MCI Minutes:
31. "Paramedical and Physiotherapy Central Council Bill - 2007"
Read: The D.O. letter dated 13.05.2008 from Dr. S.C. Goyal DGHS, Nirman Bhavan, New Delhi along with copy of the report of the Sub-Committee with regard to Paramedical and Physiotherapy Central Council Bill - 2007
The members of the Adhoc Committee appointed by the Hon'ble Supreme Court and of the Executive Committee of the Council observed that a Sub-Committee comprising of Dr.D.K. Sharma, Chairman, Registration & Equivalence Committee, Dr. C.V. Bhirmanandham, Chairman, TEQ Sub-Committee and Dr. Ved Prakash Mishra, Member, Executive Committee was constituted at its meeting held on 13/14th June, 2008 in the matter of the D.O. letter dated 13.05.2008 from Dr. S.C. Goyal, DGHS, Nirman Bhavan, New Delhi with regard to the proposed "Paramedical and Physiotherapy Central Councils Bill - 2007."
The members of the Adhoc Committee appointed by the Hon'ble Supreme Court and of the Executive Committee of the Council considered and approved the following report of the Sub-Committee:-
The present Committee came to be constituted by the Executive Committee of the Council at its meeting dated 13th & 14th June,2008 while considering the D.O. letter dated 13.05.2008 from Dr. H.C. Goyal, Additional D.G.H.S., Directorate General of Health Services, Govt. of India, in regard to the proposed "Paramedical and Physiotherapy Central Councils Bill - 2007" The Executive Committee desired that the Committee so constituted should go through the Bill and submit its report for further consideration of the Executive Committee.
The Committee at its meeting held on 05.05.2008 at 11.30 a.m. in the office of the Council perused the communication dated 13.05.2008 from Dr. H.C. Goyal addressed to the Secretary wherein amongst other things it has been brought out that Ministry of Health & F.W. has introduced "Paramedical and Physiotherapy Central Council Bill - 2007" in the Lok Sabha on 04.12.2007. The said Bill has been referred to the Parliamentary Standing Committee on Health and Family Welfare for comments. Rajya Sabha secretariat has invited suggestions in this regard from various stake holders all over the country. It is catalogued therein that the said Bill 28 is to regulate and maintain n proper & uniform standards of education for various disciplines of paramedics and maintenance of register of paramedics. The Ministry of Health and Family Welfare is said to have received several objections and suggestions in this regard and hence, it was thought appropriate by them to seek the opinion of the Medical Council of India with justification pertaining to important points which have been raised by various paramedical discipline associations.
The Committee therefore is restricting itself to furnishing its considered opinion in regard to the focused points that have been brought out in the communication referred to above. The said letter includes demands, which have been put in by Indian Association of Physiotherapy (IAP) in one group and those put in by Society of Indian Radiographers and Medical Lab Technical Staff Forum.
The Indian Association of Physiotherapy is demanding to replace the definition of physiotherapy as proposed in the Bill with the definition physiotherapy as given in Delhi or Maharashtra Councils of Physiotherapy and Occupational Therapy. The focused merit in the definition which has been proposed in the Bill would be with reference to the phrase "Medically Directed". The Committee is of the considered opinion that the practice of physiotherapy has to be under medical directions and the medical directions are the ones which are coming out of the learned expertise at the disposal of the medical practitioner by virtue of he/she possessing requisite medical qualifications included in the appropriate Schedules appended to the Indian Medical Council Act,1956. The contour of the words "Medically Directed" have to be taken note of on the basis that the treatment which has been aimed is not with reference to a condition, but for the patient as a whole which contemplates holistic approach. In this context, holistic approach means the services as may be required under the directions of the medical practitioner can be incorporated as and when required. It is for this reason retention of the words 'Medically directed' in the definition as of now is advocated.
With reference to considering physiotherapy as "Physiotherapeutic System of Medicine" or a "Separate System of Medicine" like Ayurveda, Unani, Yoga, Homeopathy, Siddha, Modern system of Medicine to be included in the definition is untenable, in view of the observations given in the preceding para. The practice of physiotherapy therefore has to be under medical direction. As such, the grant of a separate system of medicine status to the same would be an antithesis to the observation in the preceding para.
