Sunday, September 8, 2013

Unethical Practice where and how happening and destroying Quality of Medical Education in India

Need for Awareness about unethical Practices by the Private Medical Colleges
Unethical Practice where and how happening and destroying Quality of Medical Education in India
Hon’ble SC in a recent case Rohilkhand Medical College & Hospital, Bareilly vs. Medical Council of India & Another, made following observation which are important to know why Quality of Medical Education in India deteriorated and Faculty Members have been exploited or indulged in unethical practices. This awareness is important to prevent such practices in future.
SC Observations:
SC observed that we  have  noticed  that  the  Central  Government  had  accorded approval for 3rd batch of 100 students for the academic year 2008-09 on 26.09.2008, despite the repeated negative recommendations  made  by the MCI and before the grant of permission on 26.09.2008, the MCI  was not even consulted.  We have indicated the facts to show the situation that prevailed in the year 2008-09 and the manner in which permission was accorded for intake of 100 students by the Central Government. [Para 17]
The MCI, following its decision taken on 04.06.2013, vide its letter dated 20.06.2013 decided to convey its approval for renewal of permission for admission for the second batch of MBBS students against the increased intake i.e. from 100 to 150 seats to the College for the academic year 2013-14. The approval was granted taking into consideration of the assessment report dated 26/27-02-2013 submitted to the Board of Governors of MCI subject to certain conditions which are extracted herein below:
“I am further directed to inform that you and your institution are fully responsible to fulfil and maintain norms including the infrastructure both physical and human resource, teaching faculty and clinical material, etc. throughout the  academic  year, as stipulated in Regulation of Medical Council  of  India. In case false/wrong declaration or fabricated documents  have been used for procuring permission of the Board of Governors for the increased intake and  the  said  misconduct  is  brought  to notice or comes to the knowledge of MCI at any stage during the current academic year, your institution is not liable  to  be considered for renewal of permission against  increased  intake for the next  academic year and  this  renewal  of  permission against the increased intake for the next academic year and this renewal of permission against the increased intake is also liable to be revoked for current academic year. Besides, MCI is entitled to take all such measures against you and your college/ institution as permissible under the law.” [Para 19]
Unethical practices: Capitation Fees
We may notice with concern the unprecedented growth of the Technical and Medical Institutions in this country which has resulted in widespread prevalence of various unethical practices. Collection of large amount by way of capitation fee running into crores of rupees for MBBS and Post-Graduate seats, exorbitant fee,  donation  etc,  by many of such self financing institutions,  has  kept  the  meritorious financially poor students away from those institutions.  Pressure, it  is also seen, is being  extended  by  various  institutions,  for  the additional intake of students, not  always  for the  benefit  of  the student community and thereby serve the community, but for  their  own  betterment. [Para 24]
We are not commenting upon the acceptability, or otherwise, of the charges leveled against the Minister, bureaucrats or the Chairman of the College.  But the fact remains, the CBI after conducting an investigation had to charge-sheet them under Section 120B, 468, 471 IPC and Section 13(2) read with Section 13(1)(d) of the PC Act. CBI’s investigation prima facie establishes the criminal conspiracy between the Chairman of the College and the then Union Minister of Health and Family Welfare, Government of India, New Delhi along with the then Deputy Secretary, Ministry of Health and Family Welfare, New Delhi, two doctors, one is the head of Nephrology  VMMV and Safdarjung Hospital and  the other  is  Professor of Department of Community Medicine, VMMC and Safdarjung Hospital, New Delhi which  lead  to  the issuance of the order passed for the additional intake of 50  students for the academic year 2008-09 on 26.09.2008. For the prosecution of both the doctors necessary prior sanction was obtained from the competent authority by the CBI. [Para 25]
The CBI, in its charge-sheet, points out serious infirmities in the  report  submitted  by  the  central  team,  which  conducted  the  inspection of the College on 25.09.2008, which are as follow:
“The above chart clearly proves that accused Dr.Vindu Amitabh and accused Dr.S.K. Rasania were party to the larger conspiracy and they deliberately by way of limiting the shortage of faculty to 2% in their report; had glossed over the glaring deficiencies in the strength of the faculty members (15% i.e. 17 out of  115) and  thereby,  facilitated the private College in getting  permission of the Central Govt. [Para 26]
Their involvement in the criminal conspiracy is further established by the fact that during the inspection they did not ask the faculty members as to whether they (faculty members) were full timers or part-timers/merely called to make up the members for the purpose of inspection. The investigation has established that at least 5 doctors, namely, Dr.Harbeer Singh Sodhi, Dr.Anil Madan, Dr.Birendra Kumar Sinha, Dr.Jamaludin and Dr.Shiv Nath Banerjee, who have been shown as full time faculty members and residents in the records of Rohilkhand Medical College, Bareily during 2008, have confirmed that they had never worked as full-timers in the said College during 2008, but were rather, visiting faculty. These facts prove that the inspection report of accused Dr.Vindu Amitabh and accused Dr.S.K. Rasania was perfunctory and biased in favour to the private Medical College. [Para 26]
