pibphoto.nic.inpibphoto.nic.in/documents/rlink/2017/jul/i201771401.docx · web viewthe said...
TRANSCRIPT
-1-
REPORT OF THE COMMITTEE
1. PROLOGUE
The present committee came to be constituted in terms of a communication
dated 6th May, 2016, under the signature of Shri Pravir Krishn Joint Secretary
(Ports] in the Ministry of Shipping, Government of India, (Annexure-1) with Dr.
Vedprakash Mishra Hon'ble Chancellor of Krishna Institute of Medical Sciences
(Deemed University], Karad and Chairman of the Academic Committee of the
Medical Council of India, New Delhi as Chairman of the Committee with Shri
Prakash Page, Chartered Accountant, Dr. Pradip Shingore, Dr. Prabhakar Kore,
Member of Parliament (Rajyasabha), Dr. Agrawal from Dr. Agrawals Eye Hospital,
Shri Ashutosh Pandya, Udaipur, Shri Samir Meghe, Member of Legislative
Assemble, Shri Ashish Deshmukh, Member of Legislative Assembly Maharashtra,
Dr. Ashok Khurana From Ultrasound Lab, New Delhi, Dr. Subhash Bhamre,
member of Parliament, Dhule, Maharashtra and presently Union Minister (State]
for Defense in Govt. of India, Shri P. D. Patil, President of D.Y. Patil Vidyapeeth,
Pune and Shri Sarang Kale as Members with Shri Abhishek Chandra Deputy
Secretary in the Ministry of Shipping as Member Secretary.
The terms of reference that were attributed to the present committee in terms
of the vested mandate was to study port hospitals at all the major ports and to
suggest model for development and the process to be followed for
modernization of the hospital on public private partnership basis at no cost to
the ports and also to explore the possibilities of setting up medical colleges
-2-
along with these hospitals.
As such, the cardinal points that were taken up by the committee for the
purposes of making appropriate suggestions and recommendations are as
under:
1. The developmental propositions for the port hospitals have to be evoked
in terms of without any financial liability on to the said port hospitals.
2. Augmentation of the existing health care facilities and the services that
are being rendered by the existing port hospitals
3. Academic utilization of the hospital facilities at the Port Hospitals
including feasibility of starting of medical college and postgraduate
speciality courses.
4. The developmental plan to be proposed under the aegis of Public Private
Partnership Model
In order to crystallize the recommendations on the aforesaid counts set out by
the committee for itself commensurate with the terms of reference attributed to
it the committee took note of the existing policy frames that have been
stipulated by the Government of India, and the same are in vogue as of now as
in the context of these policy frames the suggestions would be evoked.
The committee taking into consideration the policy proposition of the Govt. of
India to the effect that in the districts where there is no Govt. Medical College, to
have a medical college on the Public Private Partnership Basis in all such
-3-
districts whereby the District Hospitals would be upgraded and transformed into
teaching hospitals to be availed for starting of a Govt. run and sponsored
medical college without any accrual of heavy financial onus on the Govt. under
Public Private Partnership mode.
The committee took note of the fact that higher education including professional
education sector has grown tremendously. In terms of the observations brought
to fore by the Ministry of Health and Family Welfare, Government of India, the
number of Universities have increased by 34 times and colleges by a 74 times
ever since 1950. However, this quantitative expansion necessarily has not grown
with qualitative incorporations which is a matter of grave concern. The five year
plan period have taken note of the said gap and have ventured into various
initiatives and mechanisms to mitigate the same.
The 12th Five year plan recognizing the challenges confronting the domain of
higher education including medical education over a period of time proposed
initiative with reference to six focused areas wherein public private initiative
gains significance and relevance. The focused areas are :-
1. Expansion - Aiming at augmentation of the capacity in the existing institutions
2. Equity- To create targeted schemes for the backward and the minority communities
3. Excellence - building excellence through research and innovation, faculty development and internationalization.
4. Governance - Enhancing the institutional autonomy and transparency
-4-
5. Funding-increasing public and private funding and linking them to the outcomes
6. Implementation and monitoring-towards improving coordination across the ministries and the agencies.
The medical education also hinges around these areas of focus contemplated
vide the various five years plan including the 12th Five year plan and starting of
medical colleges in desired number is one such significant initiative in the said
direction.2. STARTING OF A MEDICAL COLLEGE
It is pertinent to note that the procedure governing starting of a medical college
is stipulated under section 10(A) of the Indian Medical Council Act, 1956
(hereinafter referred to as 'Act'], which reads as under :
“1) Notwithstanding anything contained in this Act or any other law for
the time being in force-
a] No person shall establish a medical college, or
b] No medical college shall-
(i) Open a new or higher course of study or training (including a
postgraduate course of study or training], which would enable a
student of such course or training to qualify himself for the
award of any recognized medical qualification or
(ii] Increase its admission capacity in any course of study or training
(including a post-graduate course of study or training]
except with the previous permission of the Central Government
obtained in accordance with the provisions of this section.
-5-
Explanation 1: For the purposes of this section, “person” includes
any University or a trust but does not include the Central Government.
Explanation 2: For the purposes of this section, “admission capacity”
in relation to any course of study or training (including post-graduate
course of study or training] in a medical college, means the maximum
number of students that may be fixed by the council (Medical Council
of India] from time to time for being admitted to such course or
training.
(2) (a] Every person or medical college shall, for the purpose of
obtaining permission under sub-section (1], submit to the Central
Govt. a scheme in accordance with the provisions of Cause (b) and the
Central Govt. shall refer the scheme to the Council for its
recommendations.
(b) The scheme referred to in clause (a) shall be in such form and
contain such particulars and be preferred in such manner and be
accompanied with such fee as may be prescribed.
(3) on receipt of the scheme by the council under sub-section (2), the
council may obtain such other particulars as may be considered
necessary by it from the person or the medical college concerned, and
thereafter it may-
(a) if the scheme is defective and does not contain any necessary
-6-
particulars, give a reasonable opportunity to the person or college
concerned for making a written representation and it shall be open to
such person or medical college to rectify the defects, if any, specified
by the council.
(b) consider the scheme, having regard to the factors referred to in
subsection (7) and submit the scheme together with its
recommendations thereon to the Central Govt.
(4) The Central Govt. may after considering the scheme and the
recommendations of the council under sub-section (3) and after
obtaining where necessary such other particulars as other considered
necessary by it from the person or college concerned, and having
regard to the factors referred to in sub-section (7), either approve
(with such conditions], if any, as it may consider necessary] or
disapprove the scheme and any such approval shall be a permission
under sub-section (1).
Provided that no scheme shall be disapproved by the Central Govt.
except after giving the person or college concerned a reasonable
opportunity of being heard.
Provided further that nothing in this sub-section shall prevent any
person or medical college whose scheme has not been approved by
the Central Govt. to submit a fresh scheme and the provisions of this
-7-
section shall apply to such scheme, as if such scheme has been
submitted for the first time under subsection (2).
(5) Where, within a period of one year from the date of submission of
the scheme to the Central Govt. under sub-section 2 no order passed
by the Central Govt. has been communicated to the person or college
submitting the scheme, such scheme shall be deemed to have been
approved by the Central Govt. in the form in which it had been
submitted, and accordingly, the permission of the Central Govt.
required under sub-section (1) shall also be deemed to have been
granted.
(6] In computing the time limit specified in sub-section (5] the time
taken by the person or the college concerned submitting the scheme,
in furnishing an particulars called for by the council, or by the Central
Govt. shall be excluded.
(7] The council, while making its recommendations under clause (b] of
subsection (3] and the Central Govt. while passing an order either
approving or disapproving the scheme under sub-section (4] shall have
due regards to the following factors -
a] Whether the proposed medical college or the existing medical
college seeking to open a new or higher course of study or
training, would be in a position to offer the minimum standards of
-8-
medical education as prescribed by the Council under section
19(a] or, as the case may be, under section 20 in the case of
postgraduate medical education.
b] Whether the person seeking to establish a medical college or the
existing medical college seeking to open a new or higher course
of study or training or to increase its admission capacity has
adequate financial resources.
c] Whether necessary facilities in respect of staff, equipment,
accommodation, training and other facilities to ensure proper
functioning of the medical college or conducting the new course
of study or training or accommodating the increased admission
capacity have been provided or would be provided within the
time limit specified in the scheme.
d) Whether adequate hospital facilities having regard to the number
of students likely to attend such medical college or course of
study or training or as a result of the increased admission
capacity, have been provided or would be provided within the
time-limit specified in the scheme.
e) Whether any arrangement has been made or programme drawn
to impart proper training to students likely to attend such medical
college or course of study or training by persons having the
recognized medical qualifications.
f) The requirement of manpower in the field of practice of medicine
-9-
and
g) Any other factors as may be prescribed
(8) Where the Central Govt. passes an order either approving or
disapproving under this section a copy of the order shall be
communicated to the person or college concerned.