Grant of equity to Physiotherapy graduates with MBBS, BDS and BAMS graduates, the Committee would like to restrict itself in regard to the MBBS graduates as the same squarely falls within its jurisdiction. By virtue of practice of physiotherapy under 'medical directions', the question of equity does not arise.
Further consideration pertains to use the prefix of word 'Dr' (Doctor) before their name for physiotherapists like medical doctors.
In this connection, the Committee would like to bring on record the decision that has been taken by the General Body of the Council. The Ethics Committee of the Council decided that the title "Doctor" may be used by the registered medical practitioners in the modern medicine, Ayurveda, Homeopathy and Unani. No other group of workers in the field of medical profession whether nursing or para-medical staff should use the title "Doctor".
The said recommendation of the Ethics Committee were adopted by the Executive Committee of the Council at its meeting held on 19.04.2003 wherein the Executive Committee further recommended that the same should be placed before the General Body of the Council for a policy decision thereon.
The General Body of the Council at its meeting held on 20.10.2003 decided that a legal opinion should be sought on the matter. Accordingly, the legal opinion was furnished by the Learned Counsel of the Council on 03.02.2004, wherein amongst other things it was brought out that the official stand of the Medical Council of India is correctly depicted by the decision taken by the Ethics Committee and approved by the General Body of the Council.
This was based on the basis of the provisions of Indian Medical Degrees Act of 1916 which clearly shows that the basic purpose of the said enactment was to ensure that certain persons are not permitted to pose to the public as possessing qualifications in medicine and surgery which they do not possess. The main focus is with reference to Section 6A of the Act wherein it has been clearly laid down that it is not permissible for any person to add to his name any title, discription, letter or abbreviation which imply that he holds degree, diploma, licence or certificate as his qualification to practice any system of medicine unless and until he actually holds such degrees, diploma or certificate.
The entire issue was with reference to a query from one Dr. Edmund M. D'Couto who was Principal/Program-Director of KMCH College of Physiotherapy, Coimbatore. In the legal opinion it was advised that the said Principal of KMCH College of Physiotherapy be informed in unambiguous and unequivocal terms that a person holding any qualification in physiotherapy is not entitled to use the title of 'Doctor' as prefix.
It is further brought out in the said legal opinion that wherever any person found to be using the title of 'Doctor' as a prefix when such a person is holding a qualification in physiotherapy but not possessing any recognized medical qualification, he would be violating the provisions of Act of 1916 and as such he would expose himself for necessary action by filing or requiring the filing of a complaint in accordance with Section 7 of the 1916 Act for violation of Sections 6 and 6A of the extent applicable. The said legal opinion was adopted by the General Body of the Council at its meeting held on 29.03.2004 and in terms of the decision Dr. Edmund M. D'Couto was informed of the said decision by a communication from the Deputy Secretary of the Council vide a communication dated 26.07.2004.
The Committee reiterates the decision of the General Body of the Council in regard to its operational effect and therefore a person with qualifications in physiotherapy is not entitled to use the prefix of 'Doctor' under any circumstances whatsoever. The observations of the Committee pertaining to medically directed has already been included in its opening observations and therefore does not call for any separate further elaboration.
The Society of Indian Radiographers and Medical Lab Technical Staff Forum have observed that the title of the Bill be changed to "Paramedical Council of India" or "Allied Health Professional Council of India" and removal of word "Physiotherapy" from the title of the Bill. The Committee is of the opinion that the said observation is not called for in view of creation of separate Physiotherapy Council vide retention of words 'medically directed' in the definition of the word 'Physiotherapy'. As such, the considered opinion of the Committee is that Physiotherapists formed an integral part of the larger rubric of 'paramedic'."
PA1/mydoc/Minutes/ECMN 25.8.2008/08.09.2008
No.MCI-5(3)/2008-Med./
MEDICAL COUNCIL OF INDIA
EXECUTIVE COMMITTEE
25th August, 2008.