Draft Report of the High Level Group on Services Sector

5.2.5 Health Education
Medical education is highly regulated and there is an access barrier for setting up new medical and dentist colleges. Eligibility for setting up medical or dentist colleges is limited to the following organizations:

1. 
   A State Government/ Union territory;
   
2. 
   A University;
   
3. 
   An autonomous body promoted by Central and State Government;
   
4. 
   A Society registered under the Societies Registration Act, 1860(21 of 1860) or corresponding Acts in States; or
   
5. 
   A public religious or charitable trust registered under the Trust Act, 1882 (2 of 1882) or the Wakf Act, 1954 (29 of 1954).
   

What is significant here is that the corporate sector is not eligible and only not-for-profit organizations can apply. The private sector medical and dental colleges that have been established in large numbers have all done so by setting up not-for-profit societies.

For medical colleges another access barrier is the condition that the applicant must own or possess a suitable single plot of land measuring not less than 25 acres by way of 99 years lease for the construction of the college. For dental colleges the requirement is less restrictive and only an area of 5 acres is required and that too for a minimum period of 30 years. For nursing colleges it is significant that companies are eligible to set up nursing colleges and schools and there is no bar on commercial (for-profit) organizations. Further instead of the requirement for a specific area of available land, the requirement is for built up space. However, here too there is an access barrier as the requirement of a large size campus of more than 23 000 square feet for the college and 30,000 for the hostel is out of proportion of the requirement for a 50-seat college.
For the paramedical personnel there several institutions, in the States but also in the private sector but these are unregulated and there is lack of uniformity in the training imparted. For regulating training of paramedics it is proposed to set up the Paramedics Council and a Bill for the same has already been introduced in Parliament. Separately, there is also a proposal in the Ministry of Health & Family Welfare to set up a National Institute of Paramedical Sciences (with branches in New Delhi and Chennai) for undertaking and coordinating training programmes in the country in collaboration with State Governments. The Ministry is proposing to use distance education to ensure large coverage of the training programmes.
Besides the problem of the numbers of healthcare personnel there is an acute problem of quality as well. Some of the private colleges are produce graduates far below the standards required but the Government colleges have also deteriorated, in part because of shortage of staff, the vacancies remaining unfilled because of unattractive remuneration. In Government medical colleges another reason for deterioration of the quality of medical graduates is that they do not get the opportunity to observe the treatment of patients because of the fall in the number of patients coming to Government hospitals for treatment.