A National Medical Commission(NMC) notification restricting the opening of new medical colleges has created a “regressive scenario” and should be kept in abeyance, the Tamil Nadu government said on Wednesday, 4 October.
In a letter, Chief Minister MK Stalin urged Prime Minister Narendra Modi to instruct the Union Health Ministry to keep the notification in abeyance and initiate a consultative process to address the matter.
According to the commission’s Extraordinary Gazette Notification Guidelines for Undergraduate Courses Under the Establishment of New Medical Institutions, Starting of New Medical Courses, Increase Seats for Existing Courses & Assessment and Rating Regulations, 2023, dated 16 August 2023, medical colleges shall follow the ratio of 100 MBBS seats for every 10 lakh population in that state or Union Territory (UT).
“After AY (academic year) 2023-24, the Letter of Permission (LOP) for starting new medical colleges shall be issued only for an annual intake capacity of 50/100/150 seats: Provided that the medical college shall follow the ratio of 100 MBBS seats for every 10 lakh population in that state/UT,” reads the notification.
It has put the southern states, which have more seats in MBBS courses, in a fix.
If the formula of 100 MBBS seats for every 10 lakh population in that state is followed, all the southern states — Andhra Pradesh, Karnataka, Kerala, Tamil Nadu, and Telangana — will not be able to start a new medical college: They have crossed the mark.
“I wish to draw your kind attention to the regressive scenario created by the recent notification issued by the NMC to restrict the opening of new medical colleges. It has been notified by the NMC that after the academic year 2023-2024, the Letter of Permission for starting new medical colleges shall be issued only for an annual intake capacity of 50/100/150 seats, provided that the medical college shall follow the ratio of 100 MBBS seats for 10 lakh population in that State/ UT,” Stalin wrote in the letter.
The recent NMC restriction on new medical colleges is another attempt to encroach upon the rights of States!
Why penalise the States that have tirelessly built their strong public health infrastructure over decades? Is it fair to deprive backward districts of getting tertiary… pic.twitter.com/LVdXIxIdLQ
— M.K.Stalin (@mkstalin) October 4, 2023
Direct encroachment on state right
Stalin also said that the notification was a “direct encroachment” on the rights of all state governments and penalisation of those who have invested more in their public health infrastructure over the years.
He said progressive states like Tamil Nadu have been strengthening their tertiary healthcare network for many decades, leading to ample availability of doctors and nurses, which he said has manifested in their better performance in terms of various health indicators.
“Chennai has emerged as the healthcare capital of India. In both public and private sectors, our skilled medical professionals have been able to successfully serve not only the people of Tamil Nadu but also other states as well as other nations. This has generated a huge demand for quality health services and new institutions are necessary for us to cater to it in the future,” Stalin added.
“The criterion proposed for such restriction, the higher doctor-population ratio at the state level as compared to the norms, is also not appropriate. Even when there is adequate availability of doctors at the state level, there are districts where their availability continues to be a persistent issue,” he said.
The problem can be effectively addressed only by starting new medical colleges in backward areas and any restriction based on state-level criteria will deprive these deserving districts of much-needed tertiary institutions.
“I would also like to point out the fact that in states like Tamil Nadu which have a higher doctor-population ratio, such high availability of doctors has been achieved predominantly due to investments made by State Governments and the private sector and not by investments made by the Union Government.”
“We have been continuously urging that the Union Government needs to contribute more but projects like AIIMS, Madurai are yet to take off,” Stalin said.
Given this situation, a restriction on new institutions will eliminate any chance of TN getting new Central investments in the health sector.
In a recent judgment, the Supreme Court also held that executive instructions could not impose reasonable restrictions on the fundamental right to establish educational institutions under Article 19(1)(g) of the Constitution of India.
“Thus, the above NMC notification may also be legally untenable. Considering all the above issues, I request you to instruct the Union Ministry of Health and Family Welfare to keep this notification in abeyance and initiate a consultative process with the State Governments on the steps to address this issue,” Stalin told the PM.
More medical seats than the NMC norm
In a reply to a question in the Lok Sabha, Union Minister of State for Health and Family Welfare Dr Bharati Pravin Pawar regarding the seats in Medical Colleges and the projected population till 31 March 2023, by the Unique Identification Authority of India (UIDAI), all South Indian states have more seats than the NMC’s new norm.
In Andhra Pradesh, the projected population is 5.34 crore, which means that the state can have 5,346 seats. The state now has 6,435 MBBS seats.
Karnataka, with a projected population of 6.76 crore has 11,695 seats, the highest in the country. According to the NMC norm, the state should have only 6,770 seats.
Kerala with a projected population of 3.57 crore has 4,655 seats, 3,577 more than the NMC.
The NMC notification put the number of seats in Tamil Nadu with a projected population of 7.68 crore at 7,686, around 4,000 less than the existing 11,600.
Telangana, which has been adding MBBS seats over the past few years has plans for another 800 seats next year. It has a projected population of 3.8 crore, and the seats should be around 3,809 seats.
However, the state currently has 8,540 MBBS seats, around 5,000 more than the NMC-prescribed seats. The state, meanwhile, has already sanctioned the construction of eight new medical colleges to add the aforementioned 800 seats.
The largest state in India, Uttar Pradesh, whose projected population is around 23.5 crore, has just 9,703 seats, around 14,000 less than the 23,568 seats as per the NMC norms.