities,” said the source.

Fitch Ratings analysts Shashikant Ranjan and Nikhil Gupta in a recent report said the outlook for India’s healthcare sector is stable for 2010.

They expect the industry to expand by 10-15% and the revenues of industry players to increase as occupancy rates rise for existing hospitals, and newly commissioned facilities become operational.

“Healthcare being a high-operating-leverage business, Ebitda margins are likely to improve with capacity utilisation, and also due to hospitals increasing their focus on high-margin tertiary and quaternary services. Expansion will continue to be driven by a persistent demand-supply gap and significant investments funded by private sources… Increasing concentration of reputed players in metropolitan cities should see many established players chalking out plans to spread to Tier 1 and Tier 2 cities to increase their catchment area. However, a limited supply of doctors and trained medical staff will continue to restrict industry growth,” the analysts said.

According to independent research estimates, India will need to add 3.1 million beds by 2018, calling for an immediate investment of $82 billion (Rs 4 lakh crore). The favourable demand-supply gap, and the promising state of the Indian healthcare sector overall, has prompted significant investment in the last few years.

There were substantial investments announced in 2009 by several private equity firms, including Global Technology Investment Group in Nova Medical Centres ($60 million), International Finance Corporation in Max India ($33 million), India Venture Advisors in Kavery Medical Centre ($20 million), and India Venture Advisors’ second healthcare fund ($150 million).

The private sector is expected to continue to make substantial investment, and to contribute nearly 80-85% of the sector’s total annual spend. Within healthcare, the most favoured sectors for investors are likely to be diagnostic services, medical devices, hospital chains, and wellness products and services.

Link: Original Article

May 15, 2010

Ordinance empowers Health Ministry to dissolve the MCI

The Cabinet on Thursday approved an Ordinance allowing the health ministry to take over the charges of the Medical Council of India (MCI). The Ordinance will lead to the setting up of a seven-member board of governors for the MCI to run the council on a day-to-day basis.

It will be valid for one year. During this time, the government is expected to decide whether the MCI would be brought within the ambit of the National Council for Human Resources in Health (NCHRH) under the health ministry, or the National Commission on Higher Education and Research (NCHER) under the human resource development ministry.

The health ministry is opposed to the idea of bringing medical education under the NCHER. Union health minister Ghulam Nabi Azad favours the idea of the National Council for Human Resources in Health, which will subsume the MCI, along with the Dental Council, Nursing Council and other similar councils. The bill on the establishment of the council has been sent to all states. So far the responses have come from 13 states.

The Prime Minister’s Office favours including medical education under the NCHER. Sources in the human resource development ministry are confident that eventually medical education will be brought under the purview of the NCHER.

After MCI president Ketan Desai’s arrest by the CBI on April 11, the government opted for the ordinance route rather than handing over the reins to MCI vice-president Kesavankutty Nair, apprehending a repeat of 2001 when Desai ran the show from behind despite not being the MCI president, thanks to a Delhi High Court directive. Mr Nair is seen as a staunch supporter of Ketan Desai because he not only protected him since 2001 but was also instrumental in Desai’s re-election as the MCI president in 2009 through an uncontested election.

Mr Azad had made it clear that the Indian Medical Council Act, 1956, was inadequate to deal with the situation in the Council. In his reply to a discussion in Parliament, Mr Azad had said: “I am increasingly of the opinion that provisions of the Indian Medical Council Act, 1956, are inadequate to ensure transparent, healthy and constructive decision-making within the council.” However, the government is not in favour of bringing any amendments to the Indian Medical Council Act of 1956 till Prime Minister Manmohan Singh takes a decision on which new commission will subsume the MCI as well as other councils in the health sector.

The ordinance will give the government executive powers to set the Council in order. An earlier attempt under UPA-I to amend the Indian Medical Council Act to allow for government intervention was turned down by the parliamentary standing committee on health, which argued that the move will destroy the council’s autonomy. The ordinance route was opted for as there has been resistance from many MPs to giving government greater powers and the fact that amending the law would be a time-consuming affair.

Link: Original Article

Directive to States on PG medical admissions

To prevent the 50 per cent ‘All India Quota' (AIQ) seats in post graduate medical courses from going back to the States without any counselling, the Supreme Court on Thursday directed the Directorate-General of Health Services to conduct the ‘extended second round of counselling' between June 2 and 12 in the capital.

To facilitate such counselling, a Bench of Justice R.V. Raveendran and Justice Gyan Sudha Misra directed all States to send a report to the DGHS by 5 p.m. on May 27 the updated number of vacancies resulting from non-joining, resigning and surrendering of seats in AIQ. The Bench asked the States to strictly adhere to the time schedule in regard to the reporting of vacancies.

Passing orders on a writ petition filed by Dr. Naval Asija and others, the Bench directed the DGHS to put the time-schedule on the website by May 20 and notify the total number of vacancies on June 1. After the extended second round of counselling the students will join the allotted colleges by June 20 and the vacant AIQ seats may be deemed to be surrendered to the States on June 21 and the deadline for students to join the allotted course will be June 30.

The grievance of the petitioners was that most of the States did not comply with the counselling schedule for admission to post graduate courses deliberately with the intention of usurping the seats belonging to the AIQ to their own State quota. It was submitted that rank holders in the all-India entrance examination conducted by the AIIMS would be irreparably harmed if the seats which belonged to the AIQ were taken away by the States and not offered to the AIQ.

The petitioners pointed out that the second round of counselling under the AIQ was normally held after the first round was completed by the States under the State quota since a large number of students took both the AIIMS and the State entrance tests. Students vacated the AIQ seat if they obtained a better seat in the State quota and it was for this reason the States must complete the first round of counselling on time and report the vacant seats. But many States did not conduct the first counselling and report the vacant seats under the AIQ and as a result this quota got added to the State quota seats.

Hence they wanted a direction for further round of counselling in the AIQ and a direction to the States to report the vacancies.

