ISLAMABAD: Represen­tatives of various medical organisations have expressed reservations over the rece­ntly passed Pakistan Medical Commission (PMC) bill, claiming that it will give unlimited autonomy to private medical and dental colleges in fixing fees and admitting students.

The Pakistan Medical Association (PMA), a representative body of health professionals, said the step would deteriorate the standard of medical education and create problems for doctors serving abroad after the Pakistan Medical and Dental Council (PMDC) is abolished.

The Pakistan Association of Private Medical and Dental Institutions (PAMI) seemed to be satisfied with the bill but claimed that the decision to pay remuneration for house jobs would leave them with no option but to increase fees.

However, Special Assis­tant to the Prime Minister on Health Dr Faisal Sultan said it was time the medical and dental institutions were left on their own with the government only checking the graduates through exit exams. No graduate would be able to practice without clearing the exit exam, he said.

Last week, the Pakistan Medical Commission Act 2020 was passed in a joint session after which it was sent to the president for approval. Once the bill becomes an act, PMDC will be abolished and replaced by PMC.

Last year, PMC Ordinance was promulgated which not only abolished the PMDC but also terminated services of 220 employees of the council. Meanwhile, the Islamabad High Court declared the ordinance null and void and reinstated the employees.

According to a draft of the bill available with Dawn, Pakistan Medical Commission will have three components — The Medical and Dental Council (MDC), The National Medical and Dental Academic Board (NMDAB) and The National Medical Authority (NMA).

MDC will have nine members with three from the civil society nominated by the prime minister. Among them will be a nationally-recognised philanthropist or person of known repute, a legal professional and a chartered accountant. The other three members will be licensed medical practitioners with at least 15 years of experience, also nominated by the prime minister. However, those serving on the posts of vice chancellor, dean, principal or administrator as well as owners or shareholders of a medical or dental university, college or hospital will not be eligible.

The other three members will consist of a licensed dentist with at least 15 years experience of outstanding merit, the Surgeon General of the Armed Forces Medical Service or his nominee and the federal health secretary.

The president of the College of Physicians and Surgeons Pakistan (CPSP), who used to be a council member, will now be member of NMDAB. There will be seven members of NMA and will be appointed for four years.

According to the bill, the centralised admission policy, which was introduced in the past so that students would be admitted on merit, will be abolished and medical and dental colleges will have the power to frame the admission policy.

The bill states that any violation by a medical or dental college shall be actionable by the accrediting university in accordance with regulations as may be presented by the Higher Education Commission (HEC).

All colleges have been allowed to fix their fees but they have to announce it at least three months before the start of the annual admission process. It states that the authority may conduct inspections of recognised facilities on a periodical basis provided that every institution shall be re-inspected at least once in every five years.

Talking to Dawn, PMA General Secretary Dr Qaiser Sajjad said the bill had abolished the only regulator of medical and dental institutions, and health professionals as a commission could never have powers of a council.

“The bill will empower colleges to charge fees of their choice and run the institutions without having proper equipment and faculty. Moreover, as colleges have been allowed to affiliate themselves with any university, they will not listen to universities and hold inspections as per their choice,” he said.

Dr Sajjad said medical education and training would deteriorate in Pakistan and a number of doctors working abroad would lose their jobs as only PMDC is recognised across the globe.

Former Senate chairman Raza Rabbani told Dawn that the bill was passed through a supplementary order of the day in a joint session so majority of the legislators were not aware of it.

“It is the same bill which was struck down by the Senate of Pakistan and declared null and void by the court. So I can say that there is much more behind it and it can be challenged in court,” he said.

PAMI General Secretary Dr Riaz Janjua, while talking to Dawn, said a number of positive features were included in the bill such as every graduate will have to clear the exit exam before starting practice.

“Medical education will improve because of the bill as earlier PMDC used to count heads/numbers rather than quality of service. People invested up to Rs2 billion on medical colleges but the PMDC closed down colleges with just one stroke of the pen which was not fair,” he said.

While replying to a question, Dr Janjua said the only negativity in the bill was that it suggested private colleges pay stipend equal to public sector institutions for house job.

“It will increase burden on the students in the shape of fee because colleges cannot give stipends on their own. In a number of countries, colleges even charged students for house jobs,” he said.

Special Assistant to the Prime Minister Dr Faisal Sultan said though over the years PMDC, which was established in the 1960s, did a good job, but with the passage of time the number of colleges had increased and at present over 100 medical colleges were functioning.

Published in Dawn, September 21st, 2020