How the National Medical Commission Quietly Stripped Patients Rights

Patient rights | Representative image | Photo courtesy: Special arrangement

Article 32 of the Indian Constitution, often referred to as the 'heart and soul' of our democratic charter by Dr. B.R. Ambedkar, is a pivotal provision that grants citizens the right to seek redressal from the Supreme Court in cases of fundamental rights violations. Recently, this constitutional safeguard was invoked by Uttam Chand Meena, who filed a Public Interest Litigation (PIL) against the Central government and the National Medical Commission (NMC), formerly known as the Medical Council of India (MCI).

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Meena's plea hinges on the contention that specific sections of the NMC Regulation 2023 - namely regulations 39(G) and 44 of the NMC Regulation, 2023 - should be struck down due to their infringement upon fundamental rights, including the right to equality (Article 14), the right to freedom of speech and expression (Article 19), and the right to life and liberty (Article 21).

So, what is the contentious issue that prompted Meena to take legal action, and why does it infringe upon some of the most cherished rights enshrined in our Constitution? The bone of contention lies within the National Medical Commission Registered Medical Practitioner (Professional Conduct) Regulations, 2023.

Regulation 44 of the NMC Regulation 2023 confers the right upon Registered Medical Practitioners (RMPs) who are aggrieved by decisions made by the State Medical Councils to appeal before the Ethics and Medical Registration Board (EMRB). If an RMP remains dissatisfied with the EMRB's decision, they can further appeal to the National Medical Commission. However, glaringly absent from the NMC regulations is any provision granting victims of medical malpractice the right to appeal if they fail to attain justice from their respective State Medical Councils.

In essence, if you or a family member becomes a victim of medical negligence and your State Medical Council fails to deliver justice, you are left without recourse. Conversely, RMPs - the doctors against whom complaints are filed, are afforded the right to appeal if they believe justice was not served by the State Medical Council. They can first approach the EMRB and subsequently appeal to the National Medical Commission within 60 days from the date of the EMRB's decision. Notably, the NMC regulations stipulate that the State Medical Council's order will be considered stayed until a final decision is reached by the EMRB or the NMC.

This glaring disparity raises serious questions about the principles of justice and equality enshrined in our Constitution. It is incumbent upon our government and the authorities responsible for medical regulation to address this imbalance and ensure that all citizens, irrespective of their role in the medical profession, have equal access to the avenues of justice.

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The National Medical Commission (NMC) regulations 2023 have raised eyebrows and generated considerable debate in medical circles yet this has not been reported by mainstream media organisations. In a nation that grapples with numerous cases of medical negligence, both in private and government hospitals, on a daily basis, these regulations have left the victims of such negligence in a perplexing predicament: they find themselves stripped of their right to appeal if justice eludes them at the State Medical Council level. Conversely, doctors, who often find themselves at the centre of allegations of medical negligence, enjoy the privilege of a dedicated redressal forum. This stark disparity calls for a closer examination of the NMC's priorities and its commitment to the public interest.

The question that looms large is this: Who does the National Medical Commission truly serve? Is it an institution working diligently in the interest of the public, or does it seem to be crafting and bending rules that inadvertently favour the medical establishment?

It is undeniable that the landscape of medical negligence in India is rife with complex issues. Citizens place their trust in healthcare professionals and institutions with the expectation of receiving quality care. However, when this trust is shattered due to instances of medical negligence, it becomes imperative that a fair and equitable avenue for redressal be available to those affected.

What essentially the NMC has done is that it seems to have quietly removed the right of medical negligence victims to appeal, a right that was previously enshrined in the Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations of 2002. The 2002 regulations were clear in their stance on matters of misconduct and the right to appeal. Regulation 7 addressed misconduct, and regulation 8.8 explicitly granted the right of appeal to both victims and doctors. It stated, "Any person aggrieved by the decision of the State Medical Council on any complaint against a delinquent physician shall have the right to file an appeal to the Medical Council of India (MCI) within a period of 60 days from the date of receipt of the order passed by the said Medical Council."

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Fast forward to the NMC Regulations 2023, and we find a stark contrast. The right of medical negligence victims to appeal has seemingly vanished, leaving them without an avenue for redressal. Within the labyrinthine NMC Regulations 2023, another deeply concerning issue emerges in the form of Regulation 39(G). This regulation pertains to the manner in which inquiries into medical complaints are conducted and contains a provision that restricts the parties involved from seeking legal representation at any stage of the proceedings before the State Medical Council or the Ethics and Medical Registration Board (EMRB)/NMC.

The language of Regulation 39(G) is unequivocal: "The parties shall not be allowed to bring in any lawyer to represent them in their case at any stage of the proceedings before the State Medical Council or EMRB/NMC."

The ramifications of this restriction are far-reaching and alarming. It disproportionately affects individuals who may be illiterate, unable to articulate their grievances effectively, or in dire need of legal expertise to navigate the complexities of a medical complaint. By denying them the right to legal representation, the NMC appears to have effectively shut its doors to those who require the most assistance and care.

Consider the case of victims like Uttam Chand Meena, who tragically lost his wife due to alleged medical negligence. These individuals often find themselves in a state of vulnerability, grappling with the emotional and logistical challenges posed by their situation. In such circumstances, legal representation becomes not just a right but a lifeline, a means to seek justice, and a way to ensure that their voices are heard.

During the conversation of this author with Prashant Vaxish, the legal representative for Meena, he expressed concerns about the NMC's exercise of delegated legislation. He pointed out that it appears to selectively restrict appellate jurisdiction to healthcare practitioners while overlooking the rights of affected patients and their families. This not only skews the legal framework but also poses a threat to patient safety—a fundamental right that surpasses mere policy or regulation. Those who entrust their well-being to healthcare providers should have the assurance that their rights will be protected, and justice will be upheld in cases of any wrongdoing.

The NMC's apparent disregard for patient rights in this matter is deeply concerning. It suggests a lack of empathy and understanding of the realities faced by those who have suffered due to medical negligence. The denial of legal representation is not just a procedural hurdle; it is a fundamental obstruction to the pursuit of justice and the protection of individual rights.

In a nation where access to quality healthcare is still an aspiration for many, it is paramount that regulatory bodies prioritise patient rights and the principles of fairness and equity. Denying victims of medical negligence the right to legal representation does a disservice to the very values upon which our legal system is built.

Amid the dark clouds that have gathered over the NMC Regulations 2023, there emerges a glimmer of hope for patient rights and justice. The Supreme Court of India has taken cognisance of Meena's petition, issuing notices to both the Central government and the NMC. This move by SC offers a ray of hope for those who have long advocated for patient safety and accountability within the healthcare system. Patient safety is not merely a matter of policy or regulation; it is a fundamental right. Individuals who entrust their lives and well-being to the hands of healthcare professionals deserve the assurance that their rights will be protected and that justice will be served if those rights are violated. 

Prema Sridevi is an Indian investigative journalist and Editor in Chief of The Probe. In a career spanning 20 years, Sridevi has worked with some of the top news brands in India and she specialises in stories related to accountability, transparency, corruption, misuse of public office, terrorism, internal security to name a few.

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