Link: Original Article

Dhathri chalks out plan for affordable ayurveda

Ayurveda major Dhathri has chalked out a strategy to make ayurveda affordable for the masses and take it to the rural populace. Company officials said the initiative, titled Dhathri Gramodayam, was targeted at ensuring health and economic empowerment of the rural population across Kerala.
As part of the programme, the company plans to open Dhathri Ayurveda Vaidyasalas at 100 rural destinations.

Dhathri managing director S Sajikumar said the plan was to hold 100 free medical camps by the end of the year, covering all general diseases like diabetes, hypertension, arthritis, psoriasis and gynecological disorders, among others.

He said the objective was to address local health problems at concessional rates, and that patients would be referred to the Dhathri Ayurveda Vaidyasala or Dhathri’s Specialty Medical Centres, based on the diagnosis.

Under the Gramodayam programme, Dhathri will also encourage the cultivation of herbal and medicinal plants in home-based farms and gardens across rural areas, which will open up niche career opportunities in ayurveda for rural youth, officials said.

Sajikumar said the programme was also expected to revive the prospects of ayurveda in a big way.

Link: Original Article

More insurance companies under CBI scanner for irregularities

The Central Bureau of Investigation (CBI) will initiate a probe against three insurance companies in connection with alleged financial irregularities and forgery in the Universal Health Insurance Scheme (UHIS), sources said Thursday.

During its raids at the Lucknow and Varanasi offices of the National Insurance Company (NIC), the Lucknow branch of CBI's anti-corruption wing had Saturday seized over 100 fake medical insurance certificates and detected financial anomalies over Rs 30 lakh.

It is now going to investigate three more companies, officials said.

The UHIS scheme is meant to provide medical benefits strictly to the below poverty line population. While the person opting for the scheme has to provide Rs 100 per year, the central government provides Rs 300 and the insurance company offers free medical treatment up to Rs 30,000.

Preliminary investigation indicates other insurance companies entrusted with the task of running the central government's scheme may also be involved in embezzlement of government funds. The several health cards were issued to those above the poverty line, sources added.

According to officials, poverty line for the urban areas is Rs.296 per month and for rural areas Rs 276 per month.

Link: Original Article

Gates Foundation, Bihar ink deal for better health

The Bill and Melinda Gates Foundation has signed a Memorandum of Cooperation (MoC) with the Government of Bihar to ensure better delivery of medicare.

With the signing of this MoC, the foundation will extend aid to various health projects in selection districts of the state.

The memorandum was signed in the presence of Bihar Chief Minister Nitish Kumar. "The Gates Foundation has its biggest focus on improving health. So, as we watched over the last few years, Bihar really makes a priority to improve health, including things like immunisation. We have been very impressed. So, during my last visit, the Chief Minister and I had a conversation that kicked off the discussions that led to today's Memorandum of Co-operation," said Bill Gates.

The memorandum aims to improve and increase the availability, quality and utilisation of health-care facilities and services.

This is an initiative to reduce maternal mortality rate (MMR) and infant mortality rate in Bihar.

Various health-related projects including eradication of tuberculosis, pneumonia, diarrhoea using will see support of the Gates Foundation.

"There will be intervention by the foundation in eight districts, to scale up and improve the work that has already been started in the state. The projects in which they will support in these eight districts include work in the fields of pneumonia, diarrhoea, Kalaazar and tuberculosis," said Nitish Kumar.

During the visit, Gates interacted with the locals and generated awareness on various health-related measures.

The Bill and Melinda Gates Foundation, regarded as one of the biggest charitable trusts in the world, is expected to collaborate with the Rajiv Gandhi Charitable Trust for running various welfare programmes at several places in India.

Link: Original Article

May 14, 2010

Indian traditional medicine gets pharmacopoeia commission

Indian traditional medicine received a major boost on Thursday with the cabinet sanctioning Rs.14.08 crore for establishing a pharmacopoeia commission to set and maintain standards in the sector.

“The union cabinet today approved the establishment of a pharmacopoeia commission for ayurveda, yoga and naturopathy, unani, siddha and homeopathy (AYUSH),” Information and Broadcasting Minister Ambika Soni told reporters after a cabinet meeting chaired by Prime Minister Manmohan Singh.

“It is estimated that the global market for traditional and herbal medicines is worth $62 billion, of which China’s share is $19 billion. India still has a long way to go to increase its share and the establishment of the pharmacopoeia commission for AYUSH is a very important step in this direction,” Ms. Soni explained.

The cabinet also sanctioned Rs.14.08 crore to be spent over the next two years on establishing the pharmacopoeia commission, which will function from the health ministry-controlled Pharmacopoeial Laboratory for Indian Medicine (PLIM) at Ghaziabad on the outskirts of New Delhi, an official said.

“It is envisaged that the commission will become self-reliant in five years,” the official said.

“Right now, various people are doing various things. Ramdev is doing something and Shahnaz Hussain is doing something else. Everyone is doing a good job, but given that there are some 1,000 drugs and an equal number of compound formulations (in the traditional medicine sector), standards need to be developed.

“The identity, purity and strength of raw materials need to be laid down and standard operating procedures need to be worked out for the manufacture of AYUSH drugs,” the official explained.

“We also need a national repository of Indian traditional medicine and hence the need for an autonomous society headed by an eminent technical person,” the official added.

The government said last month that it was making all efforts to mainstream the AYUSH sector through quality control and holistic medical education.

“The National Rural Health Mission (NRHM) is the main vehicle to achieve the goal. The NRHM seeks to open up local health tradition and mainstream AYUSH including the manpower and drugs and to strengthen the public health system,” Minister of State for Health and Family Welfare S. Gandhiselvan said at a conference here.

Link: Original Article

Ketan Desai quits as MCI chief

Ketan Desai, the Medical Council of India (MCI) President accused in a corruption case, on Wednesday tendered his resignation from the post.

Sources confirmed that he had forwarded his resignation to the Union Health Ministry. Desai was arrested by the Central Bureau of Investigation (CBI) last month for allegedly accepting a bribe for giving permission for admission to a private medical college in Patiala.

