The replacement bill the govt is planning to introduce will deal a blow to efforts at improving medical education

The government on Sunday withdrew the Medical Education Ordinance Replacement Bill from Parliament following the fierce protest from the main opposition, Nepali Congress (NC), over its contents on key issues. The replacement bill, which was tabled by Minister for Education, Science and Technology Giriraj Mani Pokharel, was not in conformity with the ordinance introduced by the previous government and issued by President in October last year. The Ordinance on Medical Education was reintroduced by the incumbent government on April 26. The ordinance on National Medical Education was introduced following an agreement with Dr Govinda KC, a senior orthopaedic surgeon, who during his various fasts-unto-death had demanded that medical education should be made affordable to the meritorious students and that the government should provide more scholarships to MBBS and MD students in public medical institutions. As per the constitutional provision, a replacement bill of an ordinance should be tabled in the House within 60 days of the first meeting of Parliament. The deadline to table the replacement bill on ordinance expires on Wednesday after which its legality will cease to exist. It means that the old law will prevail until the new bill to this effect is enacted by Parliament.

The replacement bill was designed to facilitate the private sector to open more medical colleges in the Capital and in urban centres. It has now become evident that the government has been influenced by a handful of private players who have already obtained letters of intent from the Ministry of Health to open medical colleges even without having fully functional hospitals. The replacement bill has been revised in many areas. The ordinance, as per the deal with Dr KC, has provisions under which no new private medical colleges shall be allowed to open in the Kathmandu Valley for 10 years; a private institution must have to run a 300-bed medical hospital and a 100-bed hospital each for dental and nursing course at least for three years to obtain a letter of intent; a university cannot issue affiliation to more than five medical colleges; and 75 per cent of the total students in public medical institutions should get scholarship. These provisions have been removed or made quite vague in the replacement bill.

The bill says a medical education commission chaired by the prime minister shall determine the scholarship quota in public medical institutions. This is a clear deviation from the ordinance. The replacement bill also states that a private medical college fully funded by the domestic investor(s) should provide 10 per cent scholarship while the quota has been doubled for foreign joint ventures. It will discourage FDI in the medical education sector. The replacement bill, it seems, aims to open the doors for a handful private players which are motivated by profiteering rather than imparting quality medical education. If this bill is reintroduced in Parliament and passed as it is, it will not bode well for the country. If more medical colleges are allowed to run in the Valley and in other urban centres, people in the remote areas will always be deprived of quality health services for which Dr KC has been on the fast-unto-death, now in Jumla for the 15th time.

Accountability is key

A suspension bridge over the Aduwa Khola at Haldibari Rural Municipality in Jhapa has collapsed within a month of its construction. According to reports, the bridge collapsed due to its faulty design. This is an example of how public works are carried out in the country. Faulty designs and substandard construction have been the bane of various infrastructure projects in Nepal. Contractors are often blamed not only for massive delays but also for using substandard materials. Such negligence on public works while means loss of money, it can also put people’s lives at risk.

In the case of the said suspension bridge, there seems to be something wrong with the design. But there seem to be various faults in the system when it comes to public works. The root of the problem is lack of accountability. There is a need to set up strong monitoring mechanisms to ensure that contractors do not play foul. The government should not turn a blind eye to the construction of infrastructure that is of public interest. The government must hold accountable those who fail to abide by due procedures.