Dear Ms. Smriti Irani/ Dr.Harshvardhan I am happy that you are approaching your responsibility with the right intent. While you work on an agenda for change, I am pointing out a few things effecting students directly and need an immediate redressal. This part will deal with Medical education only. Medical education is the golden egg for the mandarins at the health ministry and hence HRD ministry is denied any control over it. The fact that India produces only 50,000 doctors an year is a crying shame. It is a deliberate attempt to control supply, create shortage and ensure cartels profiteer. You would have heard of the NEET judgement and the way cartels fought to deny a transparent admission process. They know better - Lesser the transparency, greater the profits. Last year, a medical college was caught with 100 crores of cash in raids during the admission season. Need I say more? The license raj has driven donations for a medical seat northwards. It ranges from Rs.60 lacs to Rs.1Crores per seat for UG, and 2 Crores for PG. You can well imagine the commitment to the profession by Doctors who come out of such a system. - Any increase in capacity of medical education seats has a price tag of Rs.One crore per seat to be paid as bribes. Typically, a sanction is for 60 seats at the least. That is the scale of rot in the system. - a one time payout doesnt end the rot. We also have annual payouts. You would be surprised that the sanction letter most medical colleges is renewable each year, to enable the mandarins their cut every year. The rate cards for bribes are fixed. - The chairman of Medical Council of india is elected by a set of members of MCI. As an election promise, the members are promised a certain number of inspections every year, to earn for themselves ( the price for their vote in electing the chairman). - The model for setting up a medical college are many, but I will explain two models which I know. Model A - The person setting up a medical college has fixed everything because of access and having worked the system. He has the land and sets up a trust. He then collects donations to the trust. It is in multiples of 5 Crores. For every 5 crore of donation to the trust, a medical seat every year is given for life. The donor earns 1 crore as donation by selling that seat, every year. So, it is a 1 crore annuity for life time on an investment of 5 Crores. And the medical college is thus set up with donations from the rich and based on access, corruption and political patronage. The project cost is 150 crores for a 60 seat college. 30 seats are thus given away to donors and the balance 30 seats is for the Entreprenuer! After this, Growth is fuelleed with internal accruals. Model B - The eduprenuer sets up the infrastructure, gets all the permissions etc. The first years fees is allocated as bribes - from ministry to the regulators to inspectors. So, if the capacity is 120 seats, the bribes would be 120 crores paid right through the ministry downward. At every level the rates are fixed and non negotiable. The cost of the project is infrastructure + first years fees and donations. What can you do? Here are a few simple suggestions: - Enforce a common entrance test and admission process across the medical colleges in the country. In the interim, go for an ordinance that will stand judicial scrutiny. Usher in an era of transparency. Enforce it on all medical colleges. Let a student know where he stands. Declare a merit cum rank list through a common admission test conducted by a competent authority. - Ensure proper coordination between the health ministry and HRD ministry. Ideally medical education must move to HRD ministry, but who would give up the golden goose? Health ministry has enough on its hands to make the nation healthy, and it is strange that they want to control medical education? Only a honest minister will have the conviction to give this up. Can you, Dr.Harshvardhan? - Start increasing supply. Have a target of adding 10,000 seats per year for the next five years, thus doubling your capacity. This will reduce the donations and resultant corruption. - As an immediate measure, double the capacity for state and central funded medical colleges like AIIMS etc. At the least they will not use increased capacities to fleece more donations. - All costs ultimately are borne by the students. Reduce the corruption at all levels. Create transparency. Give permissions with 5 year terms. Kick the yearly renewal out. Build trust between the institution and the ministry. Monitor any complaints with inspections. Control by exception. I hope you can redress issues dealing with medical education immediately. The ROI for a student is impossible with the current costs. The nation needs more doctors, but not in the current format. I hope you can solve these pressing issues with conviction and honesty. Will you do it, or you will me more of the same? I hope the badlaav you promised is real and not cosmetic. Warm regards Maheshwer Peri
Posted on: Wed, 04 Jun 2014 11:19:17 +0000
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