According to the Indian Medical Council Act, the vice president is entitled to preside over meetings in the absence of the president. "In this case too the vice president Keshavkutti Nair will preside over the meetings. However, it is uncertain that he would be made president," added the source. Sources said that while re-election for the post was on the cards, a final view would be taken after a detailed discussion is amongst the senior officials on Thursday.

Earlier this week the Gujarat government had also terminated the services of Dr Desai, a professor in the urology department in the State government-run B J Medical College and its head since 2005.

Link: Original Article

India needs over 10 lakh more nurses, says health minister Azad

Expressing concern over the shortage of nurses in healthcare and hospital administration, Union health minister Ghulam Nabi Azad said the shortfall was a whopping 60%.

"Around four lakh nurses in the country are in active service. Around 10 lakh more nurses are required at present," Azad said. He was speaking at the National Florence Nightingale Awards being given to nurses for meritorious services.

There are around 10.35 lakh nurses registered with the Nursing Council of India of whom an estimated 40% are in active service. Many have retired or have gone abroad or given up nursing services after marriage. That leaves only around four lakh nurses in the country in active service, the minister said.

In order to meet the shortage of nurses and bring the availability of nursing personnel on par with developed countries, an expenditure of over Rs 2,000 crore is being incurred to establish infrastructure for promoting nursing in the country.

About 132 auxiliary nursing and midwifery schools and 137 general nursing and midwifery schools are expected to come up while nursing councils and nursing cells are being strengthened at different states and districts.

Along with this, the government has also relaxed certain norms to encourage more admissions to nursing courses.

Link: Original Article

Rural health care degree plan as scheduled, says Azad

The Union government will go ahead with the proposed Bachelor of Rural Health Care. This assertion came from Health and Family Welfare Minister Ghulam Nabi Azad in response to questions by journalists whether the government would put the proposal on hold in the wake of the arrest of Ketan Desai, president of the Medical Council of India (MCI).

The Minister said it was a government initiative where public sector hospitals would also function as training schools with no involvement of the private sector.

“It is for the States to decide on the nature and implementation of the scheme,” he said. The role of the Medical Council of India would remain confined to formulating the syllabus, which has already been done and degrees would be given by varsities.

The course was approved by the MCI and a preliminary announcement was made by Dr. Desai with much fanfare.

Earlier, addressing the first meeting of the newly constituted Institute Body of the All India Institute of Medical Sciences (AIIMS) here, Mr. Azad assured the members that the institute would not be privatised. The Valiathan Committee had come up with some “futuristic” recommendations on corporatisation of the AIIMS and it would be taken up step by step. The basic character of the AIIMS of providing tertiary healthcare, cutting edge research and education would not be diluted. While elaborating on the AIIMS' expansion programmes and the new one coming up at Jhajjar in Haryana, Mr. Azad sought suggestions to decongest the hospital. The new AIIMS at Jhajjar and others coming up elsewhere in the country had adequate facilities for attendants, particularly of the patients from outside the area. He felt similar facilities should be created at the AIIMS and Safdarjung Hospitals here also.

The Institute Body postponed till June a decision on a proposal presented by the Department of Personnel and Training to fill vacancies in the AIIMS. It was decided that since the members were new, they should be given some time to study the proposal.

Link: Original Article

May 13, 2010

Government to have a say in medical council

The government will play a more active role in the functioning of the scandal-hit Medical Council of India (MCI) in order to prevent concentration of power that can lead to corruption, official sources said on Tuesday.

Stung by the arrest of MCI president Ketan Desai on charges of taking bribes to recognise a medical college in Punjab, the health ministry wants to arm itself with powers so as to intervene if charges of misconduct are hurled against the council's members.
Presently, the MCI is a body of elected members and the government has no right to intervene in its affairs.
Under the proposed changes, the health ministry will have the authority to take charge of the council if the president's post falls vacant, the sources said.
The government can also nominate members for vacant posts, including that of the vice president.
A draft legislation also seeks to limit the terms of the president and vice-president to a maximum of two.
Also, it will give the central government power to dissolve the executive committee or dismiss its office bearers under specified conditions.
The MCI is a statutory body that oversees the standards of medical education in India.
It grants recognition to medical degrees, gives accreditation to medical colleges, registers medical practitioners, and monitors medical practice in the country.
An earlier amendment along the same lines in 2005 was rejected by a parliamentary committee on the plea that it will destroy the autonomy of the prestigious institution.
But the mood in the health ministry changed after last month's stunning arrest of Desai for allegedly taking Rs.2 crore in bribe for recognising a medical college in Punjab though it did not meet MCI's quality standards.
After Desai's arrest, Health Minister Ghulam Nabi Azad had told parliament that the Medical Council Act will be amended to give greater authority to the government vis-a-vis the council.

Link: Original Article

TN and Maharashtra abolish All-India quote of PG seats

From the next academic session, more students from the state can hope to get a chance to bag a seat in government-run medical colleges.

The medical education department, led by senior NCP leader Vijaykumar Gavit, has initiated a proposal to abolish the all-India quota in government-run medical colleges, so that more seats will be available to students from Maharashtra. "We have carefully studied the law enacted by the Tamil Nadu government, which has already abolished the all-India quota. We are in the process of bringing in an identical legislation. We expect the new legislation will come into force from the 2011-12 academic session," a
senior MED official told TOI on Tuesday.

Well over a decade ago, the all-India quota was introduced in government-run medical colleges following a directive from the Supreme Court. According to the directive, 15% of the seats in the undergraduate level and 50% at the post-graduate level will be reserved for all-India students. However, the Tamil Nadu government felt that aspiring doctors from that state were losing out owing to the national quota. In a bid to benefit its students, the Tamil government enacted its own law, abolishing the all-India quota in their state. If the medical education department official is to be believed, then the legal validity of
the Tamil Nadu legislation has been upheld.

In Maharashtra, the MED official said, the intake capacity of at the UG level in 14 medical colleges is 1,700, while the figure stands at 1,000 for PG courses. "If we abolish the all-India quota, then 255 additional MBBS seats and 500 PG seats will be available to state students. We are sure, we will bring in the new legislation before the next academic session starts," he said.