The provisions of the Act on the said count are required to be read with the
regulations that are notified by the Medical Council of India as provided under
section 33 of the Act, which reads as under :
“33. Power to make regulations -
The council may, with the previous sanction of the Central Govt. make
regulations generally to carry out the purposes of this Act, and without
prejudice to the generality of this power, such regulations may provide for
-
(a) the management of the property of the Council and the maintenance
and audit of its accounts;
(b)the summoning and holding of meetings of the Council, the times and
places where such meetings are to be held, the conduct of business
thereat and the number of members necessary to constitute a
quorum;
(c) the resignation of members of the Council;
(d) the powers and duties of the President and Vice-President
-
10-
(e) the mode of appointment of the Executive Committee and other
Committees, the summoning and holding of meetings and the conduct
of business of such Committees;
(f) the tenure office, and the powers and duties of the Registrar and other
officers and servants of the Council;
(fa] the form of the scheme, the particulars to be given in such scheme,
the manner in which the scheme is to be preferred and the fee payable
with the scheme under clause (b] of sub-section (2] of section 10A;
(fb) any other factors under clause (g) of sub-section (7] of section 10A;
(fc) the criteria for identifying a student who has been granted a medical
qualification referred to in the Explanation to sub-section (3) of section
10B;
(g) the particulars to be stated, and the proof of qualifications to be given
in applications for registration under this Act;
(h) the fees to be paid on applications and appeals under this Act;
(i) the appointment, powers, duties and procedure of medical inspectors
and visitors; (j) the courses and period of study and of practical training
to be undertaken, the subjects of examination and the standards of
proficiency therein to be obtained, in Universities or medical institutions
for grant of recognized medical qualifications;
(k) the standards of staff, equipment, accommodation, training and other
facilities for medical education;
(l) the conduct of professional examination; qualifications of examiners
-
11-
and the conditions of admissions to such examinations;
(m) the standards of professional conduct and etiquette and code of
ethics to be observed by medical practitioners; and
(m a) the modalities for conducting screening tests under sub-section
(4A), and under the proviso to sub-section (4B), and for issuing eligibility
certificate under sub-section (4B), of section 13,.
(n) any matter for which under this Act provision may be made by
regulations.
Accordingly, Regulations governing Establishment of Medical College as
contemplated under section 10(A) of the IMC Act, are in vogue as amended from
time to time (Annexure-2). The said regulation under section 2 titled Definition
the word appropriate 'Government' has been defined, which reads as under:
"Appropriate Government" means in respect of
establishment/instrumentalities/ agencies/undertaking under the
control of Central Government, the Central Government, and in
all other cases, the State/Union Territory Government"
The governing regulations provides for the scheme for obtaining permission of
the Central Govt. to establish a new medical college, wherein 'eligibility criterion'
have been stipulated as clause 1 and qualifying criteria at clause 2 respectively.
The 'Eligibility criteria' prescribed there under are -
(1) A State Government/Union territory;
(2) A University;
-
12-
(3) An autonomous body promoted by Central and State
Government by or under a Statute for the purpose of medical
education;
(4) A society registered under the Societies Registration Act,
1860 (21 of 1860) or corresponding Acts in States; or
(5) A public religious or charitable trust registered under the
Trust Act, 1882 (2 of 1882) or the WAKFS Act, 1954 (29 of 1954).
(6) *Companies registered under Company Act may also be
allowed to open medical colleges. Permission shall be withdrawn
if the colleges resort to commercialization.
The 'Qualifying Criteria' incorporated there under are -
The eligible persons shall qualify to apply for permission to establish a medical
college if the following conditions are fulfilled: -
(1] that medical education is one of the objectives of the applicant in case
the applicant is an autonomous body, registered society, charitable trust
& companies registered under Company Act.
(2] that a suitable single plot of land measuring not less than 25 acres is
owned and possessed by the person or is possessed by the applicant by
way of 99 years lease for the construction of the college (For the medical
colleges/Institutions established upto 30.11.2008}.
The medical college or medical institution shall be housed in a unitary campus of
-
13-
not less than 25 acres of land. However, this may be relaxed in a place
especially in Urban areas where the population is more than 25 lakhs, hilly
areas, and notified tribal areas where the land shall not be in more than two
pieces and the distance between the two pieces shall not be more than 10 kms.
The hospital, college building including library and hostels for the students,
interns, PGs/Residents and nurses shall be in one piece of land which shall not
be less than 10 acres. Other facilities may be housed in the other piece of land.
Proper landscaping should be done. (For the medical colleges/Institutions
established from 01.12.2008 to 12.11.2009}.
* As per the terms of Notification published on 13.11.2009 in the Gazette of
India. *The medical college or medical institution shall be housed in a
unitary campus of not less than 20 acres of land except in metropolitan
(New Delhi, Mumbai, Kolkata & Chennai] and A class cities (Ahmedabad,
Hyderabad, Pune, Bangalore and Kanpur}. However, this may be relaxed
in a place especially in Urban areas where the population is more than 25
lakhs, (*other than the nine cities mentioned in the Clause], hilly areas,
notified tribal areas, North Eastern States, Hill states and Union Territories
of Andaman & Nicobar Islands, Daman & Diu & Dadra & Nagar Haveli,
Lakshadweep, where the land shall not be in more than two pieces and
the distance between the two pieces shall not be more than 10 kms. The
hospital, college building including library and hostels for the students,
interns, PGs/Residents and nurses shall be in one piece of land which shall
-
14-
not be less than 10 acres. Other facilities may be housed in the other
piece of land. Proper landscaping should be done.
* As per the terms of Notification published on 30.01.2010 in the Gazette of
India.
However, in metropolitan cities (New Delhi, Mumbai, Kolkata & Chennai]
and “A” class cities (Ahmedabad, Hyderabad, Pune, Bangalore and
Kanpur], the permissible FAR/FSI would be the criterion for allowing the
medical colleges *provided that the built up area required for total
infrastructure o fa medical institute i.e., affiliated teaching hospital,
residential complex, with regard to amendment in Minimum Standard
requirement Regulations is made available in an area of not less than 10
acres based upon the permissible FAR/FSI allowed by the competent
authority (For the medical colleges/institutions established from
13.11.2009 onwards].
* As per the terms of Notifications published on 30.01.2010 in the Gazette of
India.
Clause 2 (2] shall be substituted as under:
*The medical college or medical institution shall be housed in a unitary
campus of not less than 20 acres of land except in mega cities (Mumbai,
Kolkata, New Delhi and Chennai] and 'A' class cities (Ahmedabad,
Hyderabad, Pune, Bangalore and Kanpur]. However, this may be relaxed
-
15-
in a place especially in Urban areas where the population is more than 25
lakhs, other than the nine cities mentioned in the clause, hilly areas,
notified tribal areas, North Eastern States, Hill States and Union Territories
of Andaman and Nicobar Islands, Daman and Diu, Dadra and Nagar Havel
and Lakshadweep, where the land shall not be in more than two pieces
and the distance between the two pieces shall not be more than 10 Kms.
The hospital, college building including library and hostels for the
students, interns, PGs/Residents and Nurses shall be in one piece of land
which shall not be less than 10 acres. Other facilities may be housed in
the other piece of land, proper landscaping should be done.
However, in mega cities (Mumbai, Kolkata, New Delhi and Chennai] and
'A' class cities (Ahmedabad, Hyderabad, Pune, Bangalore and Kanpur],
the permissible FAR/FSI would be the criterion for allowing the medical
colleges provided that the total build up area required for adequate
infrastructure including medical college, hospital, hostels, residential
quarters, and other infrastructure required as per Minimum Standard
Requirement Regulations is made available in an area of not less than 10
acres based upon the permissible FAR/FSI allowed by the competent
authority.”
* As per the terms of Notifications published on 26.02.2010 in the Gazette of
India.
The above has been amended as under:
-
16-
*The medical college or medical institution shall be housed in a unitary
campus of not less than 20 acres of land except in mega cities (Mumbai,
Kolkata, New Delhi and Chennai] and 'A' class cities (Ahmedabad,
Hyderabad, Pune, Bangalore and Kanpur]. However, this may be relaxed
in a place especially in Urban areas where the population is more than 25
lakhs, other than the nine cities mentioned in the clause, hilly areas,
notified tribal areas, North Eastern States, Hill States and Union Territories
of Andaman and Nicobar Islands, Daman and Diu, Dadra and Nagar Havel
and Lakshadweep, where the land shall not be in more than two pieces
and the distance between the two pieces shall not be more than 10 Kms.
The hospital, college building including library and hostels for the
students, interns, PGs/Residents and Nurses shall be in one piece of land
which shall not be less than 10 acres. Other facilities may be housed in
the other piece of land, proper landscaping should be done.
However, in mega cities (Mumbai, Kolkata, New Delhi and Chennai] and
'A' class cities (Ahmedabad, Hyderabad, Pune, Bangalore and Kanpur],
the permissible FAR/FSI would be the criterion for allowing the medical
colleges provided that the total build up area required for adequate
infrastructure including medical college, hospital, hostels, residential
quarters, and other infrastructure required as per Minimum Standard
Requirement Regulations is made available in an area of not less than 10
acres based upon the permissible FAR/FSI allowed by the competent
-
17-
authority.”
Further, in cases of Union Territory of Andaman and Nicobar Islands,
where existing Government Hospital is used as part of the Medical
college, the college, the library and the hostels for the students, interns,
PGs/Residents and nurses etc. can be housed on another plot of ten acres
within the radius of 5 kilometers.
* As per the terms of Notifications published on 14.10.2011 in the Gazette of India.
The above Clause 2(2] has been amended with the following addition
after third paragraph:
*Provided further for a period of five years in the states of Bihar,
Chhattisgarh, Jharkhand, Madhya Pradesh, Orissa, Rajasthan, Uttar
Pradesh and West Bengal, establishment of medical college shall be
allowed on two pieces of land comprising minimum of 20 (twenty) acres
of land. However, one plot of land shall not be less than 10(ten) acres and
the second plot of land shall also be not less than 5(five) acres. The
distance between two pieces of land shall not be more than 10(ten)
kilometers with well connected road and free transportation facility for
students and staff. The hospital should be on one piece of land and the
building of the college including library and hostels for the students,
interns, PGs/Residents, nurses may be housed on any of the two pieces of
land. The said hospital should be functional for atleast 3 years.
