Indian Medical Services needed to save 'crumbling healthcare system'

Dr Ved Prakash Mishra, chairman

At the first-ever virtual meeting of the National Working Group for the formation of Indian Medical Services (IMS), recommendations over its functioning were discussed. The COVID pandemic and numerous experiments with drugs have once again brought into focus the need for a dedicated IMS. Sunday's meeting detailed these.

The five-member team, under the chairmanship of Dr Vedprakash Mishra, national head of the Academic Programme (Indian Programme), UNESCO chair in Bioethics (Haifa), is working on the modulation of structure, operation and function of IMS, constituted by Dr Rajan Sharma, national president, Indian Medical Association (IMA).

The working group includes Dr Vinay Agarwal, former national president and member of IMA, Dr Shivkumar Utture, president, Maharashtra Medical Council (MMC), Dr R V Asokan, secretary-general, IMA HQ-Delhi, Dr S Arulrhaj, president, Association of Physicians of India and Dr A Marthanda Pillai, former national president, IMA.

"With the pandemic, it is necessary to push for our recommendations of 2017. We will be submitting a detailed report to the Indian Medical Association (HQ), New Delhi by July end. It will be submitted to the Government of India," Dr Vedprakash said.

Medical services history
First signs of IMS came into being, he added, with the establishment of the Bengal Medical Service on October 20, 1763, with fixed grades, rules for promotion and services. On similar lines, Madras Medical Services and Bombay Medical Services were established in 1764. Increased military actions compelled the separation of ‘Military Surgeons' from ‘Civil Surgeons'.

"Each non-native military regiment had a surgeon and the strength of the medical service grew. A census record of 1854 reveals that the Bengal Medical Service had a strength of 382 while Madras Medical Service had 217 people. Bombay Medical Service had a strength of 181. Medical services of these three presidencies were united into a single Indian Medical Service after 1857, which was in vogue till 1947."

Crumbling healthcare system
In 2017, the medical council of India had constituted a task force under the leadership of Vedprakash committee, which had submitted their 13-page recommendation in September 2017, expressing the need for IMS.

"There is a grave exodus of doctors from services, attrition of health manpower. This is further deteriorating despite special cabinet-approved committees like the Javed Choudhary Committee. Doctors are retiring every month without proper replacements. The health delivery system is crumbling with this manpower crunch. Post Graduate seats are being surrendered for the lack of teachers. Retirement of one professor without replacement leads to a loss of six PG seats," explained Dr Vedprakash.

The Medical Council of India forwarded the recommendations of the Vedprakash Committee to the Government of India. "The cadre will be under the ministry of Personnel and Training, a portfolio which has always been held by the Prime Minister. It will handle specialised tasks in line with the work of IFS, IAS, IRS, IPS cadre etc," Dr Vedprakash explained.

For training students
Dr Subhash Hira, professor of Global Health, University of Washington, USA and former technical advisor of the Ministry of Health, New Delhi expressed delight at the development. "The president of Indian Medical Council, professor Dr Vinod Paul, is also a member (health) of Niti Aayog, and his team should take this proposal forward towards the establishment of the IMS," he said. IMS is essential for the training of undergraduate and post-graduate students in medical colleges, "as the usual non-medical IAS officers won't understand their requirements," Dr Wiqar Sahikh, senior asthma and allergy specialist said.

Dr Ketan Vagholkar, professor of surgery at DY Patil Medical College, said, "The COVID pandemic has served as an eyeopener for authorities to develop a comprehensive system of health administration. An urgent appraisal of the system can be achieved by developing the IMS cadre. Health professionals selected for IMS cadre will be in a better position not only to manage existing issues but also to develop systems in case of crises."

Also in view of "the looming biological threat from certain nations, there is an intense need to develop such a cadre at the earliest," he stressed.

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