The official added that it would be wrong to compare all-India admissions for IIT and medical courses. "IITs are completely financed by the Centre, while state-run medical colleges get absolutely no monetory assistance from the Unino government. In fact, the all-India quota does not help the state much as after the completion of their courses, students selected under the all-India quota leave for other options in other parts of the country. We provide them with the best education, but we do not benefit out of it," he said.
About students from Maharashtra studying medicine in other states, the official said, the number was too few. For the MBBS course, fewer than 30 students study in different medical colleges across the country, while 70 enrol themselves for the post-graduation courses in institutes outside the state.

"At the end of the day, we lose out as deserving students from Maharashtra are deprived of their right to medical education, while those from outside get the chance," the medical education official added.

Link: Original Article

Max Group eyes education, hotels

Education and hospitality could well be the next growth hotspots for the Analjit Singh promoted Max group. “We have already decided on medicine but we are open to a wider range of education opportunities,” Max India Chairman Analjit Singh told Hindustan Times in an exclusive interview at his Aurangzeb Road residence in Lutyen’s Delhi.

The medical colleges will come up in Uttarakhand, Punjab and Haryana, Singh said.
Besides, Singh is in talks with the PRS Oberoi-promoted EIH Ltd for making a foray into the fast-growing hospitality sector. He holds 4.5 per cent stake in EIH Ltd and was in the news recently for reportedly planning to acquire 17 per cent stake in the hotel chain.

“We have made a beginning, we have acquired a 30-acre plot of land near Dehradun for the construction of a hotel-cum-wellness resort, which would be managed by the Oberoi Group,” he said.

A total investment of Rs 2,700 crore has already been made so far, while another Rs 700-800 crore is likely to be injected in the next two years, part of which Singh plans to raise by roping in private equity partners.

Max India operates its main businesses of life insurance and healthcare through two subsidiaries — Max New York Life Insurance and Max Healthcare — both contributing 84 per cent and 8 per cent, respectively, to the group’s total revenues.

Max India has recently roped in Goldman Sachs as a new investor, which put in Rs 535 crore ($115 million) for a 9.4 per cent stake in the company.

The group’s consolidated revenues stood at Rs 7,306 crore in 2008-09. It also has subsidiaries in the areas of specialty plastic products and clinical research. The company has set up a joint venture with Bupa for health insurance services. It has already set up Max Institute of Medical Excellence — a specialised division under Max Healthcare —mandated to impart education and training in the field of medicine.

Under government norms, medical colleges can be set up only within a functioning hospital.
Singh did not specify whether Max India would set up new hospitals to run colleges or buyout existing private hospitals in these areas.

Max Healthcare has been awarded land by the Punjab government to build two hospitals in Bathinda and Mohali of 300-beds each. These hospitals are expected to be functional by the next year. In all, the company plans to add around 1,000 beds in its hospitals in the next two years from the existing capacity of 800 beds.

At present, research facilities are being provided to doctors at the eight hospitals of Max Healthcare in Delhi and the National Capital Region, but no formal degree courses in medicine are offered in any of these.

“Healthcare, insurance, education and hospitality are the four areas that I am interested in and want to be in,” Singh said.

Singh, a father of three — Pia (28), Vir (27) and Tara (23) — is clear that his children would not be allowed to take over the vast business empire without proving their acumen.
They are welcome to join the family business but they have to be either managers or owners,” he said without mincing words.

“Being a manager and owner can converge later but not in the near future,” he said. “We have engaged a head hunting firm to ensure that the companies are fully governed by boards and we have appointed independent directors, who are totally independent in nature and are not buddies,” he said.

Link: Original Article

May 09, 2010

'Faulty' colleges got MCI stamp

Under its tainted boss Ketan Desai, the Medical Council of India (MCI) granted recognition to many medical colleges ignoring serious irregularities such as fraudulent faculty.

On Saturday, Desai, arrested by the CBI last month in connection with a Rs 2 crore bribe for permitting a medical college in Punjab to admit students despite lack of infrastructure, resigned from Ahmedabad's BJ Medical College.

During his tenure, the MCI allegedly closed its eyes to many an irregularity, reveal documents accessed by Hindustan Times.

Take the case of Santhiram Medical College in Andhra Pradesh. During an MCI inspection on May 24, 2008, one of the faculty members on the records was Dr Nagaraja Rao, of the department of forensic medicine. College authorities furnished his documents to MCI inspectors including his appointment letter and salary slips. The papers said Rao was residing on campus.

Only, Rao had been dead for years.

MCI secretary ARN Setalvad refused comment on the story, saying the council had authorised vice-president Dr PC Kesavankutty Nayar to talk to the media. Efforts to reach Nair on his cellphone and his residence in Kerala proved futile.

The Rao case was probed by the Central Vigilance Commission (CVC). Official communication between the MCI and CVC is in HT's possession.

In May 2009, the Ministry of Health and Family Welfare, too, intervened.

Still, the college was granted permission for that year by the MCI's executive committee headed by Desai and no inquiry initiated to verify credentials of other faculty members.

MCI rules say a new college has to be given permission after an inspection every year for the first five years. It is at such inspections that many private colleges produce fake documents and cover up crucial irregularities. While the MCI inspectors can only state facts; the final decision lies with the Council's Executive Committee headed by Desai.

During another inspection at Andhra Pradesh's Vikarabad Medical College in 2009, a student was found to be posing as a faculty member. He posed as Dr Xavier R Packianathan, a radiologist who moved out of India five years earlier. The college still got its permission.

Another document reveals at least seven doctors were proven to be fakes by the Tamil Nadu Medical Council (TNMC) in October 2009.

Official communication between the MCI and the TNMC — a copy of which is with the HT — confirmed that the medical registration certificates of the seven were "forged and fabricated".

Many such colleges, however, still got permission. MCI's own records for 2009 state that at the time, there were 325 'medical teachers' alleged to have submitted fake documents during inspections.

In fact, an MCI ethics committee noting states that the steps taken by the Council under Desai had been "cosmetic in nature".

