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What is the National Nursing & Midwifery Commission Bill 2020?
On November 5, the Ministry of Health and Family Welfare (MoHFW) informed the general public that it is proposing to scrap the existing Indian Nursing Council Act, 1947, and bring in a new law to set up a new National Nursing and Midwifery Commission. The Ministry has circulated a draft of the Bill and invited comments and recommendations by December 6.
According to the Ministry, the objective of the proposed bill is to provide for regulation and maintenance of standards of education and services by nursing and midwifery professionals, assessment of institutions, maintenance of a Central Register and State Register, and creation of a system to improve access, research and development and adoption of latest scientific advancement.
The existing law provided for the setting up of an autonomous regulatory body called the Indian Nursing Council (INC) which provided the standards for nursing qualification and recognised nursing educational institutes.
Why are healthcare professionals protesting against this Bill?
Activists and healthcare workers have said that the Bill does little to help frontline workers and is instead diluting the provisions of the previous law to give the Centre more control. According to the All India Government Nurses Federation (AIGNF), while making the draft of the Bill, the Health Ministry did not pay heed to the opinions of a vast section of the nursing professionals across the country.
In a letter dated November 11, G K Khurana, general secretary of the AIGNF, pointed out to the President of India that 95% of the nurses in India either work in hospitals or public health centres, and only 5% of the nurses are involved in the educational branch. However, the opinions of these 95% of nursing professionals were not taken into consideration while drafting the Bill. According to AIGNF, this huge change in the structure of nursing education was proposed without consulting the federation despite it being the only organisation that represents nurses of government hospitals, public health centres, and teachers of nursing colleges.
Who will be the members of the new commission?
One of the main concerns of this draft Bill is the abolition of the Indian Nursing Council (INC), which is a largely autonomous body under the Health Ministry. The INC is proposed to be replaced with a National Nursing and Midwifery Commission (NNMC). Members will not be elected but appointed by the central government based on recommendations made by a search-cum-selection committee, which will be chaired by the Cabinet Secretary. Other members of the search committee will include four experts with more than 25 years of experience in the field of nursing and midwifery education, public health nursing education and nursing health research; one expert with more than 25 years of experience in the field of management or law or economics or science and technology and the Secretary, MoHFW. All five experts will be nominated by the central government.
This search committee will then nominate 40 members to the NMMC, including representatives from nursing institutes and hospitals, and eminent members of the nursing and midwifery professions.
By doing away with elections and holding all powers to nominate members, the proposed new law gives immense power to the central government, taking away the opinions of states, say critics.
The proposed NNMC has similar objectives as the National Medical Commission (NMC), which was established in September 2020 after scrapping the existing Medical Council of India. Doctors from across the country had protested against the move but the Centre did not pay any heed. Like the proposed NNMC, the NMC too has 25 members appointed by the central government based on the recommendation of a committee.
Why are the nurses threatening to protest?
The ongoing pandemic has placed a huge burden on the healthcare professionals, especially nurses, working in government hospitals and public healthcare facilities, which are already severely understaffed. Nurses across the country have been protesting with demands for regulated norms of service and patient care, fixed details of the nurse to patient ratio and improvement of working conditions. Now, the proposal for this new Bill has angered them further.
According to the AIGNF, all the steps that the current government has taken in the recent past have made the lives of the nursing professionals difficult. They pointed out that for years, they have been urging the government to create a centralised system for the redressal of issues faced by nurses. However, the MoHFW has apparently not done anything to make their jobs easier. The AIGNF has also released a 29-point dinner charter apart from urging the government to properly consult the stakeholders before finalising the Bill.
The federation has said that if their demands are not met, they will start a national agitation within a month, and the central government will be responsible if the patients in the hospitals do not receive adequate care.
Meanwhile, 2020 has been declared by the World Health Organisation (WHO) as the International Year of the Nurse and the Midwife in honour of the 200th anniversary of Florence Nightingale’s birth and to highlight and advance the vital role played by nurses in transforming healthcare. According to the AIGNF, in the same year, the Indian government has shown nothing but apathy towards nurses.