Rajya Sabha Clears Bill To Regulate Allied & Healthcare Professions; Establish National Commission & State Councils

Introduced by the Minister of Health and Family Welfare, Dr. Harsh Vardhan, on September 15, 2020, the Bill brings 56 allied and healthcare services into 10 categories.

These broadly include professional categories such as Physiotherapy, Occupational Therapy, Ophthalmic Sciences, Nutrition Sciences, Medical Laboratory and Life Sciences, Medical Radiology, Imaging and Therapeutic Technology, Medical Technologists and Physician Associates, Trauma, Burn Care and Surgical / Anesthesia related Technology, Community Care and Behavioral Health Sciences and Health Information Management and Health Informatics.

While introducing the Bill, the Health Minister said that whereas doctors, pharmacists, nurses, dentists, etc, are regulated by their own regulatory bodies, a proper structure for development and maintenance of standards of services and education of allied and healthcare professionals through a National Regulatory Body has been long overdue.

The Statement of Objects annexed to the Bill states:

"With the advancement in the health sector, changing preferences of consumers and service providers, it is now warranted to create a fresh vision of healthcare delivery with a patient-centric approach and focus on moving to a multi-disciplinary team-based care. This has necessitated the need to implement new ways of deploying health workers, strengthening the workforce by task-shifting models and improving access to quality services through qualified and competent allied and healthcare professionals"

Therefore, it contemplates establishment of a National Commission for Allied and Healthcare Professions and Councils at the State-level.

Salient Features

The Bill specifies Allied and healthcare professions in the Schedule annexed to the Act.

An Allied health professional includes an associate, technician or technologist who is trained to perform any technical and practical task to support diagnosis and treatment of illness, disease, injury or impairment, and to support implementation of any healthcare treatment and referral plan recommended by a medical, nursing or any other healthcare professional.

Such professional should have obtained a diploma or degree under this Bill, the duration of which should be at least 2,000 hours spread over a period of 2-4 years.

A Healthcare professional includes a scientist, therapist or other professional who studies, advises, researches, supervises or provides preventive, curative, rehabilitative, therapeutic or promotional health services.

Such professional should have obtained a degree under this Act, the duration of which should be at least 3,600 hours spread over a period of 3-6 years.

National Commission for Allied and Healthcare Professions

The Bill proposes to set up a National Commission for Allied and Healthcare Professions to consist of

• a Chairperson;
• a Vice-Chairperson;
• 5 members at Joint Secretary level representing various Central Ministries/ their Departments;
• 1 representative from the Directorate General of Health Services;
• 3 Deputy Directors or Medical Superintendents appointed on a rotational basis from amongst medical institutions including AIIMS, Delhi and AIIPMR, Mumbai;
• 12 part-time members representing State Councils, charitable institutions, etc.

Functions

The Commission will perform the following functions:

• frame policies and standards for regulating education and practice,
• create and maintain an online Central Register of all registered professionals,
• provide basic standards of education, courses, curriculum, staff qualifications, examination, training, maximum fee payable for various categories, and
• provide for a uniform entrance and exit examination, among others.

Professional Councils

The Commission is also required to constitute a Professional Council for every recognised category of allied and healthcare professions. Such Councils will consist of a President and 4-24 members, representing each profession in the recognised category.

State Councils

Apart from a National Commission, the Bill also contemplates establishment of Councils at State-level, within six months from the passage of the Bill, to regulate allied and healthcare professionals.

The State Councils will consist of:

• a Chairperson with at least 25 years of experience in the field;
• 1 member representing medical sciences in the state government;
• 2 members representing state medical colleges;
• 2 members representing charitable institutions;
• 2 members from each of the recognised categories of allied and healthcare professions, nominated by the state government.

Functions

The State Councils will:

• enforce professional conduct and code of ethics to be observed by allied healthcare professionals,
• maintain respective State Registers,
• inspect allied and healthcare institutions, and
• ensure uniform entry and exit examinations.

That apart, the State Council has also been empowered to give prior permission for establishing a new institution, opening new courses, increasing the admission capacity, or admitting a new batch of students to existing institutions.

If such permission is not sought, then any qualification granted to a student from such an institution will not be recognised under the Bill.

Offences

Chapter VII of the Bill deals with offences and penalties. It prescribes that no person is allowed to practice as a qualified allied and healthcare practitioner other than those enrolled in a State Register or the National Register. Any person who contravenes this provision will be punished with a fine of Rs 50,000.

Cognizance of offences

Section 60 of the Bill provides: No court shall take cognizance of any offence punishable under this Bill except upon a complaint made by the Central Government, the State Government, the Commission, or the State Council, as the case may be. It further ousts a Metropolitan Magistrate or a Judicial Magistrate from trying cases under this law.

Parliamentary Debate

Many members said that the Bill steps in the right direction to regulate and standardize and important yet unregulated medical field. Some concerns and suggestions set forth during the debate are as follows:

• Budgetary support to Healthcare services in India is very low and the Government should increase allocation for the same;
• The duration of 3-6 years for educational courses for healthcare professionals offers a huge window and is silent as to the provision for internships. Inadequate training and internships may weaken the quality of healthcare services;
• The Bill binds all States to form State Councils. However, each State must be given enough autonomy to take a decision on this aspect on their own, given that Healthcare structure is not same in every State;
• Inclusion of medical physicist as an allied healthcare professional under the Bill is not viable since their job description is different from allied healthcare workers. Even International Labour Organization recognizes medical physicist as health professionals, and not allied professionals. Furthermore, they are already regulated by Atomic Energy Regulatory Board.

Quick Summary

The Bill provides for:

• constitution of a National Commission for Allied and Healthcare Professions for regulation and maintenance of standards of education and services;
• constitution of Professional Councils for every recognised professional category to frame policies and standards for the governance of allied and healthcare related education and professional services and to regulate their professional conduct;
• constitution of a National Allied and Healthcare Advisory Council to advice Commission on the issues relating to allied and healthcare professionals;
• constitution of State Councils for ensuring the coordinated and integrated development of education and maintenance of standards of delivery of services;
• constitution of the Under-graduate Allied and Healthcare Education Board, Post-graduate Allied and Healthcare Education Board, Allied and Healthcare Professions Assessment and Rating Board and Allied and Healthcare Professions Ethics and Registration Board for regulating the standards of allied and healthcare professionals;
• create and maintain an up-to-date online and live Central Register and State Register of allied and healthcare professionals;
• ensuring development of basic standards of education, courses, curricula, facilities, assessment, examination, training, maximum fees etc.;
• uniform entry examination with common counselling for admission into allied and healthcare institutions;
• uniform exit or licensing examination for professional practice and National Teachers Eligibility Test for academicians;
• strategic framework for rational deployment of skilled manpower, performance management systems, task shifting and associated career development pathways;
• basic standards framework for machineries, materials and services;
• constitution of committees by engaging independent experts for technical advice related to any of the professions.

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