Link: Original Article

May 08, 2010

Apollo, Cisco tie up for cost-effective telemedicine

Leading private healthcare provider Apollo Hospitals has joined hands with networking company Cisco to provide cost-effective telemedicine solutions to patients in remote areas.

"The latest technology provided by Cisco makes the work of a doctor more convenient. Earlier, the doctor would go in search of a telemedicine room, but the new technology provided by Cisco helps the doctor connect with patients on a laptop supported by an internet connection and web camera," Apollo Telemedicine Foundation president K. Ganapathy said Friday.

"Even miles apart, doctors can give medical supervision, conduct detailed clinical examination and interact with patients through web camera," Ganapathy added.

Sangita Reddy, executive director of Apollo Hospitals Group, said: "Although, Apollo Hospitals had one of the largest telemedicine network, we were not able to touch rural areas in India as the initial investment for this facility was high. The alliance with Cisco has made telemedicine user-friendly and cost-effective."

Reddy said Apollo had started deploying Cisco desktop-based healthcare technology in remote clinics and super-specialty hospitals, enabling patients to access doctors at any point of time.

Vishal Gupta, vice president of Cisco, said: "Using this new desktop-based healthcare solution, we create an environment similar to what patients experience when they visit their doctor."

"The high definition video, audio and end-to-end telemedicine and the immediate diagnosis with specialist will help patients, particularly those in rural areas," Gupta added.

Link: Original Article

Hospital Information System to make hospitals smarter in UP

The quintessential sarkari face of government hospitals in UP is in for a major change. And the tool behind this transformation is information technology. The state family welfare department has decided to install hospital information system (HIS) in its hospitals under the national rural health mission.

As many as 15 hospitals have been shortlisted to begin with. The selected ones in Lucknow are Ram Manohar Lohia, Shyama Prasad Mukherjee Civil, Veerangana Avanti Bai and Veerangana Jhalkari Bai hospitals.

“The work of laying cables has already begun in Jhalkari Bai Hospital,” said Ajay Mishra, who is closely associated with the project.

Notably, HIS involves application-based software development and its implementation to improve the overall functioning of any unit. “A patient stands at the very core of a hospital. Quality of work inside it reflects on the patient’s treatment. HIS has proved its worth at a number of places,” said Dr RS Dubey, chief medical superintendent, Ram Manohar Lohia Hospital, which was awarded the Quality Council of India accreditation last year.

“The success of HIS may be seen clearly at Sanjay Gandhi Post Graduate Institute of Medical Sciences... but the volume of patients that report at a government hospital makes the job a challenge,” said Dr LB Prasad, former director general of health services when asked to comment. Notably, the British Journal of Medicine has appreciated the HIS for enhancing the quality of general work and coordinating for patient care services. Those working on the project agree with Dr Prasad’s view. In the wake of the same, they have decided to proceed in a phased manner.

Based on a survey of some 30 hospitals, the work was divided into five main categories, viz, registration, drug store, drug distribution counter, pathological services and doctor’s prescription. Infrastructure development for registration, drug store and pathological services has been identified for the first phase. HIS would revolutionise the way things work inside a hospital. For instance, at present, each time a patient reports at a hospital he needs to register afresh. But HIS would award a unique identity to the patient and would save time.

Similarly, the picture on availability of medicines is usually hazy in any government hospital. HIS would alert the hospital authorities when the stock goes down from a certain level. Experts are of the view that features in HIS would help in disease surveillance as well.

“Many patients reporting jaundice in a single day for example would put the health machinery on an alert. Presently, the doctors do observe such trends but their information goes waste as it is not recorded. Once there will be facts and figures, things would start operating better,” said a former medical officer.

Link: Original Article

Health Minister rules out law to control population growth

The government will not use legislation to control the country's swelling population.

According to Union health minister Ghulam Nabi Azad, "We are not in favour of controlling population growth through any kind of legislation, but by way of generating awareness and persuading people to have a small family size for betterment of the health of the mother and child."

He said, "Population is a major concern. India is the world's second most populous country. Urgent steps need to be taken to stabilise the population for sustainable development."

According to Azad, India is following the demographic transition pattern of developing countries, from the initial levels of "high birth rate-high death rate" to the intermediate transition stage of "high birth rate-low death rate" which manifests in high rates of population growth, before attaining "low birth rate-low death rate".

More than 50% of the population is in the reproductive age of 15-49 years, which imparts momentum to the population growth.

"We have to bear in mind the carrying capacity of the land mass and resources available at our disposal. With a land area of 2.6% of total earth land, India has 17% of the world's population. The natural resources are limited and need to be used judiciously and equitably. Population stabilization should be brought back into focus," Azad said.

The population of India in 2001 was 1.02 billion and is projected to be 1.19 billion in 2011. It is estimated that in 20 years, India's population will exceed that of China.

According to the minister, various efforts are being made to bring down the rates of maternal mortality rate and infant mortality rate in the country, most significant of which has been the Janani Suraksha Yojana. Azad said the fertility and mortality rates are declining throughout the country though the magnitude of decline varies considerably across states. The total fertility rate has declined to 2.6 in 2008.

He added, "We have an objective of achieving replacement level fertility, that is, TFR of 2.1 by 2012. While 14 states have achieved this, some states are way behind and need to gear up their machinery to contain the population growth. Improving literacy levels, empowerment of women, increasing age at marriage and delaying first birth, also contribute to lowering the fertility rate."
Link: Original Article

1,053 government doctors dismissed in Uttar Pradesh

About 1,053 doctors of the Provincial Medical and Health Services cadre in Uttar Pradesh, who were absent from service for the past one decade, were dismissed on Friday. These doctors, posted in government hospitals and community health centres all over the State, could not be traced. It is suspected that they are either practising on their own or have gone abroad.

According to a senior medical and health official, these doctors were in the rank of Chief Medical Officer (CMO), Chief Medical Superintendent (CMS), Deputy Chief Medical Officer and Medical Superintendent.

Before taking the decision, the government referred the case to the Uttar Pradesh Public Service Commission, which ratified the dismissals.

