Surgical strike needed

The Vyapam (acronym for the Hindi equivalent of the Madhya Pradesh Professional Examination Board) scam has once again bounced into prominence, with the Supreme Court annulling the admission of 634 medical students — many of whom have already become ‘doctors’ — who cleared the tainted entrance tests between 2008 and 2012. However, punishing the students alone, some of whom seem to have secured their admissions by getting someone else to write the exam for them, leaves untouched the larger nexus between politicians, medical college personnel and officials who ran a cheating syndicate. The true scale of the scam came to light in 2013, after which the Madhya Pradesh High Court set up a Special Investigation Team to probe the matter. The CBI entered the scene in 2015, and over 2,000 arrests have been made so far. Worse, about 40 people died in suspicious circumstances in 2015, most of these being accused, witnesses and even a journalist. Vyapam is a reflection of the sordid state of medical education in India and, at another level, of the crazy rush for secure forms of income in a scenario where unemployment is rampant.

In the eye of the storm is the Medical Council of India (MCI), which has failed to rein in malpractices both in medical education and practice. If ‘health for all’ remains a far-fetched idea, one of the main reasons is the huge cost of securing admission in a private medical college, forcing doctors to fleece patients. While private hospitals and medical colleges flourish under political patronage of all hues, government facilities languish for lack of faculty and basic infrastructure. Rather than merely focussing on broad-basing health insurance, both the States and the Centre must invest in first creating hospitals and colleges.

The Budget 2017-18 has raised the outlay on health by more than 20 per cent over the revised estimates for this year to ₹48,878 crore, but even this accounts for just over 2 per cent of the Centre’s expenditure outlay of ₹21.4 lakh crore. While addressing this skew, the Centre should revamp the MCI as well as the system of medical exams to reduce scope for malpractices. A centralised all-India medical examination, which vested interests in the States have been resisting, can help. Racketeering flourishes in a situation of inordinate demand for government jobs and seats in medical colleges — which, in turn, is a pointer to the economy’s failure to create jobs elsewhere. Above all, the ruling is also a searing indictment of the lax regulation of medical education and practice in India. It is time the profession healed itself.

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