Mid-level health cadre to prescribe drugs

Aditi Tandon

Tribune News Service

New Delhi, May 3

The government has moved quietly to create a new cadre of non-MBBS medical professionals with rights to practise and prescribe medicine in specified areas and under specified conditions.

The move comes after the Parliamentary Standing Committee on Health rejected the National Medical Commission Bill provision enabling Ayush practitioners to prescribe a listed set of medicines after taking a bridge course.

Taking a cue from the committee’s recommendations to consider giving limited drug-prescription rights to nursing practitioners or pharmacists instead of Ayush experts, the Ministry of Health drafted a new provision in the Bill to grant limited licence to practise medicine to non-MBBS 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.

The new provision coins a new term, “mid-level medical practitioners”, who will get limited licence from the NMC to practise medicine.

“Mid-level medical practitioners will get limited licence to practise specified medicines in primary and preventive healthcare settings and in other settings under the supervision of a medical doctor,” says the new section in the Bill. The Bill also provides for a separate register to list such mid-level medical practitioners with limited drug prescription rights. This register will be maintained by the Board of Ethics under the NMC, which will replace the Medical Council of India once the law is passed by Parliament and assented to by the President. So far under the Indian laws, only MCI-licensed and registered medical doctors can practise medicine and prescribe them.

Once through, the new cadre of mid-level medical practitioners will get to prescribe specified medicines independently in settings specified by the NMC and in hospital settings such as ICUs under medical doctors’ supervision.

Those who qualify as mid-level medical practitioners include non-MBBS medical professionals such as a nursing practitioner who has done a specific nursing course like tertiary nursing care; pharmacists, physician assistants, optometrists, among others, ministry sources said. These practitioners will be specifically listed by the NMC.

So now under the amended NMC Bill there’s a provision to maintain two registers — one of licensed MBBS doctors and the other of specified mid-level medical practitioners with limited medicine prescription and practising licence. The idea is to tide over the crisis of dearth of doctors in rural areas. India’s doctor-patient ratio is a dismal 1:1600 as against the WHO mandated 1:1000.