Amendment to NMC bill will enable nurses to prescribe medicines

Nurses in Bhubaneswar Training nurses taking oath in Bhubaneswar | PTI

A number of amendments to the National Medical Commission (NMC) Bill have been recently approved by the Union cabinet, chaired by Prime Minister Narendra Modi. The NMC Bill is a wide-ranging legislation for reform in medicine.

Some of the key amendments include:

  • A final MBBS examination, the National Exit Test (NEXT), will serve as a common exam across India and as a screening test for doctors with foreign medical qualifications to practice in India. Also, having appeared for NEXT, students would not have to appear for a separate exam after MBBS to get a licence to practice.
  • A second key amendment will allow an army of nurses with additional training to soon be able to prescribe medicines.
  • Third, the government has introduced "severe" forms of punishment including a provision for imprisonment of up to one year, along with a fine extending up to Rs 5 lakh, for any unauthorised practice of medicine, so as to keep a check on unqualified practitioners.
  • Fourth, the provision for a bridge course for AYUSH practitioners—which allowed them to practice modern medicine to a limited extent—has been removed.
  • Fifth, the maximum limit of 40 per cent seats for which fees would be regulated in private medical institutions and deemed universities has been increased to 50 per cent. The fees would also include all other charges taken by the colleges.

The Centre considered the recommendations after a Department related Parliamentary Standing Committee (DRPSC) report was tabled in Parliament on March 20 and after feedback was received particularly from medical students and practitioners regarding certain provisions of the bill.

Also, the amendments in the NMC Bill were made with an attempt toward addressing the dismal doctor:patient ratio of 1:1,600 in India, as against 1:1,000 as mandated by WHO (World Health Organisation). Accordingly, the DRPSC recommended giving limited drug prescription rights to nursing practitioners or pharmacists instead of AYUSH experts, and a new provision got drafted in the bill to grant a limited licence to practice medicine to non-MBBS medical practitioners, known as 'mid-level medical practitioners'.

The amended provision recently cleared the cabinet hurdle and will now be part of the official amendments the government will move to the NMC Bill in the next session of Parliament. According to the bill, "The mid-level medical practitioners will get a limited licence to practice specified medicines in primary and preventive healthcare settings and in other settings under the supervision of a medical doctor."

The bill also provides for a separate register to list such mid-level medical practitioners with limited drug prescription rights. These mid-level medical practitioners include nurses with specific training, pharmacists, physician assistants and optometrists.