By Rohit & Anirudh A modified 'Modernization of State Police Forces' scheme was started by the central government in 2000-01. One of the objectives was to help police forces in meeting the emerging challenges to internal security in the form of terrorism, naxalism etc. The scheme aims to modernize police forces in terms of:
Under this scheme, States have been clubbed into different categories and Centre-State cost sharing is category specific. Since 2005-06, States have been categorized as category ‘A’ and ‘B’ with 100% and 75% Central funding respectively. All the North Eastern States, namely Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland, Tripura and Sikkim have been placed in category ‘A’ and thus, are entitled to receive 100% Central assistance for implementation of their annual approved plans. Recently, CAG decided to evaluate the working of the scheme and commissioned ‘performance audit’ reviews covering select general category and special category States. Each review covers a contiguous five year period between 2000 and 2007, but varies across selected states. For the periods under review, each state had a plan outlay (the total amount proposed to be spent in modernizing the state's police forces). However, in most cases, the actual release of funds fell significantly short of this outlay - in some cases the Centre did not contribute its share, in others the States lagged behind. For instance, in the case of Bihar, the Centre released only 56% of its share; while in the case of Rajasthan and West Bengal, the States did not release any funds at all. The graph below shows the actual releases by the Centre and the States (as percentages of their share in the proposed outlays): 
Further, even the funds that were released were not fully utilized. Thus, the amount finally spent fell significantly short of the initial proposal. The graph below shows the actual expenditure by State: 
Following are some of the other main findings from the CAG report:
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Table 1: Summary of main findings in the CAG audit for different states for Modernisation of State Police Forces |
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Purpose for which money was sanctioned |
Summary of CAG Findings |
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Planning (Every state has to propose an Annual Action Plan every year. The plan is approved by the Ministry of Home Affairs and money is released as per the plan.) |
§ Submissions by the states to the MHA were delayed. § There were also delays in the clearance granted by the MHA. § In various states such as, a) Andhra Pradesh – the government spent money on works not covered by the Annual Action Plan. b) Bihar – Persistent delays in preparation of the Plan by the state police. c) West Bengal – the plans drawn up by the state did not include items covered under the scheme. |
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Mobility |
§ Overall shortage of vehicles was observed. Most of the new vehicles replaced the old ones. § The police response time was too long in some states. § To give examples from some states: a) Andhra Pradesh – 58 percent of vehicles procured were utilised for replacing old vehicles. b) Bihar – the shortage of vehicles was 43 percent. c) Uttar Pradesh – 2400 vehicles were procured against a shortage of nearly 10,000 vehicles. |
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Residential and non-residential buildings |
§ There were considerable delays in construction of buildings in most states. Consequently, police forces’ own security was in jeopardy. § In states such as: a) Andhra Pradesh – 53 percent of staff quarters and 43 percent of official buildings were not completed (2007). b) Bihar – The total requirement of housing was nearly 60,000. Only six percent of this were included in the Plan. c) Jharkhand – District Control rooms remained non-functional because of shortage of manpower. |
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Weapons |
§ Police force in states continue to depend on outdated weapons. § Shortages of weapons also happened as acquisition from ordnance factories was very slow. § The weapons that were procured were mostly kept in the district headquarters. § In some states such as, a) Bihar – AK-47s were kept at the disposal of bodyguards of VIPs. b) West Bengal – Adequate weapons were not supplied to extremist prone police stations. |
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Communication |
§ Police Telecommunication Networks were not set up successfully in some states. In others, network was functional only up to the district level. § Shortages of various communication equipments were also observed. § In some states such as, a) Bihar - The Police Telecommunication Network system (costing Rs. 4.96 crore) remained non-functional due to non-construction of tower. b) Maharashtra – Of the 850 purchased Remote Station Units, 452 were lying in stores. |
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Forensic Science Laboratory/ Finger Printing Bureau |
§ In most States the Forensic Science Laboratories lacked adequate infrastructure. § In the absence of automatic finger print identification systems, investigation was being done manually in some States. § In some states such as, a) Maharashtra - There were significant delays in receipt and installation. There was also shortage (284 vacant posts) of technical manpower. b) West Bengal - Performance of the Forensic Science Laboratory was poor and in some cases, the delay in issue of investigation reports was as high as 45 months. |
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Training |
§ It was observed that the percentage of police personnel trained was very low. § Training infrastructure was also inadequate. § In some states such as, a) Bihar - Only 10 per cent of total force was trained. b) West Bengal - Live training was not imparted for handling useful weapons and this severely affected the performance of police forces. |
