That is how the National President of the IMA described the November 20 gazetted notification of the Central Council of Indian Medicine (CCIM), a statutory body under the AYUSH Ministry, to regulate the Indian Systems of Medicine (ISM). The notification listed 39 general surgery procedures (Shalya Tantra) and 19 procedures for diseases of ENT, eye, head, and dentistry, (Shalakya Tantra), under the Indian Medicine Central Council (Post Graduate Ayurveda Education) Regulations, 2016. These procedures included removal of metallic and non-metallic foreign bodies from non-vital organs, excision of simple cyst or benign tumours (lipoma, fibroma, schwannoma etc) of non-vital organs, amputation of gangrene, traumatic wound management, foreign body removal from stomach, squint, cataract, and endoscopic sinus surgery. The IMA objection was that this notification was illegal. This was countered by a statement that this was a mere clarification of what was already in the statute books. BAMS, the CCIM stated, stands for “Bachelor of Ayurvedic Medicine and Surgery”. The ISM Regulations, 1982 Section 11 further delineates a BAMS graduates’ duty towards an obstetrics patient in labour till delivery (Prasoti Evam Stree Roga). And so, the verbal battle rages on.
There are numerous judgments from various courts, including the SC, which clearly seek to keep the various systems of medicine separate. A practitioner of one system of medicine may not prescribe medicines from another system. Three states have permitted otherwise. The Ministry of Ayush recently informed the Supreme Court that it had permitted qualified Ayush doctors and homoeopaths to prescribe government-approved tablets and mixtures to patients who have been tested Covid positive. Courts have ruled that a general practitioner even with experience, was not permitted to do a tonsillectomy unless he was a certified specialist. In rural areas due to shortage of medical personnel, surgeons would often administer anaesthesia for patients. Courts have declared this is not permissible. The CCIM notification appears to be in conflict not only with numerous court judgments, but also with at least seven health related acts and laws; and clarity can emerge only from a court. To my mind, understanding the present state of affairs requires a brief look at the history of events.
For nearly 20 years, one individual dominated the Medical Council of India (MCI), as well as the IMA at national level. This eventually led to a writ petition and a judgment by the Delhi High Court, which ordered that, “the president of the MCI, be removed from his post after it found him guilty of corrupt practices and abuse of power.” Justices Chopra and Kumar stated. “We cannot allow an unscrupulous and corrupt person to function as the president of the MCI. Therefore, we direct that the president shall cease to hold office of president of the MCI with immediate effect.” Flying in the face of this judgment, the IMA issued a false certificate to this individual, stating that there were no outstanding court cases against him, to support his bid for the post of President of the World Medical Associations. Funds were raised through unethical endorsements of commercial products. It was increasingly felt in the higher echelons of power, that the MCI was incapable of the self-regulation demanded of the profession. For example, an oft quoted criticism has been that the vast majority of intensive care units in allopathic hospitals employ doctors from the ISM mainly as a cost cutting exercise. Sponsored conferences were another issue. Eventually, On the 15th May 2010, the Indian Medical Council (Amendment) Ordinance, 2010 was promulgated, later converted into a bill, which stated that “The Council shall stand superseded and the President, Vice-president and other members of the Council shall vacate their offices”. A new Council was to be reconstituted within one year and till then a Board of Governors was to perform the functions of the Council. The MCI has since been replaced by a National Medical Commission (NMC). A committee under the chairmanship of the late Professor Ranjit Roy Choudhury, was appointed and a “white paper” produced. The current sequence of events related to the MCI largely reflect his policy recommendations.
Against this background came the current government dispensation whose stated agenda was to promote the AYUSH systems, and restore the glory days of Sushruta and the “Sushruta Samhita”. The policy recommendations of Prof Choudhury provided the required platform to propagate the agenda of promoting the ISM, unfortunately at the cost of the allopathic system. A special AYUSH Ministry was created to promote ISM. It is believed that the NITI Aayog has even proposed a plan to implement the concept of “One Nation, One System” for healthcare by 2030.
In summary, the saga started with a corrupt MCI aided and abetted by a supplicant IMA. The authorities attempted to rectify the regulatory vacuum by scrapping the MCI and repealing the IMC Act. Professor Choudhury’s recommendations were implemented, and came as a godsend to those who sought to cut the MCI down to size, and restore the Sushruta glory days by creating a single healthcare system incorporating the ISM with the Allopathic system. The IMA response of black arm bands and one-day strikes are an exercise in futile tokenism. What is needed is a writ petition in a court of law, challenging any attempt to amalgamate the various systems of medicine in this country. Failing which, the “khichdi” will just have to be digested.
(The author is a founder member of VHAG)