-
18-
The above relaxation shall not be available to a person seeking
permission to establish a medical college in a District in above states
where two or medical colleges are already in existence.
* in terms of Notification published on 04.06.2012 in the Gazette of India.
The above Clause 2(2) has been substituted for the first and second paragraph
with the following:
*Provided that in urban agglomerations/cities having population of 25
(twenty five) lakhs or more, namely, Delhi, Jaipur, Kanpur, Lucknow,
Kolkata, Ahmedabad, Surat, Greater Mumbai, Pune, Hyderabad,
Bangalore and Chennai, according to the Census of India, 2011 conducted
by Government of India, the permissible FAR/FSI shall be the criterion for
allowing the medical colleges provide that the total built up area required
for adequate infrastructure including medical college, hospital, hostels,
residential quarters, and other infrastructure required as per Minimum
Standard Requirement Regulations is made available in an area of not
less than 10 acres based upon the permissible FAR/FSI allowed by the
competent authority.
Provided further that in hilly areas, notified tribal areas, North Eastern
States and Union Territories of Andaman and Nicobar Islands, Daman and
Diu, Dadra and Nagar Haveli and Lakshadweep establishment of medical
college shall be allowed on two pieces of land comprising minimum of 20
(twenty] acres of land. However, one plot of land shall not be less than
-
19-
10(Ten] acres and the second plot of land shall not be less than 5 (five]
acres. The distance between two pieces of land shall not be more than 10
(ten] kilometers with well connected road and the medical college shall
provide free transportation facility for students and staff. The hospital
shall be on one piece of land and the building of the college including
library and hostels for the students, interns, PGs/Residents, nurses may
be housed on any of the two pieces of land.
*in terms of Notification published on 01.10.2012 in the Gazette of India.
In the above Clause 2(2] as amended on 01.06.2012, the following addition has been
made after the fourth paragraph:
*Provided further for a period of five years in States/Union Territories
other than Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Orissa,
Rajasthan, Uttar Pradesh and West Bengal, establishment of medical
college shall be allowed on two pieces of land comprising minimum of 20
(twenty) acres of land for utilization of District Hospitals by respective
State Government for opening of medical colleges. However, one plot of
land shall not be less than 10(Ten) acres and the second plot of land shall
also be not less than 5(five) acres. The distance between two pieces of
land shall not be more than 10 (ten) kilometers with well connected road
and free transportation facility for students and staff. The hospital should
be on one piece of land and the building of the college including library
-
20-
and hostels for the students, interns, PGs/Residents, nurses may be
housed on any of the two pieces of land. The said District Hospital should
be functional for atleast 3 years.
The above relaxation shall not be available to a person seeking
permission to establish a medical college in a District in the states where
two or more medical colleges are already in existence.
*in terms of Notification published on 01.10.2012 in the Gazette of India.
In the above Clause 2(2) the last paragraph, as given below, is deleted.
*The above relaxation shall not be available to a person seeking
permission to establish a medical college in a District in the states where
two or more medical colleges are already in existence.
*in terms of Notification published on 22.08.2014 in the Gazette of India.
(3) that Essentiality Certificate in Form 2 regarding No objection of the
State Government/Union Territory Administration for the establishment of
the proposed medical college at the proposed site and availability of
adequate clinical material as per the council regulations, have been
obtained by the person from the concerned State Government/ Union
Territory Administration.
(4) that Consent of affiliation in Form-3 for the proposed medical college
has been obtained by the applicant from a University.
(5) That the person owns and manages a hospital of not less than 300
beds with necessary infrastructural facilities capable of being developed
-
21-
into teaching institution in the campus of the proposed medical college.
The above Clause 2(5) has been substituted with the following:
*“That the person owns and manages a hospital of not less than 300 beds
with necessary infrastructural facilities capable of being developed into
teaching institution in the campus of the proposed medical college.
Provided that in North Eastern States and Hill States, the beds strength
required at the time of inception shall be 200 beds, which shall be
increased to 400 beds at the time of recognition for a medical college
having annual intake of 50 students and it shall be 250 beds at the time
of inception which shall be increased to 500 beds at the time of
recognition for a medical college having annual intake of 100 students.”
*in terms of Notification published on 22.10.2009 and 26.02.2010 in the Gazette
of India Addition has been made in the above Clause 2(5] after the last para with
the following:
*“Provided that any agency or instrumentality of appropriate Government
desirous of establishing a medical college may be permitted to utilize the
facilities of the hospital owned and managed by appropriate Government
entering into a Memorandum of Understanding for this purpose.”
*in terms of Notification published on 01.10.2012 in the Gazette of India.
The above Clause 2(5] shall substitute the last paragraph with the following:
-
22-
*Provided that an appropriate Government shall be permitted to allow the
utilization of the facilities of a hospital owned and managed by it for
establishing a Medical College by a person/agency by entering into a
Memorandum of Understanding for this purpose.”
Provided further that the clinical material, human resources and physical
infrastructure including beds are as per the relevant minimum standards
requirement, Regulations.*in terms of Notification published on 22.08.2014 in the Gazette of India
The following shall be added in Clause 2(5] after the last para, in terms of
Notification published on 29.05.2015 in the Gazette of India (Annexure-3)
“Further provided that the following conditions as set out below are
fulfilled and form part and parcel of the Memorandum of Understanding:
(1) That the hospital owned and managed by the appropriate
Government should be minimum 300 bedded hospital with necessary
infrastructural facilities capable of being developed into a teaching
institution situated on a plot of land having an area not less than
prescribed under the Regulations. The medical college shall provide free
transportation facilities for students and staff. The said hospital would be
on one piece of the land and the building of the college including library
and hostel for the students/interns, PGs/Residents, nurses may be housed
on any of the two pieces of land.
-
23-
(2) The minimum 300 bedded hospital has to be transferred by the
Government to the applicant trust/society/company through an
appropriate Memorandum of Understanding for a maximum period of 33
years or by way of lease upto 99 years. While transferring the
Government Hospital facility, the State Government may safeguard the
interest of State particularly in respect of admission of students under
Government Quota in the medical college and patient care in affiliated
Hospital(s) of the Medical College.
(3) The hospital must be suitably altered through appropriate
modifications into a teaching hospital specially with reference to the
break up of the 300 beds into 120 beds for Surgical Specialities, 120 for
Medical Specialities and 60 for Obst. & Gynae. and also capable of
forming clinical units of 30 beds each with required ward size, teaching
and training space and other prescribed requirements as per the
governing regulations before the application is made by the applicant for
starting the new medical college.
(4) The hospital should have all the feasibility for it being periodically
upgraded including the augmentation of the number of beds and
commensurate teaching units and teaching compliment as prescribed by
the Governing Regulations with respect to the permitted annual intake for
the college of 50/100/150/200/250 as the case may be.
(5) The personnel working in the said hospital, technicians, para clinical
-
24-
staff including nurses and the menial staff, if transferred to medical
college, upon their transfer shall be under the administrative control of
the Dean of the Medical College ensuring that there is no “duality” of
administrative control of any type.
(6) The administrative control so envisaged would include “Academic”,
“Clinical” and “Financial” aspects as well.
(7) The clinical staff working at the said hospital other than those who
conform to the prescribed eligibility for being designated as Assistant
Professor, Associate Professor, Professor of the concerned subject, as the
case may be prescribed by the Teachers' Eligibility Qualification
Regulations will have to be replaced by the full time appointment of the
requisite number of duly qualified full time medical teachers, such
replacement will not apply to nonteaching position like Casualty Medical
Officer, Hospital Administrators, etc. in accordance with the prescribed
requirements under the governing Regulations. In order to ensure that
the binding operational dictum that “teaching physician has to be the
treating physician” meaning thereby that the “treating” personnel would
be the one who would be the “teaching” personnel.”
*in terms of Notification published on 14.01.2016 in the Gazette of India (Annexure-4):
In Clause 2(5] under the heading “QUALIFYING CRITERIA”, point no. 2 of
-
25-
the last added para setting out the conditions to be fulfilled and to form
part and parcel of the Memorandum of understanding, the following shall
be substituted in terms of Notification published on 02.02.2016 in the
Gazette of India:-
(2] The minimum 300 bedded hospital has to be transferred by the
Government to the applicant trust/society/company through an
appropriate Memorandum of Understanding of minimum of 33 years or by
way of lease of 99 years preferably but in any case not less than 33
years. While transferring the Government Hospital facility, the State
Government may safeguard the interest of State particularly in respect of
admission of students under Government Quota in the medical college
and patient care in affiliated Hospital(s) of the Medical College.
As such, it is evident that Government of India, is eligible in terms of the
prescribed eligibility criteria for establish a medical college.
The qualifying criteria have been broadened by an amendment to the said regulation notified on 29th December, 2015 called as 'Establishment of Medical College Regulations' (Amendment 2015] whereunder, the Public Private Partnership modalities have been appropriately incorporated. A correction to the said amendment came to be notified by a Notification dated 02.02.2016 in the Gazette of India wherein the clause 2 the word 'maximum' has been replaced by the word 'minimum'. As a result the amended clause reads as under:
"The minimum 300 bedded hospital has to be transferred by the
Government to the applicant trust/society/company through an
-
26-
appropriate Memorandum of Understanding of minimum of 33
years or by way of lease of 99 years preferably but in any case
not less than 33 years. While transferring the Government
Hospital facility, the State Government may safeguard the
interest of State particularly in respect of admission of students
under Government Quota in the medical college and patient care
in affiliated Hospital(s) of the Medical College".
