Tamil Nadu Chief Minister M.K. Stalin on Wednesday wrote to Prime Minister Narendra Modi, urging him to instruct the Union Ministry of Health and Family Welfare to temporarily suspend the notification issued by the National Medical Commission (NMC) that restricts the establishment of new medical colleges.
Expressing deep reservations about NMC’s decision, Stalin said that “imposing the condition of 100 MBBS seats per 10 lakh population at the state level was a direct encroachment on the rights of all state governments and penalisation of states who have invested more in their public health infrastructure over the years.”
Stalin, in the letter, said that even when there was adequate number of doctors at the state-level, shortage of doctors in district-level hospitals is still a persistent issue. “This problem could be addressed only by opening new medical colleges in such backward areas. Any restriction on new medical colleges based on state-level criteria will deprive these deserving districts of much-needed tertiary institutions,” he said.
Arguing that Tamil Nadu was able to achieve a higher doctor-population ratio due to the consistent investments made by the state government and private institutions, he said the state was continuously urging the Union government to contribute more. “But projects like the All India Institute of Medical Sciences (AIIMS) in Madurai are yet to take off. Imposing restrictions, in such a situation, on new medical colleges would only deprive Tamil Nadu from getting any investments in the healthcare sector by the Union government in the future,” Stalin pointed out.
Stating that southern states like Tamil Nadu had been strengthening its tertiary healthcare network for decades, he said the persistent efforts by the state government has led to the ample availability of doctors and nurses and better performance on various health indicators. “This has generated huge demand for quality health services and new institutions are absolutely necessary for us to cater to it in the future,” he said.
Stating that the new NMC notification infringes into the state’s rights, Stalin requested Modi issue instructions to place the notification in abeyance. He said a consultative process could be initiated with state governments, regarding steps to address this issue. Quoting a recent judgment of the Supreme Court, which said that the executive instructions could not impose reasonable restrictions on the fundamental rights of states to establish educational institutions, Stalin said, “the NMC’s notification may therefore be legally untenable, going by the Supreme Court judgment.”
What do the new guidelines say
Tamil Nadu has 11,600 seats for a projected population of 7.64 crores as per data provided in the parliament in 2021. Other southern states like Karnataka have 11,695 seats for 6.68 crore population, Andhra Pradesh has 6,435 seats for 5.27 crore population, Kerala has 4,655 seats for 3.54 crore population and Telangana has 8,540 seats for 3.77 crore population.
As per the new guidelines issued by the NMC, Tamil Nadu should have only 7,600 seats while Karnataka will have 6,700 seats, Andhra Pradesh 5,300 seats, Kerala 3,500 seats and Telangana 3,700 seats. The doctor-population ratio in the southern states is 1:1000 as against the national average of 1:854. The new guidelines will not only be a body blow to Tamil Nadu to have at least one medical college in each district but also infringe upon the state's rights in providing health care and medical education.
The NMC and the Union government are of the opinion that the medical seats should be proportionate to the state’s population as any excess number will only lead to unemployment.
The new guidelines published in the extraordinary gazette of the Union government on August 16, not only cap the number of MBBS seats in both private and government medical colleges in the states but also introduce a ratio of 100 MBBS seats for 10 lakh population.
“Applications for establishing new undergraduate medical education colleges shall be allowed only for 50, 100, 150 seats provided that the medical college shall follow the ratio of 100 MBBS seats for 10 lakh population in that state,” the guidelines published in the extraordinary gazette says. Going by this guideline, all the southern states and Puducherry have already surpassed the mark of 100 seats per 10 lakh population set by the NMC.
Going by the new guidelines none of the five southern states will be able to open a new medical college or add more number of MBBS seats in the existing institutions. As of now Tamil Nadu has a total of 74 medical colleges of which 38 are government medical colleges. The state has plans to open six more government medical colleges.