R.R. Bharti, Director-General of Medical and Health Services, told The Hindu that simultaneously the government moved the Public Service Commission for appointing 5,500 PMHS doctors. “About 3,500 doctors have already been appointed on a regular pay.”

As for the missing doctors, Dr. Bharti said that since they could not be traced for the past eight-10 years, it was suspected that they were engaged in private practice or had migrated to some Gulf countries. They were not entitled to salary and other benefits for the period of absence.

The problem surfaced three years ago. The Medical and Health Department launched a massive exercise to trace them. “Notices were inserted in newspapers and in the visual media to trace their location, but to no avail,” the official said.

Link: Original Article

May 05, 2010

PM may put medical education under NCHER

In a bid to stem the rot in medical education, the Prime Minister's Office has asked the HRD ministry to bring it under the purview of the proposed National Council for Higher Education and Research (NCHER).

In the present form, the NCHER Bill excludes medical and agriculture education. Inclusion of medical education in NCHER will mean that health ministry's proposal to set up a regulatory authority for medical education is likely to be shelved. PMO sources said a meeting between HRD and health ministry officials has already taken place on this issue.

Coming in wake of the arrest of MCI chief Ketan Desai, the decision can be seen as PMO's lack of confidence in health ministry's ability to clean the mess in medical education. Sources said, "The arrest of Desai has shown the extent to which the rot has spread. It can't be allowed." However, MCI's function as a regulatory to manage the medical profession will not be taken away.

Another reason for inclusion of medical education in the proposed NCHER is that the National Accreditation Regulatory Authority For Higher Educational Institutions Bill, 2010 provides for accreditation of higher educational institutions, including medical colleges. Another HRD Bill — Prohibition of Unfair Practices Bill — also accounts for malpractices in medical colleges. Both the Bills were introduced in the LS on Monday by HRD minister Kapil Sibal. Sources said it would have created a strange situation whereby medical education would have been under MCI/health ministry but accreditation and control of malpractices would have been under HRD.

The PMO's directive has come at a time when HRD ministry, after a nationwide consultation, is in the process of finetuning the NCHER Bill further. Sibal is planning to go on a retreat with experts like former NCERT director Krishna Kumar, Devesh Kapur of Pennsylvania University, educationist Vinod Raina, Pratap Bhanu Mehta of Centre for Policy Research, historian KN Pannikar and others for further consultations on NCHER.

Link: Original Article

No power to stem rot in MCI: Health Minister

Countering Opposition charges on the Centre turning a blind eye towards the Medical Council of India’s corrupt practices, Union Health Minister Ghulam Nabi Azad said the existing law does not provide any scope for the ministry to take the MCI head on.

An emotionally charged up Azad said in the Rajya Sabha on Tuesday that when he took over as chief minister of Jammu and Kashmir he wrote to all secretaries, commissioners, deputy commissioners and superintendent of police on his personal pad instructing them not to entertain telephone calls from his wife and son and relatives. The agitated minister then expressed his inability to take any action as the law did not allow him to do so.

The ministry had proposed an amendment to the Indian Medical Council Act of 1956 to make the council more responsible and to empower the Centre to take steps to make the council more transparent and accountable.

But the parliamentary standing committee on health headed by Amar Singh (SP) rejected the draft bill, arguing that it will destroy the autonomy of the council.

“The time has come for us to revisit the issue. Recent events suggest the need for further reform in all aspects of the structures governing medical education in the country,” he said.

The obvious reference was to the tainted MCI president Ketan Desai who was arrested on April 22 by the Central Bureau of Investigation for accepting Rs 2-crore bribe for granting recognition to a private medical college in Punjab. He is still in CBI custody for interrogation.

Azad said he referred the MCI case to the Union law ministry on April 29 with all previous documentations for the right direction.

The minister’s response comes after members, cutting across party lines objected to the level of corruption at the MCI, which is the sole regulatory body to look after medical education.

This is not Desai’s first brush with the law. In 2002, he was removed from the post of MCI chairman by the Delhi High Court, which asked the CBI to prosecute him. In 2005, the CBI gave him a clean chit saying Desai received Rs 65 lakh from two families as “goodwill money.”

While giving the verdict, the Delhi High Court appointed an administrator. But the vice-president of MCI approached the Supreme Court seeking permission to run the organisation on a day-to-day basis. Subsequently, fresh elections were held under apex court supervision.

Desai, who was elected earlier with 60 per cent vote, received 99 per cent votes this time. Azad said both government and courts tried to stem the rot in the past in MCI with little success.

Link: Original Article

May 04, 2010

Lok Sabha passes the Clinical Establishments Bill to regulate private hospitals and clinics

The Lok Sabha on Monday passed the Clinical Establishments Bill to regulate private hospitals and clinics across the country. “It would also ensure that no clinic runs unless it has been duly registered in accordance with the prescribed procedure,” Union Health and Family Welfare Minister Ghulam Nabi Azad said.

No debate

The Bill was passed without any discussion as the House witnessed uproar over reported scam in allocation of 2G spectrum and the alleged links of a Union Minister with an arms dealer.

According to the Bill, every establishment will have to follow minimum standards of facilities and services for registration and continuation of operation.

The establishments will have to provide the medical examination and treatment as may be required to stabilise the emergency medical condition of any individual, who is brought to the facility.

The Bill envisages the setting up of a National Council for Clinical Establishments and State councils to regulate the medical facilities.

The State councils will be responsible for compiling and updating the State register of clinical establishments and sending monthly returns in digital format for updating the national register.

A State government will set up district authorities for registration of health units, with the collector and district health officer as members.

Link: Original Article

May 03, 2010

Charging capitation fee a cognisable offence: Bill in parliament

A bill that makes charging of capitation fee by any medical or technical institute a cognisable offence and empowers police to arrest the erring administrators without warrant was introduced in the Lok Sabha today.

The Prohibition of Unfair Practices in Technical Educational Institutions, Medical Educational Institutions and University Bill, 2010 was introduced by HRD Minister Kapil Sibal amid din caused by opposition members over reported scam in 2G spectrum allocation and alleged involvement of Telecom Minister A Raja in it.