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Sources: CAG Compendium of Performance Audit Reviews on Modernisation of Police Force; PRS. Note: The audit has been done broadly from 2000 to 2007. Consequently, the period of audit for different states may vary. |
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Table 1: Summary of main findings in the CAG audit for different states for Modernisation of State Police Forces |
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Purpose for which money was sanctioned |
Summary of CAG Findings |
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Planning (Every state has to propose an Annual Action Plan every year. The plan is approved by the Ministry of Home Affairs and money is released as per the plan.) |
§ Submissions by the states to the Ministry of Home Affairs (MHA) were delayed. § There were also delays in the clearance granted by the MHA. § In various states such as, a) Andhra Pradesh – the government spent Rs 32 crore on works not covered by the Annual Action Plan. b) Bihar – Persistent delays in preparation of the Plan by the state police. c) West Bengal – the plans drawn up by the state did not include items covered under the scheme. |
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Mobility |
§ Overall shortage of vehicles was observed. Most of the new vehicles replaced the old ones, and no additions were made. § The police response time was too long in some states. § To give examples from some states: a) Andhra Pradesh – 58 percent of vehicles procured were utilised for replacing old vehicles. b) Bihar – the shortage of vehicles was 43 percent. c) Uttar Pradesh – 2400 vehicles were procured against a shortage of nearly 10,000 vehicles. 203 ambassador cars were procured, though only 55 were approved by the MHA. |
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Residential and non-residential buildings |
§ There were considerable delays in construction of buildings in most states. Consequently, police forces’ own security was in jeopardy. Satisfaction levels with the housing provided were also very low. § In states such as: a) Andhra Pradesh – 53 percent of staff quarters and 43 percent of official buildings were not completed (2007). b) Bihar – The total requirement of housing was nearly 60,000. Only six percent of this were included in the Plan, and only 1045 units were completed by 2006. c) Jharkhand – District Control rooms remained non-functional even after spending Rs 2 crore because of shortage of manpower. |
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Weapons |
§ It was observed that the police force in states continue to depend on outdated weapons. § Shortages of weapons also happened as acquisition from ordnance factories was very slow. § The weapons that were procured were mostly kept in the district headquarters. § In some states such as, a) Bihar – AK-47s were kept at the disposal of bodyguards of VIPs. b) West Bengal – Adequate weapons were not supplied to extremist prone police stations. |
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Communication |
§ Police Telecommunication Networks were not set up successfully in some states. In others, network was functional only up to the district level. § Shortages of various communication equipments were also observed. § In some states such as, a) Bihar - The Police Telecommunication Network system (costing Rs. 4.96 crore) remained non-functional due to non-construction of tower. b) Maharashtra – Of the 850 purchased Remote Station Units, 452 were lying in stores. |
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Forensic Science Laboratory/ Finger Printing Bureau |
§ In most States the Forensic Science Laboratories lacked adequate infrastructure. § In the absence of automatic finger print identification systems, investigation was being done manually in some States. § In some states such as, a) Maharashtra - There were significant delays in receipt and installation. There was also shortage (284 vacant posts) of technical manpower. b) West Bengal - Performance of the Forensic Science Laboratory was poor and in some cases, the delay in issue of investigation reports was as high as 45 months. |
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Training |
§ It was observed that the percentage of police personnel trained was very low. § Training infrastructure was also inadequate. § In some states such as, a) Bihar - Only 10 per cent of total force was trained. b) West Bengal - Live training was not imparted for handling useful weapons and this severely affected the performance of police forces. |
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Sources: CAG Compendium of Performance Audit Reviews on Modernisation of Police Force; PRS. Note: The audit has been done broadly from 2000 to 2007. Consequently, the period of audit for different states may vary. |
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Today, the National Medical Commission Bill, 2019 was passed by Lok Sabha. It seeks to regulate medical education and practice in India. In 2017, a similar Bill had been introduced in Lok Sabha. It was examined by the Standing Committee on Health and Family Welfare, which recommended several changes to the Bill. However, the 2017 Bill lapsed with the dissolution of the 16th Lok Sabha. In this post, we analyse the 2019 Bill.
How is medical education and practice regulated currently?
The Medical Council of India (MCI) is responsible for regulating medical education and practice. Over the years, there have been several issues with the functioning of the MCI with respect to its regulatory role, composition, allegations of corruption, and lack of accountability. For example, MCI is an elected body where its members are elected by medical practitioners themselves, i.e., the regulator is elected by the regulated. Experts have recommended nomination based constitution of the MCI instead of election, and separating the regulation of medical education and medical practice. They suggested that legislative changes should be brought in to overhaul the functioning of the MCI.