In the normal course the applicant for opening of a new medical college has to
own a and manage a minimum 300 bedded ongoing hospital as a condition
precedent, which by virtue of the amendment notified to the Governing
Regulation vide notification dated 29th December, 2015, whereby the conditions
that are required to be fulfilled and would be forming a part and parcel of the
Memorandum of Understanding to be evoked between a private party and the
concerned appropriate Govt. for the purposes of starting of a medical college.
In terms of the said provisions an appropriate Govt. may transfer a minimum
300 bedded hospital to the applicant trust/society/company through an
appropriate memorandum of understanding for a maximum period of 33 years
or by a way of lease up to 99 years. While transferring the Govt. hospital
facility, the State Govt. may safeguard the interest of the State
particularly in respect of admission of students under Government
Quota in the medical college and patient care in affiliated hospitals of
the medical college.
-
27-
The hospital so transferred has to be suitably altered through required
modifications into a teaching hospital specially with reference to a break up of
300 beds into 120 beds for surgical specialities, 120 for medical specialities, and
60 for Obst. And Gynecology and also has to have clinical units of 30 beds each
with required ward size, teaching and training space and other prescribed
requirements vide the Governing regulations before an application is preferred
by the applicant for starting of the new medical college.
It is also stipulated therein that the hospital so transferred ought to have all the
feasibility for its periodic upgradation including the augmentation of the number
of beds and commensurate teaching units and teaching compliment as
prescribed vide the governing regulations governing the annual permissible
intake of the concerned college for the MBBS course.
It is clearly prescribed therein that the personnel working in the said hospital,
technicians, para-clinical staff including the nurses and the menial staff is
transferred to medical college, upon their transfer shall be under the
administrative control of the Dean of the medical college, whereby there would
not be any duality of administrative control of any type. The administrative
control so envisaged includes 'academic, clinical and financial aspect' as well.
It is also made very clear therein that the clinical staff of such a hospital other
than those who conform to the prescribed eligibility for being designated as
'Assistant Professor, Associate Professor, Professor of the concerned subject' as
the case may be prescribed by the Teachers Eligibility Qualification Regulations,
-
28-
will have to be replaced by a full time appointment of the requisite number of
duly qualified full time medical teachers and such replacement will not be
applicable to the non-teaching positions including casualty medical officer,
hospital administrator etc. The core consideration guiding the same is that 'the
teaching personnel' has to be the 'treating personnel'.
In terms of this broadening incorporated in the governing regulation, the
applicant for starting of a medical college is not the appropriate Govt. but the
person, the trust, the society, the company to which the minimum 300 bedded
hospital is transferred is the applicant. However, the compensation that is
accruable to the concerned appropriate Govt. is that it would be entitled to
safeguard its interest in terms of provisions included at Clause 2 whereby, the
said Govt. would be able to do so in respect of admissions of students under the
Govt. quota in the said medical college and patient care in affiliated hospitals of
the medical college by mutual understanding, as may be evoked from time to
time. This model does not entail any financial liability on the appropriate Govt. of
any typa
It is pertinent to note that the General Body of the Medical Council of India at its
meeting held on 30th March, 2016 taking note of the limitation as in vogue in the
amended Regulation governing Establishment of Medical College (2015), and
intending to broaden the same have resolved as under (Annexure-5):
“The General Body, therefore, recommended that clause (2] of the
conditions of the Memorandum of Understanding should be amended
-
29-
to make it read as under:
"The appropriate Govt. (Central Govt./State Govt.) as the case
may be may permit an applicant Trust/Society/Company to
manage and run a hospital of not less than 300 beds and all its
facilities for a period of minimum 33 years through invocation of
an appropriate Memorandum of Understanding for
Undergraduate / Postgraduate /Super speciality medical
education"
This amendment ensures that the concerned hospital owned by the
appropriate Government is not transferred to a Trust / Society or a
Company. The recommendation so made by the General Body of the
Council would be forwarded to the Ministry of Health and Family
Welfare, Government of India, for approval and notification thereto.
In spite of the said amendment the present proposition makes
Public Private Partnership Model restrictive in as much as it is
limited to grant of permission by the appropriate Govt. to an
applicant Trust / Society / Company to utilize the facilities of the
minimum 300 bedded hospital for Under Graduate / Post
Graduate / Super Speciality Medical Education.
It may therefore, be broadened, so that a semi-Government
Undertaking may also be construed as eligible to make an
-
30-
application for starting of a medical college and be construed at
par with an applicant Trust / Society /
Company for the purposes of being permitted by the appropriate
Govt. to manage and run a hospital of not less than 300 beds and
all its facilities for a period of minimum 33 years for the purposes
of Under Graduate / Post Graduate/Super Speciality Medical
Education".
The said recommendations if approved, by the Government of India, would
result in an amendment to Clause 2, which would then stand substituted as
under:
"The appropriate Govt. (Central Govt./State Govt.) as the case
may be may permit an applicant Trust/Society/Company to
manage and run a hospital of not less than 300 beds and all its
facilities for a period of minimum 33 years through invocation of
an appropriate Memorandum of Understanding for
Undergraduate / Postgraduate / Super speciality medical
education"
By virtue of the said incorporation the hospital owned by the appropriate Govt.
would not be required to be transferred as is the position vide the present
Regulation but would be required to permit an applicant Trust, Society or
company to manage and run the said hospital of not less than 300 beds and all
its facilities for a period of minimum 33 years through an appropriate invocation
-
31-
vide a Memorandum of Understanding for Undergraduate/Postgraduate/ Super
speciality medical education, as the case may be.
Further, the council has proposed to broaden the ambit of the said
Public Private Partnership model, so as to include a semi-Government
Undertaking to also be construed as eligible to make an application for
starting of a medical college and be construed at par with an applicant
Trust / Society / Company for the purposes of being permitted by the
appropriate Govt. to manage and run a hospital of not less than 300
beds and all its facilities for a period of minimum 33 years for the
purposes of Under Graduate / Post Graduate/Super Speciality Medical
Education".
In case the aforesaid recommendations unanimously made by the Medical
Council of India is approved by the Ministry of Health and Family Welfare,
Government of India, and is appropriately notified as an amendment to the
Governing Regulation a semi-Govt. undertaking would also be an eligible
applicant in terms of the eligibility criteria for starting of a medical college.
3. THE MODELS AS IN VOGUE
The models of medical colleges in the country as in vogue are in terms of the
eligibility criteria incorporated in the governing regulation. They are :
1. Medical colleges run and managed by the Central Govt.
2. Medical Colleges run and managed by the State Govt.
-
32-
3. Medical Colleges run by the Govt. of Union Territories
4. Medical Colleges run and managed by a University within the
scope and meaning of section 2(f) of the University Grants
Commission Act, 1956
5. Medical Colleges run and managed by the Deemed Universities
(Public Funded/Private Funded) within the scope and meaning of
Section 3 of the University Grants Commission Act, 1956.
6. Medical colleges run and managed by an autonomous body
promoted by Central and State Govt.
7. Medical colleges run and managed by an autonomous body under
a statute for the purposes of medical education.
8. Medical Colleges run and managed by a Society registered under
the Societies Registration Act, 1860 or a corresponding Acts in
the state as the case may be.
9. Medical colleges run by the statutory Municipal Corporations.
10. Medical colleges run and managed by a Public Religious or
Charitable Trust registered under the Trust Act, 1882 or the
WAKFS Act, 1954.
11. Medical colleges run and managed by the companies registered
under Companies Act with a rider that the permission for such
college would be withdrawn if the company resorts to
commercialization.
-
33-
4. PUBLIC PRIVATE PARTNERSHIP MODE
The concept of Public Private Partnership in a way defines a relationship
between the Public and the Private arena through an appropriate mode of
collaboration between the public authorities and the economic operators.
This mode of public private partnership in the developed world emerged in the
early 80s under the Reagan and Thatcher administrations for the purposes of
achieving goals in the domain of urban development. It was success in this
arena which realistically paved the way for its replication in other sectors, to the
extent that the momentum generated has resulted in the said modality being
construed as a solution to mitigate the ever growing expectations needs and
requirements for public services, which amongst other things also includes
quality based education in both the developing and the developed world.
United Nations Development Programme (UNDP] defines the Public Private
Partnership as several types of relationship between public and private sectors
for public service delivery. The private participants may include private
businesses as well as nongovernmental organizations and community based
organizations as well. The core assumption in the model is that it brings to fore
the merits of private sector which includes innovation, access to finance,
technological update, managerial efficacy and entrepreneurial spirit. These
advantages when merged with the inherent strengths of the public sector, the
hybridized results are vivid positive gains for the larger public good.
The Govt. of India, has observed that the public private partnership project,
-
34-
means a project based on the contract or concession agreement between a
Govt. or statutory entity on the one side and a private sector company on the
other side for delivering an infrastructure service on payment of user charges.
Taking into consideration the increasingly corporatized culture infiltrating in the
domain of medical education it is natural that the same has been included as a
'Service' or a 'Commodity' vide the General Agreement on Trade and Tariffs
(GATT] and World Trade Organization (WTO). It is on the said edifice that
strategic partnership in the public private partnership mode that have evolved
are private involvement in the curriculum development as well as evoking
quality centricity. The Dr. K. B. Pawar committee constituted by the University
Grants Commission has recommended the following four models of Public
Private Partnership in higher education -Model 1 :
Basic Infrastructure Model -
In this model, the private sector invests in infrastructure while the Govt. retains
the responsibility for the operations and the management of the institutions and
makes annualized payments to the private investors.