Sibal also introduced in the House the Educational Tribunal Bill, 2010 that provides for setting up specialised tribunals at the Centre and the states for adjudicating matters relating to disputes in educational institutions.

The National Accreditation Regulatory Authority Bill, 2010, seeking to set up a body to assess and accredit every institution in higher education was also introduced. The prohibition of unfair practices bill seeks to classify malpractices into two categories.

Charging capitation fee will be a cognisable offence while other offences will be treated as non-cognisable and attract some fine. The civil offences will be adjudicated in the educational tribunals, while the cognisable offences will be dealt by courts.

At present, the fee structure in private engineering and medical colleges is fixed by a state-level committee headed by a retired high court judge. However, there are instances of many institutes charging fee higher than that suggested by the panel.

Certain institutes demand donations for admitting students and do not issue receipts for payments made by them. They give misleading advertisements in media with intent to cheat students. They also withhold certificates and other documents of students who want to quit the institute.

Certain institutes, which promise good quality education but do not deliver it, will face penalty under this new regulation. "Capitation fee charged by any institute will be a cognisable offence. People will be prosecuted without fear and favour," Sibal had said after the bill was cleared by the Cabinet.

The Accreditation Regulatory Authority Bill provides for setting norms for accreditation. The process of accreditation will be outsourced to agencies of integrity registered with the authority. At present, accreditation is voluntary. But with the new authority in place, every institute will go through mandatory accreditation.

The present accreditation agencies like National Accreditation and Assessment Council and National Board of Accreditation will function under the National Accreditation Regulatory Authority. The purpose of creating the Accreditation Regulatory Authority is to ensure that people get quality education.

Every institute will make self-disclosure which can be audited by the accreditation authority. It will be an independent statutory body for quality control. The authority would also monitor and audit the accreditation agencies registered under it.

The Educational Tribunal Bill provides for adjudication by tribunals the disputes pertaining to accreditation, affiliation and inter-institution matters. The tribunals will act as fora for fast-track and speedy resolution of issues in institutions.

The legislation also provides for imprisonment for a term which could extend to three years and/or a fine of up to Rs ten lakh. The state tribunals will adjudicate matters concerning teachers, employees and students of institutions in the respective states.

The national tribunal, having nine members, would deal with all matters concerning regulatory bodies in higher education and also matters involving institutes located in two or more states. It would act as an appellate body against the orders of the state educational tribunals, the Statement of Objects and Reasons of the bill said.

Link: Original Article

Pharma firms flouted Medical Council's ban on freebies to doctors

Ever since the Medical Council of India (MCI) banned doctors from accepting gifts and freebies from the pharma and healthcare industry, some companies have openly induced the medical profession to disobey the directive, according to a New Delhi-based industry watchdog.

The Monthly Index of Medical Specialities (MIMS) has collected data on violations of the MCI code by drug companies.

In the second week of April, an unknown body calling itself 'Udaan Diabetes Care Foundation' organized a 'Regional Insulin Summit Meet - North' at Fortune Grace Hotel, Mussoorie, where over 50 rooms were reserved. The Rs.5,500 per night room tariff of this ultra luxurious hotel was picked up by Bangalore-based Novo Nordisk which sells insulin, MIMS editor Chandra Gulhati, a keen observer of the pharma industry, says in an editorial.

Some time ago, the same company had distributed thousands of copies of a glossy, four colour publicity booklet under the title 'Levemir: Indian Experience', which carried the photographs and endorsements by 63 diabetologists in violation of the MCI rule (6.1) wBAhich clearly states 'A physician shall not give... any approval,... endorsement with respect to any drug, or any commercial product', says Gulhati.

Investigation by MIMS has unearthed several violations of the MCI code by drug companies that have openly sponsored doctors to go on foreign jaunts despite the ban.

* Piramal Healthcare in Mumbai took some 200 diabetologists to Turkey in late January followed by a batch of oncologists in mid-March to the same destination. Some of these travellers are now facing investigation by MCI.

* Dr. Reddy's Lab in Hyderabad paid for about 200 doctors to visit Hyderabad in January.

* Navi Mumbai-based Wanbury dispatched some 100 doctors to Dubai in mid-February and put them up at luxurious Dhow Palace Hotel. The package tour was handled by Cox and Kings at a cost of about Rs.40,000 per person.

* Lupin of Mumbai held an all expense paid promotional event at Indore in late February and reserved rooms in three luxurious hotels (Sayaji, Amar Vilas and Landmark Fortune) for obliging doctors mainly from Madhya Pradesh. MCI is believed to be in possession of some names.

* MCI has received information on Macleods having dispatched just over 90 doctors to Bangkok in the third week of February and an additional 100 doctors to Dubai in early March.

Despite the MCI ban on doctors accepting gifts, Gulhati found that Ahmedabad-based Troikka distributed some LCDs. Acting on a tip off, MCI is investigating the case, says Gulhati.

Gulhati said MCI has already approached the health ministry to empower the Drugs Controller General, India, to take action against companies that induce doctors to violate the law.

'Even more effective will be a new provision in the income tax laws to disallow all expenses incurred by the healthcare industry that are in violation of MCI regulations,' Gulhati told IANS.

Link: Original Article

New sub-specialities to be fast-tracked

The Tamil Nadu Dr. MGR Medical University will fast-track initiation of fellowship programmes in new sub-specialities, the University Vice-Chancellor, Mayil Vahanan Natarajan said on Sunday.

Inaugurating a Continuing Medical Education programme on paediatric dermatology hosted by the CHILDS Trust Medical Research Foundation (CTMRF), the academic arm of the Kanchi Kamakoti CHILDS Trust Hospital, Dr. Natarajan said the university recognised the enormous scope for sub-specialities in modern medicine and sought to start more fellowship and research projects in the emerging disciplines.

Noting that the area of research in paediatrics was in a nascent stage, the Vice-Chancellor said it was proposed to launch a fellowship programme in paediatric dermatology in June in association with the CHILDS Trust Hospital.