The investigation further disclosed that accused Dr.Vindu Amitabh and accused Dr.S.K. Rasania have claimed to have done personal inspection of the -wards and the departments. In their inspection report, they mentioned that the presence (of patients in the OPDs of all Departments was good, the bed occupancy was about 90% and that the ICU was full to its capacity. However, during the investigation, physical verification of 14 patients, who were shown present in the OPD registers on the date of inspection, i.e. 25.09.2003, was got conducted through the Postal Deptt. on the random basis. It was revealed that 09 of them were fake or non-existent.  The claim of the accused doctors of the Central Team of having done personal inspection of the  wards  and  the departments, which was one of the  important  criteria,  on  the basis of which they gave a green signal  to  the  College,  thus turns out to be devoid of merit and a falsehood. [Para 26]
Fake and forged Documents:
The investigation further revealed that the Central Team comprising of accused Dr. Vindu Amitabh  and  accused Dr.S.K. Rasania  has  stated  in  its  report  that  it  accepted  the photocopies of the declaration  forms,  submitted  to  MCI,  for verification.  During the investigation, it  has  been  revealed that declaration forms are provided by the College concerned, include details  of  all  faculty  members,  their  educational qualification,  appointment  letter,  identification documents (like PAN card, etc.) documents in support of their residence in the Medical College (like ration card, in order to certify their being permanent faculty members there). [Para 26]
Visiting Faculty used for MCI Inspection:
During the investigation, 5 so called faculty members (Dr.Harbeer Singh Sodhi, Dr. Anil Madan, Dr. Birendra Kumar Sinha, Dr.Jamaludin and Dr. Shiv Nath Banerjee) have stated that they used to be called only for the inspections of the said College. [Para 26]
They were at best, visiting faculty members.  Incidentally, the MCI rules have not provision for part-timers or visiting faculty members. Though the - said 5 doctors have owned their signatures on their Declaration Forms, they have denied receiving the appointment letters shown to be annexed with their respective declaration forms. They have also stated that the ration cards, residential certificates, Form-16 (Income Tax) etc. shown as having been issued in their names, were never given to them. Besides, it has been found that they are all bogus/fake and forged, as they (the doctors) were neither resident on the addresses shown in the records nor had they ever applied for any ration card. The District Supply Officer, Bareilly has denied their issuance and confirmed that the said ration cards are fake and forged.  It is pertinent to mention that the fake ration cards have been used by the College authorities to falsely establish before the MCI Inspectors that the said doctors were their permanent faculty members. Similarly no Form-16 was ever issued to them by the College. [Para 26]
The investigation further disclosed that in case of the aforesaid doctors, the appointment letters were issued in their name by the College authorities without their knowledge and the details of appointments do not even bear the signatures of their doctors/employees of the College in the acceptable column. This proves the fabrication and use of (forged) documents by the College authorities, for the purpose of obtaining the approval of Govt. of India on the recommendations of MCI/Central Team deputed by GOI.  However, the accused doctors i.e.  Dr.Vindu Amitabh and Dr.S.K. Rasania of the Central Team in pursuance of the criminal conspiracy did not confirm the genuineness of the documents put up by the College authorities and without verifying the documents accepted photocopies of the Declaration Forms and furnished a positive report in favour of the College on the very next day. It is pertinent to mention that despite mentioning about the presence -of such doctors, who were even practicing in Bareilly and the non-production of the  original  appointment  letters,  even when asked for, the said Central Team still went ahead to give clean chit to the College. ” [Para 26]
Capitation fees charged:
SC further added that we can also take judicial notice of the fact that many a times the medical colleges and engineering colleges and others are being established after availing large amounts by  way  of  loans  from the financial institutions and other borrowings, with no  funds  of  their own, and once the college gets approval and students  are  admitted,  loan availed of is being repaid from the capitation fee charged from the students and ultimately  that  amount constitute  their  capital. [Para 27]
Many a times, even without any sufficient facilities they put pressure on the various agencies and the Central Government and get approval overlooking the regulatory  authority,  like  MCI,  which  adversely affects the  quality  of  medical education  in  this  country.  For instance, the MCI has taken in the instant case a consistent view and sent negative reports to the Central Government, but overlooking all the reports submitted by the MCI, the Central Government got a  report of its own and granted permission vide its  letter  dated  26.09.2008. [Para 27]
CBI in its charge-sheet has categorically and clearly reported that this was done on the basis of bogus, fake and forged records. CBI noticed that the college authorities had produced fabricated  and  forged documents before the inspection team and  the  team  failed  to verify  the  correctness  or  otherwise  of  those   documents.  CBI investigation has revealed  that  fraud  has  been  practiced  by  the Central team as well as the college to get the sanction  for  the  3rd batch of MBBS students for the academic year 2008-09. [Para 27]
K.S. Radhakrishnan, J., A.K. Sikri, J. Rohilkhand Medical College & Hospital, Bareilly vs. Medical Council of India & Another, Writ Petition (Civil) No.585 of 2013, Date of Judgment: September 06, 2013,

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