Model - 2
Outsourcing Model:
In this model, the private sector invests in the infrastructure and also has the
responsibility of the operations and the management of the institution, while the
Govt. pays the private investors for the specified services.
-
35-
Model-3
Equity or Hybrid Model:
This is a hybrid model wherein, the investments in infrastructure are shared
between the Govt. and the private sector, while the operations and the
management are with the private sector.
Model-4
Reserve Outsourcing Model:
This model proposes Govt. investments in the infrastructures and the private
sector with the responsibility towards the operations and the management.
5. PPP MODE IN MEDICAL EDUCATION
In the context of medical education, it needs to be noted that much before the
amendment to the qualifying criterion in the governing regulation in terms of the
Notification dated 28th October, 2013 published in the official Gazette of the
Government of India, where under it came to be provided that “an appropriate
Govt. shall be permitted to allow the utilization of the facilities of a hospital
owned and managed by it for establishing a medical college by a person /
agency by entering into a Memorandum of Understanding for this purpose
provided the clinical material, human resources and physical infrastructures
including beds are as per the Minimum Standards Requirements Regulations and
also its subsequent amendment in terms of notification dated 29th December,
2015 and subsequent correction vide a notification dated 2nd February, 2016, a
medical college came to be established under the Public Private Partnership
-
36-
Mode.
6. MANIPAL SIKKIM MEDICAL COLLEGE, GANGTOK, SIKKIM
The Ministry of Health and Family Welfare, Government of India, in terms of the
available records vide a letter dated 28th November, 1998 forwarded a proposal
received from the President, Manipal Foundation Manipal for establishment of a
new medical college at Gangtok, Sikkim by the Sikkim Manipal University of
Health, Medical and Technological Sciences, Gangtok, which came to be
constituted by a State Act.
The Government of India, had informed with regard to the ownership of the
hospital that the Sikkim State Government had transferred the 500 bedded
Govt. Central Referral Hospital to the University on 99 years lease. The Deed of
perpetual lease was made on 15th September, 1998 between the Governor of
Sikkim through the Secretary to the Govt. of Sikkim, Health & F.W. Deptt. and
Sikkim Manipal University of Health, Medical & Technological Sciences, Gangtok,
Sikkim established under the Sikkim
Manipal University of Health, Medical Technological Sciences Act, 1995
represented by its Vice Chancellor.
In the said Deed, it was categorically brought out that “the lessee shall
use the property and the building only for the purposes of office and
establishment of the university, hospitals, colleges, laboratories,
diagnostic centers, staff quarters, hostels, workshops and related
-
37-
facilities and other establishment connected with the activities of the
university including all facilities for multi speciality hospital with
advanced facilities and continuous up gradation thereof and nothing
else”.
In addition, it also provided that “the lessee shall provide super
speciality facilities such as super speciality diagnostic center including
ultrasound, echo cardiology, CT scan etc. and super speciality in-
patient department”.
Further, it was also stipulated therein that the lessee shall maintain all
the units/clinics/wards of the hospital at its running condition all the
time.
The Central Referral Hospital so leased in terms of its description was
an RCC framed structure of 09 stories with total plinth area of 33551.14
sq.mtrs.
The inspection team of the Medical Council of India that conducted inspection of
the said college on 15 /16/17 October, 1999 amongst other things had observed
in the report as under:-
“The college and the hospital are owned by the Govt. of Sikkim
whereas the day to day running equipping and the staff
procurement of the medical college is by Manipal Pai Foundation.
Thus, in Manipal Sikkim University, the Manipal component is the
-
38-
Manipal Pai Foundation whereas is the Sikkim component is the
Govt. of Sikkim. As such, there is a dichotomy about the
ownership and the manager ship whereas the mandatory
requirement under the Act is that it should be one the same.”
7. MEDICAL COLLEGE AT BHUJ, GUJARAT
After Bhuj, a geographical location in the State of Gujarat was heavily divested
due to earthquake as a part of rehabilitation the Govt. of Gujarat built a
independent hospital for rendering health services to the people thereat. By a
policy decision the said hospital came to be transferred to Adani Industrial
House, vide which a medical college has been created and is in vogue. This is
yet another case of a State Govt. transferring a hospital owned and managed by
it to a private person / trust for opening of a medical college and the application
to the required effect for the same under section 10(A) of the IMC Act, 1956, has
been granted and the said medical college is in vogue.
8. EMPLOYEES STATE INSURANCE CORPORATION MEDICAL COLLEGES
It may be noted that the Director General, Employees state Insurance
Corporation, New Delhi vide letter dated 30.8.2011 forwarded an application for
establishment of Employees State Insurance Corporation Medical College,
Bangalore by Employees State Insurance Corporation, New Delhi u/s 10A of the
-
39-
Indian Medical Council Act,1956. The hospital referred to in the said application
was the 350 bedded Employees State Insurance Corporation Hospital which is
owned and managed by the Employees State
Insurance Corporation under the Ministry of Labour & Employment, Government
of India.
The permission was accorded by the Central Govt. for the said college on the
recommendations of the Medical Council of India in terms of the procedure
stipulated under section 10(A] of the Act, read with governing regulations
thereto. As of now there are six medical colleges that are in vogue vide the said
pattern.
These three instances have been catalogued by the Committee for the
purposes of bringing to fore the utilization of non-teaching hospital for
the purposes of starting a medical college in one case between a
private partner in the form of State University and the other being the
State Government and in another case a Government run Corporation
availing its own service hospitals for starting of medical colleges.
However, these approaches per-se are not reflective of the public
private participation model in total operational sense.
9. AUTONOMOUS COUNCIL FOR GOVT. MEDICAL COLLEGES IN STATE OF MADHYA PRADESH
The Govt. of Madhya Pradesh in terms of a policy decision decided that all the
public funded Govt. Medical Colleges run and managed by the State of Madhya
-
40-
Pradesh would be put under an autonomous council to be headed by the
Minister of Medical Education in the Govt. of Madhya Pradesh. Each of the
colleges would be monitored by an Executive Committee under the overall
umbrella of the autonomous council to be headed by the Divisional
Commissioner of the Revenue Division , where under the concerned college is
located.
By virtue of placing the Govt. colleges under the autonomous council each of the
college was entitled to generate its own resources through its hospital facilities
for running and managing the affairs of the concerned medical college. To begin
with the staff, teaching and non-teaching which was working in the said medical
colleges continued to be paid salary out of the salary grants given by the State
of Madhya Pradesh, till such employees resigned took voluntary retirement,
superannuated or died. The autonomous council authorised the said medical
colleges to employ the eligible people against the vacancies on their own by
adhering to the reservation policy notified by the Govt. Under the autonomous
council the concerned colleges are supposed to bear the financial responsibility
of the salary as well of the incumbents appointed by it. The model has worked
successfully and is in vogue as of now.
However, it has to be borne in mind that the teaching/ non-teaching employees
appointed by the concerned college under the autonomous council are not open
to any transfers of any type. They continue to work in the concerned college.
The said model continues to be in vogue in the State of Chhattisgarh under the
-
41-
aegis of Govt. of Chhattisgarh a State which came to be carved out of the
erstwhile Madhya Pradesh.
10. MEDICAL COLLEGE RUN BY THE MUNICIPAL CORPORATIONS
The civic authorities of the cities as Municipal Corporations of the concerned city have also ventured into owning and managing the medical colleges out of their own resources. The classical examples are Mumbai Municipal Corporation in the State of Maharashtra and Surat Municipal Corporation, Ahmedabad Municipal Corporation in the State of Gujarat.
Nagpur Municipal Corporation was also running its Indira Gandhi Medical College
at Nagpur, however for financial difficulties the college was taken over by the
Govt. of Maharashtra and is now named as 'Indira Gandhi Govt. Medical College,
Nagpur'.
Further the medical colleges run by Surat Municipal Corporation and Ahmedabad
Municipal Corporation have now been put under the State Govt. Sponsored
Society.
11. MEDICAL COLLEGES UNDER STATE SPONSORED SOCIETY
The Govt. of Gujarat has evoked a model by placing certain medical colleges,
owned and managed by it under the society sponsored by the State Govt. of
which the Hon'ble Minister for Medical Education for the State is the Chairman.
Resultantly each of the college is now under the society with liberty to raise its
own financial resources for its cause. By virtue of the nature of the alteration of
-
42-
the said colleges, they have been immune from rendering their 15% seats to the
All India Quota the admissions to which are made by All India Pre-Medical Test
(AIPMT). The onus of salary of the staff is borne by the Govt. of those who were
primarily recruited by the State Govt. and later on came under the ambit of the
sponsored State. However, the teaching staff recruited by the society have their
pay-scales prescribed by it. However, as against the model of autonomous
colleges under the autonomous councils in the State of Madhya Pradesh,
whereby the staff recruited under the society is exclusively for the said college,
the Govt. of Gujarat still holds the authority of transferring the said staff within
the State as a part of governing and prescribed service conditions.12. MEDICAL COLLEGE BY GOVT. OF ANDAMAN AND NICOBAR
(UNION TERRITORY)
In terms of the permissibility incorporated in the governing regulation titled
'Establishment of a new Medical College' notified by the Govt. of India on the
recommendations of the Medical Council of India, the Govt. of the Union
Territory of Andaman and Nicobar availing the District Hospital owned by the
State Govt. thereat have started a Govt. run medical college in Andaman and
Nicobar in terms of scheme submitted by them under the provisions of Section
10(A) of the IMC Act, 1956.