To meet this objective, the Bill repeals the Indian Medical Council Act, 1956 and dissolves the current MCI.
The 2019 Bill sets up the National Medical Commission (NMC) as an umbrella regulatory body with certain other bodies under it. The NMC will subsume the MCI and will regulate medical education and practice in India. Under the Bill, states will establish their respective State Medical Councils within three years. These Councils will have a role similar to the NMC, at the state level.
Functions of the NMC include: (i) laying down policies for regulating medical institutions and medical professionals, (ii) assessing the requirements of human resources and infrastructure in healthcare, (iii) ensuring compliance by the State Medical Councils with the regulations made under the Bill, and (iv) framing guidelines for determination of fee for up to 50% of the seats in the private medical institutions.
Who will be a part of the NMC?
The Bill replaces the MCI with the NMC, whose members will be nominated. The NMC will consist of 25 members, including: (i) Director Generals of the Directorate General of Health Services and the Indian Council of Medical Research, (ii) Director of any of the AIIMS, (iii) five members (part-time) to be elected by the registered medical practitioners, and (iv) six members appointed on rotational basis from amongst the nominees of the states in the Medical Advisory Council.
Of these 25 members, at least 15 (60%) are medical practitioners. The MCI has been noted to be non-diverse and consists mostly of doctors who look out for their own self-interest over public interest. In order to reduce the monopoly of doctors, it has been recommended by experts that the MCI should include diverse stakeholders such as public health experts, social scientists, and health economists. For example, in the United Kingdom, the General Medical Council which is responsible for regulating medical education and practice consists of 12 medical practitioners and 12 lay members (such as community health members, administrators from local government).
What are the regulatory bodies being set up under the NMC?
The Bill sets up four autonomous boards under the supervision of the NMC. Each board will consist of a President and four members (of which two members will be part-time), appointed by the central government (on the recommendation of a search committee). These bodies are:
How is the Bill changing the eligibility guidelines for doctors to practice medicine?
There will be a uniform National Eligibility-cum-Entrance Test for admission to under-graduate and post-graduate super-speciality medical education in all medical institutions regulated under the Bill. Further, the Bill introduces a common final year undergraduate examination called the National Exit Test for students graduating from medical institutions to obtain the license for practice. This test will also serve as the basis for admission into post-graduate courses at medical institutions under this Bill. Foreign medical practitioners may be permitted temporary registration to practice in India.
However, the Bill does not specify the validity period of this license to practice. In other countries such as the United Kingdom and Australia, a license to practice needs to be periodically renewed. For example, in the UK the license has to be renewed every five years, and in Australia it has to renewed annually.
How will the issues of medical misconduct be addressed?
The State Medical Council will receive complaints relating to professional or ethical misconduct against a registered medical practitioner. If the medical practitioner is aggrieved of a decision of the State Medical Council, he may appeal to the Ethics and Medical Registration Board. If the medical practitioner is aggrieved of the decision of the Board, he can approach the NMC to appeal against the decision. It is unclear why the NMC is an appellate authority with regard to matters related to professional or ethical misconduct of medical practitioners.
It may be argued that disputes related to ethics and misconduct in medical practice may require judicial expertise. For example, in the UK, the regulator for medical education and practice – the General Medical Council (GMC) receives complaints with regard to ethical misconduct and is required to do an initial documentary investigation in the matter and then forwards the complaint to a Tribunal. This Tribunal is a judicial body independent of the GMC. The adjudication decision and final disciplinary action is decided by the Tribunal.
How does the Bill regulate community health providers?
As of January 2018, the doctor to population ratio in India was 1:1655 compared to the World Health Organisation standard of 1:1000. To fill in the gaps of availability of medical professionals, the Bill provides for the NMC to grant limited license to certain mid-level practitioners called community health providers, connected with the modern medical profession to practice medicine. These mid-level medical practitioners may prescribe specified medicines in primary and preventive healthcare. However, in any other cases, these practitioners may only prescribe medicine under the supervision of a registered medical practitioner.
This is similar to other countries where medical professionals other than doctors are allowed to prescribe allopathic medicine. For example, Nurse Practitioners in the USA provide a full range of primary, acute, and specialty health care services, including ordering and performing diagnostic tests, and prescribing medications. For this purpose, Nurse Practitioners must complete a master's or doctoral degree program, advanced clinical training, and obtain a national certification.