The University was also examining another proposal from the institution for a similar programme in paediatric emergency medicine, he said.

K. Mathangi Ramakrishnan, CTMRF chairperson said the hospital maintained a balance between teaching and academic activity. The institution, which had earned accreditation from the Department of Science and Technology, was currently pursuing 13 core research projects, she said.

This year's CME on hypospadias sought to highlight a congenital deformity in the male neonate that led to unpleasant adolescent life if it was not properly operated upon, she said.

Prabhavathy, Head of Dermatology, Madras Medical College, launched a souvenir on the occasion.

S. Sridharan, Honorary Medical Director, CHILDS Trust Hospital, Prema Krishnaswamy, Trustee and Priya Ramachandran, organising secretary of the CME also spoke.

Delivering the 19th Dr. M.S. Ramakrishnan Memorial Endowment Oration, UK-based genito-urethral plastic surgeon Aivar Bracka said there was a disconnect between surgeons and their patients in the quality of surgery outcomes. This was mainly because there was no long-term follow-up of apparently well executed hypospadias surgeries on children into their adulthood.

Stating that until a few years ago one-stage hypospadias repair compromised cosmetic appeal for functionality, Dr. Bracka said only a long-term follow-up of patients would reveal the true incidence of complications and patient dissatisfaction. In fact, some surveys, including his own studies, found that at least 50 per cent of the patients preferred further surgery as they were unhappy with their surgery outcomes, he said.

According to Dr. Bracka, while procedures such as “Snod graft repair” provided a reliable and fairly versatile single-stage solution for hypospadias, the two-stage surgical intervention was still an option in a limited number of cases, especially those involving re-operation or salvage surgery where the previous operation had been imperfect.

Pointing to the polar divide between paediatric surgeons and urologists who preferred flaps and plastic surgeons who advocated grafts, Dr. Bracka said graft repairs were an effective choice as they were not prone to dilatation at a later stage.

Link: Original Article

May 02, 2010

Medical degrees of TN university - Vinayaka Mission's offshore campus void: HC

Refusing to give its stamp of approval for the medical degrees awarded by the Salem-based Vinayaka Mission University’s off-shore facility in Thailand, the Madras high court has declined to direct the Medical Council of India to conduct screening test for 21 ‘medical graduates’ from the Bangkok campus.

A division bench comprising Justice Elipe Dharma Rao and Justice KK Sasidharan, allowing a writ appeal filed by the Union health ministry’s National Board of Examinations, said: “The government of Thailand has not given permission to the deemed university to establish their off-shore campus in Thailand. Similarly, the Medical Council of Thailand has not given any kind of permission or recognition to the deemed university, agreeing to honour the degree awarded by them and to enable the students to register their names in Thailand...”

The deemed university invented a novel method to open an overseas campus at Thailand, on the basis of a memorandum of understanding with Rangsit University of Bangkok. Though the MoU did not have any no-objection certificate from the government of Thailand or recognition from that country’s medical council, the Vinakaya Mission admitted 21 students against the ‘sanctioned’ intake of 100 students. As the students completed the course in 2009, the university approached the authorities seeking permission for its students to write the screening test and to start internship here. After a single judge allowed the plea, an appeal was filed by the National Board of Examinations.

The judges, noting that they would not do anything that would dilute the standard of medical profession for the ultimate sufferers would be the general public, said the Centre’s nod for the Vinayaka Mission to start an off-shore campus was not a blanket permission to conduct medical course there. Pointing out that the permission was not unconditional, the judges said the deemed university was mandated to meet several conditions, including recognition from that country and application of MCI rules.

The judges said the deemed university was not able to furnish any certificate from the Thailand government or the medical council there despite several adjournments, and added: “The deemed university has not produced even a scrap of paper before the MCI or before the NBE to justify their contention regarding recognition in Thailand.”

Citing the MoU between Vinayaka Mission and Rangsit University of Bangkok, the judges said, “Strangely, none of these letters contains a statement that Thailand has permitted Rangsit University to allow an off-shore campus of a foreign university on their campus or that the medical degree which would be awarded by Rangsit was a valid degree in Thailand.”

Describing the MoU as private dealings between two private universities, the judges said, “The views expressed by the MCI and the board cannot be brushed aside so lightly.”

Educational matters require consideration of authorities and it is not within the province of courts to sit in the armchair of educational authorities and exercise their statutory powers, the judges observed, ruling out any positive direction in favour of the deemed university.

Link: Original Article

Medical faculty transferred for a day to hoodwink MCI

If private medical colleges hire house surgeons to hoodwink Medical Council of India inspectors, it’s malpractice. But what if the government itself pushes through ‘standby transfers’ during MCI inspections and submits a report that new government medical colleges meet the governing body’s guidelines?

Medical education minister Ramachandra Gowda first termed this a ‘sensitive issue’ but then said the government was trying to save students who had got admission. Later, he insisted he didn’t want to comment on the issue.

The fact is the government issued 15 transfer orders of senior residents, lecturers, assistant professors and professors between January 16 and March 6 this year. In each transfer order, seven to nine faculty members were transferred from established medical institutions like Bangalore Medical College and KIMS, Hubli to new colleges in Hassan, Mandya, Shimoga and other places.

Worse, the government, in its ‘stand-by’ transfer order, has committed that the transferred faculty will be re-transferred to their parent organisation, effective from the conclusion of the MCI inspection. During these one- or two-day transfers, the faculty would be paid their salaries from their parent organisation.

HOW IT WORKED
In a bid to expand medical education to every district, the state government opened six new medical colleges in Mandya, Hassan, Shimoga, Bellary, Bidar and Raichur. After constructing the building, the government found it difficult to get teachers.

The trouble with government recruitment was that they had fixed salaries for each grade. They couldn’t get faculty for subjects like radiology, orthopaedics and paediatrics who usually earn lakhs of rupees per month in private colleges.

Students were admitted to these colleges and MCI conducted three inspections before giving recognition. The government had no other option but to effect ‘standby’ transfers of faculty from established medical colleges.

Link: Original Article

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