The said model is a variant of the State Govt. owned models in as much as the
hospital that has been availed for starting of a medical college was a District
Hospital owned by the Govt. itself. As the governing regulation prescribes for the
-
43-
said permissibility and also certain relaxation for Union Territory Governments,
the same have been availed in the said model of starting and running of a
medical college by the Govt. of a Union Territory.
13. MAHATMA GANDHI INSTITUTE OF MEDICAL SCIENCES (SEVAGRAM), WARDHA MODEL
As a part of commemoration of Mahatma Gandhi centenary celebrations, the
Kasturba Health Society, which was founded by Mahatma Gandhi himself, a
medical college by name Mahatma Gandhi Institute of Medical Sciences, was
started in the year 1969 located at Sevagram, adjacent to Gandhiji's Ashram at
Wardha. The model pertaining to the said college is unique in terms of funding in
as much as that 50% of the expenditure on the said college is borne by the
Government of India, 25% by the Govt. of Maharashtra and remainder
25% by the parent Kasturba Health Society Trust. The college was
started in a rural set up to ensure that Gandhian Principles are
appropriately indoctrinated amongst the young generation for the
purposes of catering to the cause of health of the rural poor in the
country. The entrance test for admission to MBBS course at the said
college has a unique feature in as much as that the applicants have to
answer a question paper on Gandhian Thoughts and Principles and the
marks awarded thereat are computed with the performance of an
examinee at the remainder of the entrance examination for the
purposes of admission to the said Course. At the commencement of the
-
44-
academic year the students so admitted are required to undergo a
orientation camp of two weeks at Gandhi Ashram, Sevagram to get well
versed with the Gandhian Principles and way of life.
The core incorporation which is the crux of the issue is pertaining to
financing of the medical college. On this count it is necessary to note
that the financing for medical education can be made in the modes of -
1. Private-Private Mode
2. Private Public Mode
3. Public Private Mode &
4. Public-Public Mode
-
45-
A look at the financing of medical education would reveal that as of now three
modes of financing are in vogue.
1. Public funding
2. Private funding
3. Differential Fee Mode
The fourth mode that of Public Private Funding has been given a vent in
terms of the policy frame which has been notified by the Medical Council of
India, on 29th December, 2015. The operational mode permissible there under
is 'Public Private Mode'.
14. ENABLING CONDITIONS FOR A PARTNERSHIP
Any understanding has to have appropriate enabling conditions, so that the sameevolves in a desired manner and fructifies in the desired direction between the 'partners' for mutual benefits. The enabling conditions are :
1. A clear understanding of the responsibilities and obligations between the partners
2. Strong community support3. Need for some catalyst to start the process of partnership
(maybe an individual, a donor, a compelling vision or even a political or economic crisis)
4. Stability of the political (government) and legal climate (laws)5. Regulatory framework that is followed and enforced6. Capacity and expertise of the government at different levels in
designing and managing contracts (partnership)
-
46-
7. Appropriate organizational and management systems for partnerships
8. Strong management information system9. Clarity on incentives and penalties.
15. ISSUE OF EQUIVALENCE FOR RECOGNITION AS TEACHERS
In the context of the Public Private Partnership Mode governing opening of a
medical college brings to fore yet another aspect of recognition of persons
working in the nonteaching hospital to be recognized as 'teachers' in the context
of conversion of the said hospital from non-teaching to teaching hospital. Upon it
being availed for the purposes of opening of a medical college.
The first such occasion arose where under the non-teaching hospitals owned and
managed by the State Govt. by the Central Govt. where postgraduate courses
were permitted and were recognized the teachers teaching thereat were refused
recognition as postgraduate teachers by the examining and affiliating university
on the ground that they did not conform to the prescribed eligibility under the
teachers eligibility qualification regulation prescribed by the Medical Council of
India. In order to tackle the said issue on the recommendations to Medical
Council of India, the Govt. of India amended the Postgraduate Medical Education
Regulation vide a notification dated 15th March, 2005 by providing as under
(Annexure-6) :
"Consultants of specialists who have the experience of working for a period of not less than 18 years and 10 years in the teaching and other general departments in the institutions or
-
47-
hospitals, not attached to any medical college, where with the affiliation from any university, postgraduate teaching is being imparted as contemplated under sub regulation (1A) of regulation 8, shall respectively be eligible to be equated as Professor and Associate Professor in the Department concerned. The requisite experience for equating a consultant or specialist working in the super speciality departments of the said institutions or hospitals as Professor and Associate Professor shall respectively be 16 years and 8 years. Consultants or Specialists having postgraduate qualification, working in such an institution or hospital, who do not have the said period of experience, shall be eligible to be equated as Assistant Professor in the department concerned”
The core principle that has been availed in the said amendment is that the
number of years of professional experience for its equivalence with the teaching
experience are double the prescribed requirement of teaching experience. This
amendment was holding true for the purposes of recognition as postgraduate
teachers of those who were working in the said non-teaching hospitals and also
there equivalence with the corresponding cadre of Assistant Professor, Associate
Professor and Professor respectively at the level of speciality courses and also
that of super speciality courses.
After the permission came to be granted to medical colleges being owned and
managed by Employees State Insurance Corporation with their hospitals, the
issue came up as to how the staff working in these hospitals would be equated
for the purposes of teaching designation. The same came to be regulated
through issuance of an amendment to Minimum Qualifications for Teachers in
-
48-
Medical Institutions Regulation by a Notification dated 6 th August, 2012
published in the official Gazette of Govt. of India which provided as under
(Annexure-7):
1. For the post of Professor : "The requisite experience for equating a
Consultant or Specialist (after possessing postgraduate medical degree in the subject) working in the concerned speciality in a minimum 300 bedded ESI hospitals as professor shall be more than 18 years with four research publication in indexed journals as first author or corresponding author. Such consultant or specialist after joining a medical college shall be called as 'Designate Professor' and on completion of three years experience in the capacity of Designate Professor, such person shall be designated as "Professor".
2. For Associate Professor : "The requisite experience for equating a consultant or specialist after possessing postgraduate medical degree in the subject) working in the concerned speciality in a minimum 300 bedded ESI hospitals as professor shall be more than 10 years with two research publication in indexed journals as first author or corresponding author. Such consultant or specialist after joining a medical college shall be called as 'Associate Professor'.
3. For Assistant Professor : "The requisite experience for equating a consultant or specialist after possessing postgraduate medical degree in the subject) working in the concerned speciality in a minimum 300 bedded ESI hospitals as professor shall be more than 6 years. Such consultant or specialist after joining a medical
-
49-
college shall be called as 'Assistant Professor'.
It is pertinent to note that the said amendment as notified in the official Gazatte
as an amendment to Teachers Eligibility Qualification Regulation by the Govt. of
India on the recommendations of the Medical Council of India is limited to ESI
run and managed hospitals and hence the same cannot be made applicable to
any other similarly placed situation without an explicit amendment to the
required effect.
The Notification that has been issued on 29th December, 2015 on the Public
Private Partnership Model contemplates that the staff working in the non-
teaching hospital which is to be transferred by the concerned appropriate Govt.
to the private applicant for opening of a medical college in respect of its
recognition as teachers in the cadre of Professor, associate professor and
assistant Professor, would be subject to the fulfilment of the prescribed eligibility
in the Teachers Eligibility Qualification Regulation. This operationally means that
the modality of equivalence as is contemplated in the amendment of 2012 to
the Staff working in ESI hospitals for the purposes of opening of medical colleges
owned and managed by ESIS would not be applicable and available to the
colleges under the Public Private Partnership Model vide notification of 29 th
December, 2015.
Taking note of the same the Deputy Secretary in the Ministry of Health and
Family Welfare, Government of India, by a letter dated 28th January, 2016,
-
50-
addressed to the Secretary, Medical Council of India (Annexure-8) has brought
out that :
"The Ministry is implementing a central sponsored scheme (CSS) to establish new medical colleges attached with existing district/referral hospitals. 58 districts in 28 States/UTs have been identified under the scheme with focus on underserved areas. As may be seen, these are district headquarters much smaller in size than big cities where medical colleges are traditionally concentrated. The biggest constraint before the State Govt. / UTS is to find adequate faculties for these medical colleges. In this context, on the request of State Govt. it was considered in this Ministry that the specialists, after completion of PG degree working in these District hospitals may be designated as Professor, Associate Professor and Assistant Profess as per the formula of 18, 10 and 6 years experience in the concerned discipline along with requisite publications as was done in the case of ESI hospitals vide amendment notification dated 06.08.2012.MCI in its letter of 12.01.2016, has alluded to the amendment notification in Establishment of Medical College Regulations, 1999. However, the same will be applicable as terms and conditions of MOU for medical colleges that are proposed to be set up under PPP mode where the State Governments permit utilization of hospitals owned by it for establishment of new medical colleges by any private entity. Under the CSS, the medical colleges are proposed to be established as Govt. medical colleges by the State Governments/ Union Territories themselves. Further associate professor and professor are promotional posts and thus specialists doctors cannot be designated as such except
-
51-
when equivalence is clearly specified. It is therefore requested to reconsider the issue and furnish specific comments regarding the re-designation of PG qualified doctors in the State services as was done in the case of ESP hospitals vide amendment notification dated 06.08.2012."
As such a final policy decision on the said issue is pending as requisite
notification on the said count has not been issued by the competent authorities
that include Medical Council of India and the Central Govt. respectively.
