The government has finally publicized the much-awaited report of the high-level committee on medical education led by former vice chancellor of Tribhuvan University, Kedar Bhakta Mathema, and also promised to implement recommendations of the report within a month. This is good news. Our health sector is in a complete mess: Millions are deprived of basic health services and medical education is too expensive even for students from middleclass families. We welcome this development, for many recommendations of this report, we are confident, could be milestones in the development of a more accountable and service-oriented medical sector. For one, it recommends for a single autonomous medical education commission for regulating medical education, instead of current provision in which there are separate councils for regulating medical education, health professionals, nursing, and pharmacy and ayurvedic medicine. It is against granting affiliation to medical colleges in Kathmandu, Lalitpur and Bhaktapur to run bachelor's programs in medicine, dentistry and nursing for the next 10 years. The report advocates for one public health educational institution running bachelor's programs in medicine in each development region, limits fees for MBBS program at Rs 3.5 million, and above all, advocates for merit-based admissions in both government as well as private medical colleges. Rightly implemented, these recommendations can ensure health care to Nepalis and better regulate medical education sector. But doubts remain as to whether the report will be implemented.
It has come to the fore that there are various interests groups and "medical mafia" bent on delaying (or even stopping) the implementation of the report. The report was submitted to the Prime Minister a month ago. Then it was sent to the Social Committee of the cabinet headed by home minister and UML leader Bamdev Gautam. Education Minister, Home Minister and Minister for Health deliberately delayed making it public because they were trying, we are told, to protect interests of party leaders or their cronies who have had significant investment in country's private health institutions and medical colleges. There is a design, reveals the Committee head Mathema, to delay its implementation so that colleges can take admissions and charge fees according to old rules. The government decision to constitute a sub-committee, manned by bureaucrats with no representation of experts, and allow it one more month to study the report is fishy.
There is ample room to doubt that there will be attempts to shelve the report, as has happened with most good reports in Nepal. If that happens it will not only be an insult to Dr Govinda KC and the noble cause for which he is fighting but will be in serious breach of people's aspiration for solid health reform. A selfless doctor who has devoted his entire life to the sick and needy and led a crusade against medical mafia, Dr KC has warned of another protest if attempts are made to disregard the Mathema report. It will be unfortunate if the noble soul will have to put his life on the line yet again. In principle, the report seems to address vital demands raised by Dr KC during his fifth fast-unto-death four months ago. All that the government needs to do is to fully implement the report at the earliest possible.
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