The NNMC Bill has been much-talked about for its initiative to make working standards and occupational guidelines better for nursing professionals throughout India. It is also part of the pioneering measures taken by the Central Government to revolutionize medical and nursing sectors country-wide while addressing pressing problems.
This has been the widespread opinion of almost all stakeholders who are already hailing the NNMC Bill as a major reform for the nursing sector countrywide. However, as they say, critics will remain and there will be those with ideas/suggestions for incorporation into these measures accordingly.
Dr. Amar Jasani speaks out
Dr. Amar Jassani has adopted a skeptical position on the NNMC Bill.
In an extensive discussion relating to the NNMC Bill, Dr. Amar Jasani, noted doctor, shed some light on the bill and its implications. He talked of how the previous regime built an opinion that the medical councils were controlled by corrupt people. He opined that the people in the Council were also present in the medical associations. Historically, the establishments of councils was a recognition by society of the occupation becoming a profession.
Jasani stated that there was previously 50 years of struggle to get recognition of medical profession as a legally accepted occupation in the UK earlier. He questioned why nurses did not have representation in the Indian Council for Medical Research and the paucity of funds for nursing research. He highlighted the issue of midwives, talking of how there should be a separate Act or Bill for midwifery, requiring a major political campaign. Unless women’s organizations and reproductive health NGOs are taken into the fold, it will be difficult. External support will have to be mobilized for getting the bill amended.
He also opined that with its majority in Lok Sabha, the Government is known for passing bills swiftly. This is how the Medical Council bill was passed without discussions. He added that midwifery is not being seen seriously owing to opposition from gynaecology associations since they have competing interests and the second point is that there are concerns over community-based delivery work.
The doctor also added that a strategy has to be built for including the demand for midwifery within the aegis of the bill. He talked of how ethics remain really important, highlighting another vital area in his opinion- the need for autonomy and independence in nursing and its need for proper social status along with its own governing body. Is there a good code of ethics for nursing asked Dr. Jasani while asking whether it gives you power as a council to take action if there is any interference in the profession. There are three occupational aspects, i.e. how you behave with your clients, how you behave with other inter-linked professions and lastly, obligations to larger society. The second part is where there can be a concerted effort to gain autonomy, with every mode of interference considered a violation of professional ethics. If the commission will be passed, then there will be autonomous board for ethics. Who will write code of ethics for them asked the doctor, talking of how there can be a draft that can be deliberated upon.
If the commission bill becomes a law, there should be a strategy to interact with the commission and try to push some of the criteria like code of ethics, criteria like how the nursing institutions will be regulated and controlled according to him. Public health goals will not be possible if profiteering is allowed in nursing and health education according to him while hindering universal access to healthcare. He opined how the American model is being followed where money is being made by leading players and nurses become slaves of corporate hospitals ultimately owing to higher debt. This should be taken up as part of a bigger campaign arising due to the NNMC Bill.
What Professor Dr. Roy K George feels
In another discussion, Professor Dr. Roy K George opined that trust issues of women’s empowerment and trust issues should be solved while highlighting autonomous boards suggested in the commission, stating the importance of the separate board for nursing service and quality. This board should fix nursing qualifications, inspect institutions, inspect working conditions and so on. It should also look into minimum salary requirements according to him. He added that the procedure was however completed with all possible feedback taken into account across city and State branches.
Dr. Bimla Kapoor opines
Dr. Bimla Kapoor has talked about the extensive procedure of finalizing the NNMC Bill. She talked of how the Government is being requested to bring up the Bill in the next Parliament session with a Gazette notification in early January or February next year. She also talked about how a fully democratic procedure was followed with the bill being put up in the public domain as well. Dr. Kapoor also clarified that they had previously talked about State Nursing and Midwifery Registration will have same powers as National Nursing Midwifery Commission although the latter will handle the queries. Commission has not demarcated between nursing and midwifery, it will only come when midwifery practitioner and associates are being talked about. That will come in the Act where the Academic Council should decide about Midwifery Council and other aspects for framing all regulations, enabling them to practice. The Government has put it together according to her. She talked of how nursing has a future and how we should all believe in it and work hard for it.
Dr. Maria Therese and her views
Dr. Maria Therese also talked of the bill, stating that when she went through the draft, she felt that there are no points/elements covering fixation of salary for nurses and also how nurses were being treated as being subservient to medicos. In response to queries regarding pension schemes and insurance for nursing professionals and equal salary structures across Government and private sectors, she agreed, stating that these are areas to be highlighted and emphasized.
Opinions have also come up regarding welfare of students who are dealing with patients and are vulnerable during pandemics and for picking up other infections. Dr. Therese stated that how there are many private clinics appointing unqualified nursing officers. This is one area which has to be recognized.
All in all, most stakeholders remain in concurrence about their hope and optimism for a brighter future with the NNMC Bill, while talking about how some amendments were necessary as well.