16. CORE PENDING ISSUES
The two important issues that have a material bearing on the realistic and
meaningful operation of the Public Private Partnership model as has been
mooted vide the notification dated 29th December, 2015, which have been
brought out in this report itself are :
1. Recommendation made by the Medical Council of India upon its consideration
at its meeting of the General Body held on 30th March, 2016 to the Government
of
India, in respect of amending clause 2 of the Notification of 29th
December, 2015 to the effect that it should be rephrased as under:
"The appropriate Govt. (Central Govt./State Govt.) as the case
may be may permit an applicant Trust/Society/Company to manage and
run a hospital of not less than 300 beds and all its facilities for a period
of minimum 33 years through invocation of an appropriate
Memorandum of Understanding for Undergraduate / Postgraduate
-
52-
/Super speciality medical education" is pending consideration with the
Government of India.
2. The issue raised by the Government of India, in their communication to
the Medical Council of India dated 28th January, 2016 in respect of
recognition / equivalence of specialists and consultants working in non-
teaching District / Referral Hospitals to be dealt in terms of the scheme
incorporated under the Notification governing ESI Hospitals issued by the
Government of India, on 6th August, 2012 for those applicants under the
Central Sponsored Scheme (CSS] vide the Public Private Partnership
Mode, is pending consideration as of now.
The clearance of these two pending issues are bound to facilitate the opening of
a medical college under a Public Private Partnership Mode as contemplated
under the Notification dated 29th December, 2015.
-
53-
17. FURTHER FACILITATION
Other than the two core issues that are pending consideration which if cleared
would go a long way in facilitating the operation of the proposed Public Private
Partnership Mode, yet another aspect which merits serious consideration is
broadening the scope and ambit of the word 'Public Private Partnership' itself so
as to ensure that it also need to mean as 'Private Public Partnership',
'Public-Public Partnership', and 'Private- Private Partnership' as well.
In this broadening what would be of interest to the State Govt. would be the
'Public- Public Partnership Mode' for a simple reason that in terms of the present
notification the feasibility is of opening a medical college by a private party
availing the transfer / permission of utilization of the facilities of a minimum 300
bedded hospital owned and managed by the State Govt. It is true that the
scheme provides that the interest of the State Govt. can be protected by virtue
of the provision made in Clause -2 to the effect that "the State Govt. may
safeguard the interest of the State particularly in respect of admission
of students under Govt. Quota in the medical college and patient care
in affiliated hospitals of the medical college". However, it is be but a
limited protection, because the nature of the college which is evolving vide the
said scheme ultimately is a privately run medical college and not owned and
managed by the State Govt.
In order to obviate this limitation it is necessary that the scope and ambit of the
Public Private Partnership model as has been brought out vide the Notification
issued by the Government of India, dated 29th December, 2015, on the
-
54-
recommendations of the
Medical Council of India is broadened, so as to provide for 'Public-Public
Partnership' Model as well, whereby the nature of the colleges, which could be
generated thereunder would be owned and managed by the State Govt.
whereby the limitation of protection of interest of the State to a limited extent
vide the Public Private Partnership mode can be done away with nay tided over.
18. OTHER REGULATORY APPLICABILITY
It is a matter of record that opening of a new medical college is governed vide
the regulatory scheme as is incorporated under section 10 A of the IMC Act,
1956 and other governing regulations notified thereto in relation to the same
vide section 33 of the said Act.
Be it regulations governing establishment of a medical college, minimum
standard requirements, teachers eligibility qualifications and modalities
governing recognition thereto, in terms of their amendments from time to time
are applicable to any and every opening of a medical college independent of
their nature be it private or public as the case may be. There is neither any
provision for a 'waiver' thereof or a 'condonation' thereto.
Taking into consideration the overall view of the situation and the various
contexts and factual propositions that have been delineated and accordingly
catalogued in the report, the committee is pleased to observe as under in the
context of the terms and reference that have been attributed to it for their
-
55-
appropriate dispensation.19. STARTING OF POST GRADUATE COURSES :
The policy frame pertaining to starting of post graduate courses that includes
MD/ MS (speciality Courses], Post Graduate Diploma Courses and Super
speciality courses (DM /M.Ch.] is governed by Regulations on Postgraduate
Medical Education 2000 Notified by the Government of India, on the
recommendations of the Medical Council of India and the Regulation governing
establishment of new medical college including postgraduate courses
respectively.
Apart from the eligibility pertaining to starting of a medical college or
postgraduate courses, section 8(1](A] of Regulations on Postgraduate Medical
Education clearly stipulates that 'a hospital which is owned and managed
by the State Govt. / Central Govt. is eligible for starting of a
postgraduate course including super speciality course without the
requirement of having a medical college of its own'. The permission would
be granted to the applicants under 8(1) (A) of the Regulations on Postgraduate
Medical Education by the concerned authorities subject to the fulfillment that
applicant either has a Memorandum of Understanding with a running medical
college in its geographical vicinity or it should have pre-clinical departments
namely that of Anatomy, Physiology and Biochemistry, Microbiology, Pathology,
Pharmacology and Forensic Medicine of the strength as is applicable under
Minimum Standard Requirement Regulation of the Medical Council of India for
-
56-
the purposes of starting a medical college with an annual intake of 50 seats.
Needless to state that the Minimum Standard Regulation for starting of a
medical college have stipulated specific and categorical requirements with
reference to a medical college with an annual intake of 50, 100, 150, 200, 250
as the case may be. As such, the proposed requirement that has been
prescribed pertains to the minimal annual intake capacity that is 50 seats per
annum.
20. APPROACH AT HAND:
The aforesaid policy considerations have been brought to fore for the purposes
of clarifying the policy ambit under which the utilization of Port Hospitals for
their academic utilization would be invoked.
The committee took the stock of the present status of the various Port Trust
Hospitals in terms of the information in the desired tabular format procured from
them in regard to the nature of healthcare services rendered, existing
infrastructural facilities, available working personnel and any academic
utilization, which is in vogue thereat along with the developmental plans that
are being harbored by them, if any.
The information so received was appropriately looked into and based on the
same the perspectives crystallized by the committee were as under:
a) Augmentation of all hospital facilities to Secondary and Tertiary
-
57-
levels of health care.
b) Linking identified hospitals for the purpose of opening of a new
medical college along with ancillary & para-medical courses
including nursing.
c) Evaluating the present status of the 12 hospitals in terms of
assets, services, instrumentation, infrastructure, personnel, cost
of services and clinical workload.
d) Requirement is to be tabulated in terms of minimum standard
requirements and regulations notified by the Medical Council of
India Act with reference to annual in-take of 100 & 150.
e) Feasibility study where this has to be done.
f) What exactly would be the approach including modes permissible
under the present policy and what would be the desired policy.
g) Present level of expenditure per month annually in terms of
medical facilities & HR incurred by each of the Port Hospitals.
In the context of the above, the hospital were grouped into distinct categories
based on their indoor bed strength namely -
a. Those hospitals that had more than 200 beds
b. Those hospitals that had bed strength from 100 to 200
c. Those hospitals that had bed strength less than 100
-
58-
Accordingly, based on the primary evaluation the committee proposed that
certain chosen hospitals would be visited for an onsite appraisal. Accordingly,
visits have been made to Port Hospitals at Mumbai, Cochin, Chennai, Kolkata
and Vishakhapattanam respectively.
The observations on the basis on onsite visit have been computed. Based on the
cumulative comparison and analytical assessment thereto the committee has
ventured into crystallizing its observations thereon.
The development plans which have been formulated by the respective Port Trust
Hospitals pertaining to their upgradation and augmentation of services rendered
have been made known to the Committee and the same would required to be
appropriately linked with the recommendations made by the committee.
The committee has also received the developmental plan for the Paradip Port
Trust Hospital by a consultant agency, which has been critically looked into by
the committee and it is a very meaningful and worthy plan in which needs to be
continued as it is as the same is comprehensively taking stock of even those
propositions which have been attributed to the present committee in the ambit
of its terms of reference for making the recommendations.
In the meantime the collateral happenings have also been taken note of by the
Committee, specially with respect to the Ministry of Health and Family Welfare,
Government of India, in consultation with Government of India, proposing that
the restrictive clause that was put in respect of a company being eligible to open
-
59-
a medical college that which is not for profit to be done away with, so that the
field becomes wide open. This was specially in the context of the fact that
although a company was included in the eligibility criterion in the governing
regulation in respect of opening of a new medical colleges, but as it was
restrictive that the applicant company should be a company not for profit, no
applicant came forward towards the same and the inference was easy to draw,
that the restriction was de-motivating.
The committee has also taken note of the another initiative by the Ministry of
Health and Family Welfare, in consultation with Medical Council of India that the
registered Trust / Societies / Waqf Boards that run an ongoing unaided private
medical college may also be given an opportunity by a suitable amendment to
the governing regulation that they would be also eligible to convert themselves
into a company for running the said medical colleges under them.
Needless to state that these two collateral happenings bear a significant impact
on the issue that the present committee is seized with. As such, how the said
propositions take shape is also a matter of concern of the committee from the
point of view of making necessary suggestions pertaining to the issue at hand
with the committee.
21. RECOMMENDATIONS1. The present mode of Public Private Partnership in terms of the
notification dated 29 th December, 2015, issued by the
-
60-
Government of India, on the recommendations of Medical
Council of India defines a single mode of the Public Private
Partnership, where-under an appropriate govt. can transfer its
minimum 300 bedded hospital to a private party for opening
of a medical college by the concerned private party as an
applicant within the scope and meaning of Section 10(A) of
the IMC Act, 1956. The interest of the Central Govt. in regard
to the extent of permissible admissions and utility of hospital
services from the attached hospitals thereat is limited. As
such, this mode does not go to fulfill the legitimate
requirement of the
Central Government to have its own medical colleges under
the proposed Public Private Mode.
