IMA AP unit seeks withdrawal of government proposal to train RMPs, PMPs as community paramedics

Mumbai, September, 2017:

With an aim to prevent unqualified persons from offering healthcare services to people in the state, the Andhra Pradesh Chapter of Indian Medical Association (IMA) has urged the state government to withdraw a circular proposing to give training to registered medical practitioners (RMPs)/private medical practitioners (PMPs) as community paramedics.

The Department of Medical & Family Welfare Health recently issued government order number 465 allowing AP Paramedical Board to provide community paramedic training to RMPs and PMPs.

As per the circular, the state government will train RMPs and PMPs in government medical colleges for six months and the participants need to work in the government hospitals and 108 ambulance services for three months each. Following which an examination will be conducted for them and successful candidates will be awarded community paramedics certificates.

The GO also instructed formation of a committee led by Principal Secretary Health and Commissioner Andhra Pradesh Vaidya Vidhana Parishad. The panel will have Director of Public Health and Family Welfare and Secretary, AP Paramedical Board as members.

Dr. P. Gangadhara Rao, president of AP chapter of IMA in a letter to the AP government said, “The GO proposing to regularize the services of RMPs and PMPs as community paramedics will have repercussions in many aspects. RMP/PMP is not a degree but registration by nearly 28 unauthorized bodies. There are no basic qualification, no curriculum, no training methods for RMPs/PMPs. They are practising modern medicine not only in villages but also in towns and cities thus jeopardizing healthcare of people.  As the state is trying to establish itself as a medical hub with many medical universities of international standards, training unqualified people for providing basic healthcare will send wrong signal to the whole world and will spoil the image of our state of AP in general and image of our chief minister N Chandra Babu Naidu in particular.”

The organizations issuing RMP and PMP certificates, if not checked and closed down, will lead to a significant increase in the number of quacks practising medicine in the state thereby posing a risk to health of people, said Dr Rao.

Section 15 of Indian Medical Council Act, 1956 does not permit persons other than having qualifications of MBBS and above registered with medical council to practice modern medicine. Plans to permit community paramedics is against MCI rules and there are many Supreme Court and High Court judgments against quackery as it severely affects the quality of healthcare, he said.

There is no dearth of qualified MBBS doctors in AP. Every year more than 4200 graduates pass out in the state. If government can provide them regular employment in villages, there will not be any deficiency.   While MBBS doctors with training for 4½ years and one year internship under watchful eyes of senior professors in medical college and hospitals face difficulties in rural medicare, the community paramedics trained as per G.O.465 cannot fill the gap rather create many problems in medicare system in rural areas, he added.

The government's plan to train unqualified people in medical colleges as community paramedics will create a very bad atmosphere in the colleges and will affect the morale of qualified paramedics and also medical students undergoing training there, he quipped.

There are 600 nursing colleges in the state. Every year more than 5,000 B.Sc/GNM/Nurses are graduated. Services of ANM and also Asha workers are available in almost all the villages. If ANMs are given orientation and if their stay in the villages made compulsory, they can give better services than quacks. In order to provide better orientation to these resource persons, IMA AP unit can extend helping hand to the training schedules of the government of Andhra Pradesh, he stated.

Taking serious note of the AP government's GO 465, Union health minister JP Nadda on August 24, 2017 had written to Naidu stating that India is one of the leading producers of doctors and has quality medical education system. Practicing medicine without having a recognized medical qualification constitutes quackery and is punishable with both imprisonment and fine.

Health is a state subject. Hence it is the responsibility of the state government to take appropriate action and corrective steps under the law against quacks and also evolve suitable policies to ensure availability of quality health workforce in rural areas, Nadda added.