Will state medical councils wield the scalpel?

It’s for them to enforce new rules on gift-taking doctors.

The implementation of the Medical Council of India’s (MCI) proposed penal punishment for doctors accepting cash and any other gifts from pharmaceutical companies would depend on individual states and the willingness of state medical councils to pursue action.

MCI’s proposals were a sequel to the voluntary code of ethical guidelines it published in January for all doctors. It had listed the favours a doctor should not accept from pharmaceutical companies.

The proposals have gone to the Union health ministry. Once approved, these would be notified and all states bound to adopt these. The implementation would be through the various state medical councils.

MCI President Ketan Desai, when asked how confident he was on the code’s implementation, replied: “There are states where law and order is good and states where it isn’t.” As an apex body, MCI is where appeals would be filed.

Several doctors felt it was the start of a needed process, though there may initially be problems with implementation. Former secretary-general of the Indian Medical Association, Vinay Aggarwal, said: “The practice of taking expensive gifts from pharmaceutical companies was increasing the cost of healthcare substantially. A process has been started.”

“Faith in the profession has been dented. We are trying to bring it back,” Desai said. “We are not trying to do any policing. We are professionals. This should not happen in a profession that is called noble,” he added.

When MCI came out with the voluntary code of conduct last December, several doctors had criticised it for lacking teeth. K Srinath Reddy, president of the Public Health Foundation of India, had then said there was need for strict penal provisions to check malpractices in the profession. MCI has now done so. It even plans to publish on its website the names of erring doctors, pharmaceutical companies and the nature of offence and punishment.

Doctors accepting gifts worth Rs 1,000 to Rs 5,000 would be censured -- that is, issued a warning which would go into their record. Gifts up to Rs 10,000 would result in a three-month suspension from the medical register. For those up to Rs 50,000, the suspension would be up to six months. For gifts up to Rs 1 lakh, suspension ip to a year. And, beyond a year for taking more than this.

Desai said individual states could only increase these penalties. They could not bring down the term of punishment.