A parliamentary standing committee has rejected a Union government proposal to start a degree course in rural health for training manpower to serve in rural India. The Centre had proposed the course in response to a court direction, and it remains to be seen how the court views this development. The Supreme Court case in a related matter is scheduled to be heard on April 18.
Following a Delhi High Court order of 2010, the Centre started working on introducing an educational course of BSc programme of 3.5 years for creating rural health officers. In addition to supporting preventive health services, they were to be trained to manage emergencies like simple injuries and infections for which an qualified MBBS doctors are not needed.
While the government took steps to launch the course, the parliamentary standing committee on health took up the matter.
The delay in implementing the course may lead to contempt of court. Meenakshi Gautham of Public Health Foundation of India had filed a contempt petition, urging the government to move fast on introducing the course.
Sources said that the curriculum is in the last stages of finalisation. Many states were to roll out the course in the 2013 session. With the parliamentary committee opposing the proposal, there seems to be confusion about the status of the course now.
"Decision of the parliamentary committee is binding on the government, and the course will not be introduced now," said Sanjay Jaiswal, member of Parliament and a member of the committee.
However, Gautham said there is no legal necessity to go with the decision of the committee. "The course was to be introduced due the Delhi High Court order. Now the contempt petition is sub-judice. It is for the court to pass the final order. The government is not legally bound to go with the committee," she said.
The committee rejected the proposal on various grounds. One of them is that the course is not required when there are so many unemployed practitioners of alternative system of medicines. "The Planning Commission has said under the 12th plan there will be at least one hospital in each district of the country. Where is the need for the course then? Also, there are nearly 60,000 unemployed AYUSH doctors. Why should they not be employed instead of a new course?" said Jaiswal.
Half-baked doctors?
Meanwhile, the Indian Medical Association has welcomed the committee's decision. The IMA has been opposing the course saying it will create "half-baked" doctors for the rural populace.
The public health experts have been demanding the course based on the successful models of Chhattisgarh and Assam, where the programmes were launched in 2001 and 2005, respectively. In Assam, for example, a fleet of 80-90 doctors has made a big difference in institutional deliveries wherever the rural health officers are posted.
"These health officers will not replace the doctors. Members of the community will be trained to help the population in some immediate need or for some simple procedures. We cannot wait till a full-fledged infrastructure is developed to cater to the needs of the rural India. This system is being practiced everywhere, including developed nations," said Gautham.
With confusion prevailing over the status of the course now, the debate about powers of judiciary and legislature will assume importance again. Meanwhile, it seems that even if the course has not been stalled, its introduction will get delayed.