Discussed: National Commission for Allied and Healthcare Professions Bill 2020

The then Union Minister of Health and Family presented a bill in 2018 called the Allied Healthcare Professional Bill. Barring the name of the account, National Commission for Allied and Healthcare Professional Bill 2020, which the Rajya Sabha passed on September 15, is almost the same. The bill has been challenged by health experts and doctors' bodies, including the apex body Indian Medical Association (IMA), on various grounds.

About The National Commission for Allied and Healthcare Professional Bill 2020

The bill defines healthcare professional and allied health professional and envisions to regulate and set standards for these in healthcare. According to the new bill, a healthcare professional could be anyone from a scientist, therapist to any professional who studies, advises, researches, supervises or provides preventive, curative, rehabilitative, therapeutic, or promotional health services. They should have obtained a degree under this bill of the duration of 3600 hours over 3 to 6 years. An allied professional has been defined as "an associate, technician, or technologist trained to support the diagnosis and treatment of any illness, disease, injury, or impairment." They should have obtained a diploma/degree under this bill of 2000 hours over 2 to 4 years.

The bill seeks to set up a National Commission for Allied and Healthcare Professionals which shall consist of the representatives of Central Government Ministries, Directorate General of Health Services, medical institutions, and State Councils. The Commission's composition will be of appointed members rather than elected, and thus undemocratic.

The following functions are enumerated to be performed by the Commission:

1. framing policies and standards for regulating education and practice;
2. creating and maintaining an online Central Register of all registered professionals;
3. providing basic standards of education, courses, curriculum, staff qualifications, examination, training, a maximum fee payable for various categories; and,
4. providing for a uniform entrance and exit examination, among others.

The bill also mentions the formation of Professional Councils for every category of the profession and State Councils for every state.

A matter of great concern for the stakeholders in this bill is that upon removing a name, or a refusal to enter a name in the Central or State Register, there can't be any proceeding in any civil court. Moreover, no legal proceeding can be made against the Central or State Government or any member under this umbrella body of the Commission for "anything which is in good faith done or intended to be done in pursuance of this Act." This raises questions on transparency and accountability of members' actions and the government itself under this Act.

Apart from doctors, nurses, and frontline workers, numerous other professionals such as mental health professionals, physiotherapists, occupational therapists, etc., were demanding regulatory bodies for the standardization and recognition of their professions. However, the bill does not help them in any way but is a mere pretentious show of having listened to these demands. The bill itself states, "para-medical professionals," as well as other technologists and therapists, have finally been accorded their due recognition and are presently termed as 'Allied and Healthcare Professionals.' 

Based on the International Labour Organisation's International Standard Classification of Occupations (ISCO-08), a detailed mapping has been undertaken to identify such professions. Therefore, those who were earlier known as para-medicals will now be termed as allied and healthcare professionals, in the name of "recognition."

Concern for Psychologists

There is a dire need for standardization, quality control of training and curricula, and psychologists' recognition other than the clinical psychologists in India. Therefore, there has been a long-standing demand from the psychology fraternity to regulate the profession and education by creating a national council of psychology.

Instead of meeting this demand, psychology will now be clubbed with other professions in the Allied and Healthcare Professions under the category "Community Care, Behavioral Health Sciences and other Professionals." It was already problematic that such different disciplines should be regulated through similar training, licensing, and standardization of education under one Act. The situation is made worse by clubbing psychologists with Environment Protection Officers, Ecologists, and Podiatrists under the same category in the bill.

Psychologists in India are already under-represented in existing bodies and are often subordinate to psychiatrists in institutes. They are still treated as support staff of the medical community. Along with this, and that psychology is yet to grow and enhance in India, under-representation in new bodies could do more harm than good.

Nonetheless, that is precisely the case with the National Commission for Allied and Healthcare Professional Bill. The Council, which the Act will create, shall have 2 to 4 representatives of other fields but only 1 of psychology. This worsens because psychology professionals are clubbed in one category with podiatrists, ecologists, and environmental protection officers.

The justification for not creating separate councils of psychology or other fields that were demanding such, provided by the Ministry, is that it's impractical to have a large number of councils. "if a separate council is created for any particular segment, other segments will demand the same & it will lead to a snowballing of demands. Therefore, the Ministry has decided to have a single council for all the allied & healthcare professionals." This reflects that the Ministry of Health and Family Welfare is only doing away with the burden of creating separate councils.

The need to cater to mental health in the country has not been given any heed at all. Moreover, the term "Behavioral Health Sciences" does not do justice to the discipline and neither holds mental health in a position of priority. Doesn't it dissociate the profession from its overarching law called the "Mental Healthcare Act"?

Way Forward

The following significant demands of the psychology fraternity should be met by the government so that the discipline may grow and serve the country better.

• A separate Council should be created that caters to policy and standardization for practicing, training, and education in psychology.

• A separate budget is allocated, considering the vast shortage of psychologists and the growth needed.
• The number of psychologists should be increased at all levels, in all the regulatory bodies and institutions at the Centre and State.
• Mental health should be included in the concurrent list, and mental health institutes are opened and increased in all states.
• Civil and district hospitals should have more psychologists to cater to the mental health of the patients.

It needs to be realized on a collective basis that the study and growth of the discipline of psychology are crucial for the mental wellness of the entire country. Showing such utter disregard could be detrimental for all of us. Psychologists need to make sure that the profession doesn't eventually dissolve by taking up a stand presently. Only by vehemently voicing their issues they can ensure that the government meets their justified demands.