2. The proposed Public Private Mode contemplates recognition to
the staff working in the non-teaching district/ referral hospital
as 'teachers' in the cadre of Professor, Associate Professor
and Assistant Professor strictly in conformity with the
eligibility prescribed under the governing Teacher Eligibility
Qualification Regulation, of Medical Council of India, which
would be non-conducive as staff at such hospitals conforming
to the said eligibility may be either miniscule in number or
non-existent. As such, the problem of requisite number of
teaching faculty with prescribed qualifications would be hard
-
61-
to procure and tough to find.
3. It would be appropriate to pursue the amendment to the
Notification of 29 th December, 2015, proposed by the Medical
Council of India at its meeting held on 30 th March, 2016,
modifying Clause 2, whereby under the Public Private
Partnership Mode the State Govt. instead of transferring its
district minimum 300 bedded district hospital under an MOU
would be required only to permit the utilization of facilities
thereat, which would be far more conducive to the legitimate
interest of the State Govt.
4. It would be equally appropriate to pursue the intent of the
Central Govt. as depicted in their communication dated 28 th
January, 2016, addressed to the Secretary, Medical Council of
India to extend the provision of scheme of equivalence and
recognition of teachers in case of Employee StateInsurance Corporation run hospital for opening of new medical colleges to the proposed medical colleges to be opened under the Central Sponsored Scheme (CSS).
5. It would be in the fitness of things to propose to the Central
Govt. that the applicability of the provision of scheme of
equivalence and recognition of teachers in case of Employees
State Insurance Corporation run hospitals for opening of new
medical colleges be made applicable as it is to the Public
Private Partnership Mode contemplated vide the Notification
-
62-
of 29 th December, 2015, by appropriately amending Clause 7
thereat so that the provision of conformity with eligibility
prescribed by the Teachers Eligibility Qualification Regulation
is done away with, so that the problem of appointment of
requisite number of faculty in conformity with the prescribed
standard regulatory requirements are dispensed of and are
found to be easy to tackle.
6. It may be pursued by the Central Govt. and the Medical
Council of India to broaden the ambit of the Notification of 29 th
December, 2015, so as to include Public-Public Partnership
Mode therein, whereby by a suitable collaboration with the
Public companies and undertakings which per se in their
individual capacity are not covered as eligible to be an
applicant for starting of a medical college, within the scope
and meaning of the eligibility criterion prescribed under the
governing Establishment of New Medical College Regulation
may be availed by the Central Govt. to open its own run
medical colleges.7. The Public-Public Partnership model will definitely give a
desired fillip to the Central Govt. to open new medical colleges commensurate with the need and requirement of the State with least financial burden as compared to any other model as in vogue for the said purpose.
8. In the fitness of things it would be appropriate to await the
outcome of the two core pending issues namely, a) the
broadening of the ambit of the notification of 29 th December,
-
63-
2015 and b) the broadening of the ambit of Teachers Eligibility
Qualification Regulation in terms of the applicability of
06.09.2012 Notification by the Government of India, before
embarking on the present available mode of Public Private
Partnership.
9. During the pendency of the same the Central Govt. may avail
the model of starting of a medical college as has been evoked
by the Govt. of Union Territory of Andaman and Nicobar where
under the concerned State Govt. availing his own District
Hospital has started a State run and managed medical college,
having full control on the admission of students thereto.
10. Further, the Ministry of Shipping, Government of India,
availing its owned more than 200 bedded Port Hospitals and
getting it converted into a teaching hospital may venture in
starting of a medical college owned and managed by the
Central Govt. itself thereby having complete and total control
of the same.
11. Alternatively, the Central Govt. following the public private
partnership model as contemplated in the notification of the
Medical Council of India dated 29.12.2015 and updated by
another notification dated 02.02.2016 transfer a more than
200 bedded Port Hospital at Mumbai to a Society/Trust or
-
64-
Company, as the case may be, for starting of a medical college
and protecting its interest by taking recourse to provisions
included at clause No.2 of the 29.12.2015 notification in
respect of admissions of students under the Govt. quota at the
said medical college and patient care in the affiliated hospital
of the concerned medical college on mutually agreed terms
and conditions ensuring that the services that are being
catered to the registered employees continue to be on the
same terms and conditions for all times without causing any
prejudice to their legitimate claim and entitlement.
12. In terms of the illustration availed by the Committee by an
appropriate extrapolation of financial receipts and
expenditures in regard to a medical college in the mode of
Public Private Partnership as recommended at seriatim 11, the
extent of admissions that can be availed by the Central Govt.
under its quota could be 25% of the total admissions annually
and 25% of the patient care in the affiliated hospital of the
said medical college vide transferring more than 200 bedded
Port Hospital to the concerned Society/Trust or the Company
(Annexure-9- bringing out an illustration with reference to
transfer of 300 District Hospital by the State Govt.), with
a rider that 15% of the annual intake should be earmarked s
the NRI (Non Resident Indian) quota towards which the higher
chargeable fee would be compensating for the fee charged
-
65-
against with 25% Central Govt. quota as a cross subsidy mode.13. The healthcare facilities at other port hospitals at Mumbai,
Cochin,
Chennai, Kolkata and Vishakhapattanam need to be upgraded
into tertiary care facilities vide invocation of Public Private
Partnership Mode under mutually agreeable terms and
conditions ensuring that the services that are being catered to
the registered employees continue to be on the same terms
and conditions for all times without causing any prejudice to
their legitimate claim and entitlement.
14. It would be appropriate that the upgradation to tertiary care
facilities could be worked up in a manner that a particular
super speciality stands assigned to a specific Port Trust
Hospital, which then becomes the super speciality centre for
all referral purposes by the remaining Port Hospitals. As such,
Port Trust Hospital Chennai could be availed for development
of tertiary care facilities in the domain of Cardiovascular
Thoracic surgery, Port Trust Hospital Cochin for Nephrology,
Port Trust Hospital Kolkata for Neurology and Neurosurgery
and Port Trust Hospital Vishakhapattanam for
Gastroenterology and Surgical Gastroenterology respectively.
15. The developmental plans as of now envisioned by the
respective Port Trust Hospitals in vogue to the extent
necessary be merged with the developmental suggestions
-
66-
made in respect to them by the present committee, so that
there is no overlap and the resources do not stand squandered
as they are scares and therefore precious hence are required
to be availed judiciously.16. The developmental plan in regard to Port Trust Hospital
Paradip, which the committee has looked into critically is well conceived and has incorporated the suggestions proposed by this committee in its ambit to a substantial extent and hence needs to be pursued as such.
17. A venture is necessary to start postgraduate courses at the
Port Hospitals other than Mumbai in the relevant specialities,
where the teaching beds are allocable to the concerned
speciality with available qualified teaching manpower in
identified specialities in terms of provisions included at
section 8(1)(A) of the Post Graduate Medical Education
Regulation, 2000 notified by the Medical Council of India by
making an appropriate MoU with the medical college in the
geographical vicinity to fulfill the condition which is prescribed
on the said count.
18. The venture of starting of post graduate courses could be
feasible at Port Hospitals Chennai, Cochin, Vishakhapattanam
and Kolkata.
19. In case of Port Hospital Mumbai if the feasibility of a medical
college does not work up then it should be availed for starting
of Post Graduate Courses in relevant specialities vide the
-
67-
qualified manpower available there including the requisite
number of teaching beds in terms of provisions included at
Section 8(1)(A) of the regulations governing Post Graduate
Medical Education notified by the Government of India, on the
recommendations of the Medical Council of India.20. At Port Hospitals other than Mumbai, Cochin, Chennai,
Vishakhapattanam,
Kolkata and Paradip the upgradation of the existing
healthcare facilities to sumptuous secondary and to some
extent tertiary care level need to be augmented for
enhancement of the quality of the services to be catered to
the relevant stakeholders.
21. All these initiatives as proposed would be under Public
Private Partnership Mode and therefore, could not end up in
any financial liability on the Central Govt. and the proposed
venture even for the starting of the Postgraduate courses
would be in tune with the one which has been worked out for
starting of a medical college in tandem with Port Trust
Hospital Mumbai, including the financial implications and
appropriate balancing of the resultant liabilities in an
illustrative manner.
The committee has ventured with purpose and sincerity to look into the entire
matter to its best possible capacity and bring to fore all that was thought to be
-
68-
relevant and appropriate, in terms of the terms of reference that were attributed
to it.
The committee feels that it is duty bound to record its gratitude to Hon'ble Shri
Nitin Gadkari, Union Minister for Surface Transport and Shipping, Government of
India, for placing his faith and trust towards dispensation of the task assigned to
it. The committee also records its appreciation and gratitude Shri Abhishek
Chandra, Member Secretary and all his associates for rendering required
secretarial assistance from time to time but for which the task accomplishment
would have been tough and difficult.Report submitted to the Hon'ble Union Minister for Surface Transport and Shipping,
Government of India for the needful as may be deemed appropriate.
-
69-
(Dr. Vedprakash Mishra)Honorary Chancellor,
Krishna Institute of Medical Sciences (DeemedUniversity), Karad
ChairmanFor and on behalf of the
Members of the Committee
(Abhishek Chandra)Deputy Secretary, Department of
Shipping, Govt. of India, New Delhi,
Member Secretary
Date : 4th July, 2017Place: New Delhi
* * * *