Making doctors available for rural India:

Abstract

In the backdrop of acute shortage of allopathic doctors in rural India, this paper looks at the interplay and tension between central and state regulatory measures aimed at improving the availability and retention of allopathic doctors in the rural areas, within the overarching framework of centre-state relations and division of legislative powers between them, with respect to regulation of medical education. While the Central Government has introduced certain provisions in the central law to promote availability of doctors in rural areas, some States have implemented provisions with the same objective, that go beyond the stipulations of the Central Act. Several such measures taken by state governments; be it reservation of post graduate seats for doctors serving in government rural institutions or developing cadre of medical practitioners for rural area under certain conditionalities; have been challenged in courts and held to be violative of the central legislation which inter alia, regulates standards of medical education and registration of doctors. The measures introduced by the state governments for increasing availability of doctors in rural areas, even though struck down as invalid, were intended as instruments of equity and social justice, with far reaching implications for improving availability of health care services in underserved areas. Unless the Medical Council of India Act is amended or the subject matter of medical education is moved from Union list to State list, state interventions are likely to continue to be struck down if they are found to be affecting the standards of medical education.